The combination of the drugs phentermine and topiramate extended-release (ER) (profession business Qsymia kyoo-sim-EE-uh) is a medication used for fat burning. In clinical trials, phentermine/topiramate ER was related to modest yet statistically significant weight loss when compared to sugar pill. This weight management was linked with improvements in weight-related comorbidities such as boosted glycemia, decreased blood pressure, and also improved cholesterol.

Phentermine/ topiramate ER was evolved by Vivus, Inc., a The golden state pharmaceutical business. Phentermine is a sympathomimetic amine which works as a hunger suppressant and also stimulant. Topiramate is an anticonvulsant that carries weight loss side results. The exact system of activity for both medicines is unknown.

In 2012 the united state Fda authorized phentermine/topiramate Emergency Room as a complement to a reduced-calorie diet plan and boosted exercise for persistent weight management in grownups with a first physical body mass index (BMI) of at least 30 kg/m ², or at least 27 kg/m ² (overweight) in the existence of at least one weight-related comorbidity such as hypertension, type 2 diabetes mellitus, or dyslipidemia. Phentermine/topiramate ER is readily available in certified retail drug stores all over the country and offered via a qualified mail-order pharmacy network. Approval was refuted by European regulative authorities, who cited potential threat to the heart as well as blood vessels, psychiatric negative effects, and also cognitive side effects in describing their decision.

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Medical uses

In medical trials, individuals treated with the greatest dose of phentermine/topiramate Emergency Room in combination with a program of diet and workout shed 10 % to 11 % of their body weight contrasted to 1 % to 2 % for those that got inactive medicine. Furthermore, 62 % to 70 % of subjects getting the recommended dose or leading dose of phentermine/topiramate ER achieved >=5 % weight by week 56 (ITT-LOCF) compared with 17 % to 21 % of those obtaining a sugar pill.

Adverse effects

In medical tests, the most common adverse occasions which occurred at a rate >=5 % and >=1.5 times sugar pill included paraesthesia (tingling in fingers/toes), wooziness, dysgeusia (transformed taste), insomnia, constipation, and completely dry mouth.

In the UNITED STATE, the drug tag consists of warnings for increased heart price, suicidal behavior and also ideation, glaucoma, mood and also sleep conditions, creatine altitude, and also metabolic acidosis. Some of these precautions are based upon historic observations in epilepsy individuals taking topiramate. The FDA is calling for the company to do a post-approval cardiovascular outcomes test, due partly to the observation of boosted heart rate in some people taking the drug in clinical trials.


Phentermine/ topiramate ER can create fetal damage. Information from maternity registries and epidemiology researches suggest that a fetus subjected to topiramate in the first trimester of maternity has an increased danger of oral clefts (cleft lip with or without cleft taste buds). If a person becomes pregnant while taking phentermine/topiramate Emergency Room, therapy must be stopped quickly, as well as the patient should be apprised of the possible danger to an unborn child. Women of procreative possibility ought to have an unfavorable pregnancy examination prior to beginning phentermine/topiramate Emergency Room as well as regular monthly afterwards during phentermine/topiramate ER therapy. Females of reproductive potential need to make use of efficient birth control throughout phentermine/topiramate Emergency Room therapy.

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Phentermine/ topiramate Emergency Room is contraindicated in maternity, glaucoma, hyperthyroidism, throughout or within 2 Week of taking monoamine oxidase preventions, and also in individuals with hypersensitivity or peculiarity to sympathomimetic amines. Phentermine/topiramate ER could induce an increase in relaxing heart rate.

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Risk Examination and Reduction Strategy (REMS)

Phentermine/ topiramate ER was accepted with a REMS program to make certain that advantages of therapy surpass the dangers. Due to the teratogenic risk connected with phentermine/topiramate ER treatment, phentermine/topiramate ER is dispersed via certified pharmacies.

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Approval history

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

In October 2010, the FDA revealed its decision to not accept phentermine/topiramate ER in its current form and released a Full Feedback Letter (CRL) to VIVUS due to absence of lasting data and problems about negative effects consisting of raised heart price, significant damaging cardio events, and also birth defects.

The FDA revealed concerns about the possibility for phentermine/topiramate ER to induce abnormality as well as requested that Vivus assess the expediency of evaluating existing medical care databases to establish the historic incidence of dental cleft in offspring of women treated with topiramate for migraine headache treatment (ONE HUNDRED mg).

In October 2011, VIVUS resubmitted the NDA to the FDA with reactions to the issues resolved in the CRL. The FDA accepted the NDA in Nov 2011.

On September 18, 2012, Qsymia appeared on the US market.

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