The combination of the drugs phentermine and topiramate extended-release (ER) (field name Qsymia kyoo-sim-EE-uh) is a medication made use of for weight loss. In professional tests, phentermine/topiramate ER was connected with modest however statistically substantial weight management when compared with inactive medicine. This weight management was connected with enhancements in weight-related comorbidities such as enhanced glycemia, reduced blood pressure, and also improved cholesterol.

Phentermine/ topiramate ER was established by Vivus, Inc., a California pharmaceutical firm. Phentermine is a sympathomimetic amine which acts as a hunger suppressant and stimulant. Topiramate is an anticonvulsant that has weight loss side effects. The specific system of action for both medications is unknown.

In 2012 the united state Fda authorized phentermine/topiramate ER as a complement to a reduced-calorie diet regimen as well as enhanced exercising for persistent weight management in adults with a preliminary body mass index (BMI) of at the very least 30 kg/m ², or a minimum of 27 kg/m ² (overweight) in the visibility of at the very least one weight-related comorbidity such as hypertension, type 2 diabetes mellitus, or dyslipidemia. Phentermine/topiramate Emergency Room is available in qualified retail pharmacies across the country and available via a qualified mail-order drug store network. Approval was refuted by European regulatory authorities, that cited prospective risk to the heart and also capillary, psychiatric adverse effects, and also cognitive side impacts in discussing their decision.

Medical uses

In clinical trials, individuals treated with the highest dosage of phentermine/topiramate Emergency Room in mix with a program of diet regimen and also exercise lost 10 % to 11 % of their body weight compared with 1 % to 2 % for those that got inactive medicine. On top of that, 62 % to 70 % of subjects receiving the suggested dose or leading dose of phentermine/topiramate Emergency Room attained >=5 % weight by week 56 (ITT-LOCF) as compared to 17 % to 21 % of those receiving a sugar pill.

Adverse effects

In medical trials, the most typical negative occasions which occurred at a price >=5 % and also >=1.5 times sugar pill consisted of paraesthesia (prickling in fingers/toes), unsteadiness, dysgeusia (transformed taste), sleeping disorders, constipation, and dry mouth.

In the united state, the medication tag has warnings for raised heart rate, suicidal behavior and also ideation, glaucoma, mood as well as rest conditions, creatine elevation, and metabolic acidosis. Some of these cautions are based on historic observations in epilepsy patients taking topiramate. The FDA is needing the company to execute a post-approval cardio outcomes trial, due partially to the observation of enhanced heart rate in some individuals taking the drug in medical trials.


Phentermine/ topiramate Emergency Room could trigger fetal harm. Data from maternity windows registries and also epidemiology researches show that an unborn child exposed to topiramate in the initial trimester of pregnancy has an increased threat of dental clefts (cleft lip with or without cleft taste). If a client comes to be expectant while taking phentermine/topiramate ER, treatment must be terminated quickly, as well as the individual must be apprised of the prospective danger to a fetus. Women of reproductive potential must have an unfavorable maternity test prior to beginning phentermine/topiramate Emergency Room and month-to-month afterwards throughout phentermine/topiramate Emergency Room treatment. Ladies of procreative possibility should make use of effective birth control throughout phentermine/topiramate ER therapy.


Phentermine/ topiramate Emergency Room is contraindicated in pregnancy, glaucoma, hyperthyroidism, during or within 2 Week of taking monoamine oxidase preventions, as well as in clients with hypersensitivity or foible to sympathomimetic amines. Phentermine/topiramate Emergency Room could induce an increase in sitting heart rate.

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Risk Analysis as well as Reduction Method (REMS)

Phentermine/ topiramate ER was authorized with a RAPID EYE MOVEMENT program to ensure that benefits of therapy outweigh the threats. As a result of the teratogenic danger connected with phentermine/topiramate Emergency Room treatment, phentermine/topiramate ER is dispersed through qualifieded pharmacies.

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Approval history

In December 2009 VIVUS, Inc. sent a new medication application (NDA) to the FDA and also on March 1, 2010, VIVUS, Inc. announced that the FDA approved the NDA for review.

In October 2010, the FDA announced its decision to not accept phentermine/topiramate Emergency Room in its existing form and also issued a Total Reaction Letter (CRL) to VIVUS due to absence of long-lasting data and also problems regarding negative effects including elevated heart rate, significant damaging cardiovascular occasions, and also birth defects.

The FDA shared issues about the possibility for phentermine/topiramate ER to cause birth flaws and also requested that Vivus evaluate the usefulness of examining alreadying existing medical care databases to determine the historical occurrence of oral cleft in spawn of ladies treated with topiramate for migraine headache treatment (ONE HUNDRED mg).

In October 2011, VIVUS resubmitted the NDA to the FDA with responses to the issues dealt with in the CRL. The FDA accepted the NDA in November 2011.

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

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