The combination of the drugs phentermine and topiramate extended-release (ER) (profession name Qsymia kyoo-sim-EE-uh) is a medication used for weight-loss. In medical tests, phentermine/topiramate ER was linked with small yet statistically considerable weight loss when compared with sugar pill. This fat burning was related to renovations in weight-related comorbidities such as improved glycemia, reduced blood stress, as well as boosted cholesterol.

Phentermine/ topiramate ER was developed by Vivus, Inc., a California pharmaceutical business. Phentermine is a sympathomimetic amine which works as a hunger suppressant and also stimulant. Topiramate is an anticonvulsant that carries weight loss negative effects. The exact mechanism of action for both medicines is unknown.

In 2012 the United States Fda accepted phentermine/topiramate Emergency Room as an accessory to a reduced-calorie weight loss and also increased physical task for chronic weight monitoring in adults with a preliminary body mass index (BMI) of at the very least 30 kg/m², or at least 27 kg/m² (overweight) in the presence of a minimum of one weight-related comorbidity such as hypertension, type 2 diabetes mellitus, or dyslipidemia. Phentermine/topiramate ER is readily available in certified retail pharmacies across the country and offered through a qualified mail-order pharmacy network. Authorization was refuted by European regulatory authorities, that cited prospective danger to the heart and also capillary, psychological side results, and cognitive side effects in discussing their decision.

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Medical uses

In clinical tests, individuals treated with the greatest dose of phentermine/topiramate ER in mix with a program of weight loss and also exercise shed 10% to 11% of their body weight contrasted to 1% to 2% for those that received placebo. In addition, 62% to 70% of topics obtaining the suggested dose or top dosage of phentermine/topiramate ER achieved >= 5% weight by week 56 (ITT-LOCF) contrasted to 17% to 21% of those receiving a sugar pill.

Adverse effects

In professional tests, the most common negative occasions which happened at a price >= 5% and also >= 1.5 times placebo consisted of paraesthesia (prickling in fingers/toes), dizziness, dysgeusia (altered preference), sleep problems, constipation, and dry mouth.

In the U.S., the medicine label includes warnings for boosted heart rate, suicidal behavior and also ideation, glaucoma, mood and also rest problems, creatine elevation, and metabolic acidosis. Several of these cautions are based upon historical observations in epilepsy patients taking topiramate. The FDA is requiring the business to carry out a post-approval cardiovascular outcomes test, due in part to the observation of enhanced heart rate in some people taking the medication in clinical trials.


Phentermine/ topiramate Emergency Room can trigger fetal injury. Information from maternity computer system registries as well as public health studies suggest that an unborn child revealed to topiramate in the first trimester of pregnancy has an increased danger of dental slits (slit lip with or without slit palate). If a person becomes pregnant while taking phentermine/topiramate ER, treatment needs to be discontinued quickly, and also the individual needs to be filled in of the possible danger to a fetus. Women of reproductive capacity ought to have a negative maternity test before beginning phentermine/topiramate Emergency Room as well as monthly thereafter during phentermine/topiramate Emergency Room therapy. Females of reproductive possibility must use reliable birth control throughout phentermine/topiramate ER therapy.

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Phentermine/ topiramate Emergency Room is contraindicated in maternity, glaucoma, hyperthyroidism, throughout or within 2 Week of taking monoamine oxidase inhibitors, as well as in patients with hypersensitivity or trick to sympathomimetic amines. Phentermine/topiramate ER could create an increase in resting heart rate.

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Risk Assessment as well as Reduction Approach (REMS)

Phentermine/ topiramate Emergency Room was approved with a REMS program to ensure that benefits of therapy outweigh the risks. Because of the teratogenic threat associated with phentermine/topiramate ER treatment, phentermine/topiramate Emergency Room is dispersed through accredited pharmacies.

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Approval history

In December 2009 VIVUS, Inc. submitted a new medicine application (NDA) to the FDA as well as on March 1, 2010, VIVUS, Inc. announced that the FDA approved the NDA for review.

In October 2010, the FDA revealed its choice to not accept phentermine/topiramate ER in its present kind and also provided a Complete Response Letter (CRL) to VIVUS as a result of absence of long-term information and worries concerning negative effects consisting of elevated heart price, significant unfavorable cardiovascular events, and also birth defects.

The FDA shared problems about the capacity for phentermine/topiramate ER to trigger birth problems and requested that Vivus evaluate the usefulness of evaluating existing health care databases to identify the historic incidence of oral cleft in spawn of ladies treated with topiramate for migraine headache treatment (100 mg).

In October 2011, VIVUS resubmitted the NDA to the FDA with actions to the problems dealt with in the CRL. The FDA approved the NDA in November 2011.

On September 18, 2012, Qsymia appeared on the United States market.

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