An Old Drug with a New Twist - Qsymia

Generic Name: phentermine and topiramate
Brand Names: Qsymia

In late 2012, the Food and Drug Administration approved a diet pill called Qsymia. This isn't a new drug, but a combination of two older drugs; phentermine (part of the Fen Fen combination) and topiramate, a migraine/anti-seizure medication that has appetite suppression as one of its side effects.

Qsymia is a combination of two older drugs; phentermine and topiramate

How Does Qsymia Work?

When combined, these two drugs work mainly by suppressing the appetite and increasing metabolism. Phentermine has long been used as an appetite suppressant as it is known to increase blood levels of a hormone called leptin, which dulls the appetite.

Topiramate (sold under the Topamax name) is often prescribed for migraines and as an anti-seizure medication. It also dulls the appetite and tends to make food taste rather bland, thus discouraging overeating.

What Did Studies Find?

Clinical trials conducted for one year found that those who took this drug lost at least 5 percent of their body weight (approximately 23 pounds on average) without dieting. Compare this to the placebo group, which lost only 5.5 pounds on average.

In another study involving Qsymia, Saxenda, Contrave and Belviq, those who took Qsymia lost more weight. The group taking Qsymia also had the least amount of reported side effects, with while those taking Contrave had the highest number of side effects.

Who Can Take Qsymia?

This prescription drug is intended for those with a BMI of 30 and over or those with a BMI of 27 who also have a related health condition, such as high blood pressure or diabetes.

Those who should NOT use this drug are women trying to get pregnant, women who are pregnant, breastfeeding women, those with eye problems, a history of glaucoma, those with thyroid problems, and anyone taking an MAOI antidepressant.

Is It Safe for Long Term Use?

Yes. This is one of the few diet drugs that are, actually, intended for long term use. Phentermine, in particular, has been used for decades to help control the appetite. Many people, once they start using phentermine or phentermine based drugs, refuse to go off of them for fear they will regain the weight.

Does This Drug Have Side Effects?

The most common side effect was insomnia, dizziness, a tingling feeling in the hands or feet, constipation, or dry mouth. Most side effects appear to be minor, with some people reporting that they had difficulty concentrating.

Topiramate can increase the risk of depression and/or suicidal thoughts. Those taking this drug should take note of any extreme mood changes or thoughts and contact their doctor immediately if they notice any changes.

Is Qsymia Covered by Insurance?

Although insurance plans vary greatly, it appears that most insurance companies will not cover Qsymia. To be certain, you should call your insurance provider.

Most online pharmacies will be cheaper than retail locations. You might also find you are eligible for discounts from the manufacturer. Speak with your doctor and check the Qsymia website for possible discounts or coupons if your insurance provider does not cover this drug.

The reluctance of health insurance companies might stem from the old fear that phentermine, which was part of the old Fen Fen diet drug combination, might damage heart valves, although this was the safest part of the Fen Fen mixture and has been shown that it doesn’t cause heart problems, it’s easy to understand why insurance companies are wary.

The Bottom Line

Although it appears that this drug is not covered by many insurance companies, this combination of two older drugs has a history of working when it comes to weight loss. Whether it is safe for you is something you should discuss with your doctor.