The combination of the drugs phentermine and topiramate extended-release (Emergency Room) (brand name Qsymia kyoo-sim-EE-uh) is a medicine utilized for weight loss. In professional trials, phentermine/topiramate Emergency Room was associated with moderate however statistically considerable weight management when compared with placebo. This weight management was linked with improvements in weight-related comorbidities such as boosted glycemia, reduced blood pressure, and also boosted cholesterol.

Phentermine/ topiramate ER was created by Vivus, Inc., a California pharmaceutical firm. Phentermine is a sympathomimetic amine which acts as a cravings suppressant as well as energizer. Topiramate is an anticonvulsant that has weight loss adverse effects. The precise system of activity for both medications is unknown.

In 2012 the UNITED STATE Food as well as Medication Administration accepted phentermine/topiramate ER as an accessory to a reduced-calorie diet regimen and enhanced exercising for chronic weight administration in grownups with an initial physical body mass index (BMI) of at the very least 30 kg/m ², or at least 27 kg/m ² (overweight) in the existence of a minimum of one weight-related comorbidity such as hypertension, kind 2 diabetic issues mellitus, or dyslipidemia. Phentermine/topiramate Emergency Room is available in accredited retail drug stores across the country and readily available with an accredited mail-order pharmacy network. Authorization was rejected by European governing authorities, which pointed out prospective threat to the heart and also blood vessels, psychological adverse effects, as well as cognitive side effects in discussing their decision.

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Medical uses

In medical tests, people treated with the highest dose of phentermine/topiramate Emergency Room in combo with a routine of diet and exercise shed 10 % to 11 % of their physical body weight as compared to 1 % to 2 % for those who obtained inactive medicine. Furthermore, 62 % to 70 % of subjects obtaining the recommended dose or leading dosage of phentermine/topiramate ER accomplished >=5 % weight by week 56 (ITT-LOCF) as compared to 17 % to 21 % of those obtaining a sugar pill.

Adverse effects

In scientific tests, easily the most usual negative occasions which happened at a rate >=5 % and >=1.5 times inactive medicine consisted of paraesthesia (prickling in fingers/toes), lightheadedness, dysgeusia (altered preference), sleep problems, irregular bowel movements, as well as completely dry mouth.

In the united state, the medicine label has cautions for enhanced heart rate, suicidal habits as well as ideation, glaucoma, mood and rest disorders, creatine elevation, and metabolic acidosis. Several of these cautions are based upon historical observations in epilepsy clients taking topiramate. The FDA is requiring the firm to carry out a post-approval cardio results trial, due partially to the observation of enhanced heart rate in some individuals taking the drug in professional trials.


Phentermine/ topiramate ER could cause fetal injury. Information from pregnancy registries and epidemiology studies suggest that a fetus subjected to topiramate in the first trimester of pregnancy has an enhanced danger of dental clefts (cleft lip with or without cleft taste). If a client conceives while taking phentermine/topiramate Emergency Room, treatment ought to be stopped immediately, as well as the person ought to be apprised of the possible risk to an unborn child. Girls of reproductive possibility should have an unfavorable pregnancy test before beginning phentermine/topiramate Emergency Room and also month-to-month thereafter during phentermine/topiramate Emergency Room therapy. Girls of reproductive capacity must utilize reliable birth control throughout phentermine/topiramate Emergency Room therapy.


Phentermine/ topiramate ER is contraindicated in pregnancy, glaucoma, hyperthyroidism, throughout or within 14 days of taking monoamine oxidase inhibitors, and also in individuals with irritation or peculiarity to sympathomimetic amines. Phentermine/topiramate ER can cause a rise in relaxing heart rate.

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Risk Examination and also Mitigation Technique (REMS)

Phentermine/ topiramate Emergency Room was authorized with a RAPID EYE MOVEMENT program to guarantee that benefits of therapy surpass the threats. Due to the teratogenic danger related to phentermine/topiramate Emergency Room therapy, phentermine/topiramate Emergency Room is dispersed by means of qualifieded pharmacies.

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Approval history

In December 2009 VIVUS, Inc. sent 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 approve phentermine/topiramate Emergency Room in its current kind and issued a Complete Reaction Letter (CRL) to VIVUS as a result of lack of long-term data as well as problems regarding side results consisting of elevated heart rate, major negative cardio occasions, and also birth defects.

The FDA shared problems about the capacity for phentermine/topiramate Emergency Room to trigger birth defects and requested that Vivus assess the feasibility of analyzing alreadying existing medical care databases to establish the historical incidence of dental cleft in spawn of ladies treated with topiramate for migraine treatment (ONE HUNDRED mg).

In October 2011, VIVUS resubmitted the NDA to the FDA with responses to the concerns dealt with in the CRL. The FDA approved the NDA in Nov 2011.

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

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