Qsymia (phentermine/topiramate ER) — For Weight Management

Long‑Term Weight Loss Treamtment

Qsymia™ combines phentermine and topiramate extended‑release to help with obesity or overweight plus weight‑related comorbidities lose weight when used with a reduced‑calorie diet and increased physical activity.


*not available on all states, restrictions apply*

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About Qsymia For Weight Loss

Once‑daily extended‑release combination to support long‑term weight loss with diet and exercise. 

  • Initiation Days 1–14: 3.75 mg/23 mg once daily. Take in morning; avoid evening dosing to reduce insomnia. 
  • Titration After 14 days: 7.5 mg/46 mg once daily. 
  • Further titration: 11.25 mg/69 mg then 15 mg/92 mg once daily. 
  • Gradual taper from 15 mg/92mg to reduce seizure risk. 

Because Qsymia combines a low dose of the stimulant phentermine with the neuro-stabilizer topiramate, its side effect profile reflects both ingredients. In adult clinical trials, these effects were generally mild to moderate: 

  • Numbness and Tingling (Paresthesia): A very common "pins-and-needles" sensation typically felt in the hands, arms, feet, or face.
  • Taste Alterations (Dysgeusia): Changes in the way food tastes or a temporary loss of taste.
  • Gastrointestinal & Mouth: Dry mouth and constipation are common as your body adjusts.
  • Neurological & Mood: Dizziness, mild trouble sleeping (insomnia), and subtle changes in concentration or attention span.
  • Cardiovascular: Mild increases in resting heart rate or awareness of heart palpitations.

  • Pregnancy risk: Qsymia can cause fetal harm; obtain a negative pregnancy test before initiation and monthly during therapy; advise effective contraception. 
  • Contraindications: Pregnancy; glaucoma; hyperthyroidism; use of MAOIs within 14 days; known hypersensitivity to components. 
  • Cardiovascular monitoring: Monitor heart rate and use caution in patients with cardiac or cerebrovascular disease. 
  • Neuropsychiatric and seizure risk: Monitor for depression, suicidal ideation, and cognitive effects; avoid abrupt discontinuation of high doses because of seizure risk. 
  • Other warnings: Acute myopia/secondary angle‑closure glaucoma, metabolic acidosis, kidney stones, and other adverse reactions have been reported.

Frequently Asked Questions

Please reach us at support@ivitalitycenter.com if you cannot find an answer to your question.

Adults with BMI ≥30 kg/m² or ≥27 kg/m² with at least one weight‑related comorbidity; pediatric use (≥12 years) per label. Clinician assessment required. Vitality Wellness treats adults 18 and over. 

Clinicians typically assess response at ~12–16 weeks; follow label thresholds for continuation or discontinuation.

Negative pregnancy test before starting and monthly during therapy; use effective contraception; Qsymia is contraindicated in pregnancy.

No, Qsymia cannot be split

Do not stop high doses abruptly; You can transition off  by reducing your dose to every other day for 7 days. Discuss stopping with your health care provider. 

Yes, Qsymia is a Schedule IV (CIV) controlled substance.The U.S. Drug Enforcement Administration (DEA) classifies it as a controlled substance because one of its active ingredients, phentermine, is a stimulant that carries a risk of dependence and abuse.Because of this classification:

  • Prescriptions are subject to strict state and federal regulations regarding refills and transfers.
  • It must be taken exactly as prescribed under the supervision of a licensed healthcare professional.