Phentermine-topiramate (Qsymia)

What it means

Qsymia pairs an appetite suppressant, phentermine, with topiramate, a seizure and migraine medicine that also reduces appetite. The FDA approved it in 2012 for adults and later extended it to children 12 and older with obesity. The dose is stepped up over several weeks.

Topiramate can cause birth defects, including cleft lip and palate. Because of that, Qsymia is sold under a safety program, and people who can become pregnant are advised to take a pregnancy test before starting and each month, and to use effective birth control.

Other side effects include tingling in the hands and feet, dizziness, altered taste, trouble sleeping, constipation, dry mouth, mood changes and difficulty concentrating. Like phentermine, it is a Schedule IV controlled substance.

The label says to stop or adjust treatment if weight loss is too small after a set period on the full dose.

Why it matters

Qsymia is a non-injection, long-term option, with pregnancy rules you need to know before starting.