The combination of the drugs phentermine and topiramate extended-release (ER) (brand name Qsymia) is a drug made use of for weight reduction. In scientific trials, phentermine/topiramate Emergency Room was connected with small but statistically considerable weight-loss when compared with sugar pill. This weight-loss was connected with renovations in weight-related comorbidities such as enhanced glycemia, minimized blood stress, as well as improved cholesterol.

Phentermine/ topiramate ER was developed by Vivus, Inc., a The golden state pharmaceutical company. Phentermine is a sympathomimetic amine which serves as a cravings suppressant as well as stimulant. Topiramate is an anticonvulsant that carries weight loss negative effects. The exact system of action for both drugs is unknown.

In 2012 the united state Fda accepted phentermine/topiramate Emergency Room as an adjunct to a reduced-calorie diet regimen and raised bodily activity for persistent weight management in grownups with a preliminary physical body mass index (BMI) of at the very least 30 kg/m ², or at the very least 27 kg/m ² (overweight) in the existence of at the very least one weight-related comorbidity such as high blood pressure, type 2 diabetes mellitus, or dyslipidemia. Phentermine/topiramate ER is available in qualified retail drug stores nationwide and additionally offered with a licensed mail-order pharmacy network. Approval was rejected by European regulative authorities, which mentioned prospective threat to the heart and blood vessels, psychological side impacts, as well as cognitive side effects in detailing their decision.

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Medical uses

In professional trials, people treated with the highest dose of phentermine/topiramate ER in combo with a workout of diet and also workout shed 10 % to 11 % of their body weight as compared to 1 % to 2 % for those who got sugar pill. In enhancement, 62 % to 70 % of topics obtaining the suggested dosage or leading dose of phentermine/topiramate ER accomplished >=5 % weight by week 56 (ITT-LOCF) compared to 17 % to 21 % of those getting a sugar pill.

Adverse effects

In clinical trials, one of the most common negative occasions which occurred at a rate >=5 % and >=1.5 times sugar pill included paraesthesia (prickling in fingers/toes), wooziness, dysgeusia (altered preference), sleep problems, irregular bowel movements, and completely dry mouth.

In the united state, the medication label has warnings for enhanced heart price, self-destructive actions and ideation, glaucoma, mood and sleep disorders, creatine elevation, and metabolic acidosis. Some of these warnings are based on historical monitorings in epilepsy clients taking topiramate. The FDA is requiring the business to do a post-approval cardio results trial, due in part to the observation of raised heart price in some people taking the medicine in professional trials.


Phentermine/ topiramate Emergency Room could create fetal damage. Information from maternity windows registries and public health researches suggest that a fetus exposed to topiramate in the initial 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 ER, treatment must be stopped right away, and also the individual ought to be apprised of the prospective threat to a fetus. Women of procreative potential ought to have an unfavorable maternity test prior to starting phentermine/topiramate Emergency Room as well as month-to-month thereafter during phentermine/topiramate Emergency Room treatment. Women of procreative capacity must make use of effective birth control during phentermine/topiramate ER therapy.


Phentermine/ topiramate ER is contraindicated in maternity, glaucoma, hyperthyroidism, throughout or within 14 days of taking monoamine oxidase preventions, as well as in people with hypersensitivity or idiosyncrasy to sympathomimetic amines. Phentermine/topiramate Emergency Room could create a boost in resting heart rate.

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Risk Evaluation and Reduction Approach (REMS)

Phentermine/ topiramate ER was approved with a REMS program to make sure that perks of therapy outweigh the threats. As a result of the teratogenic risk associated with phentermine/topiramate Emergency Room treatment, phentermine/topiramate ER is dispersed by means of approved pharmacies.

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Approval history

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

In October 2010, the FDA revealed its decision to not authorize phentermine/topiramate Emergency Room in its current kind as well as released a Complete Reaction Letter (CRL) to VIVUS as a result of absence of long-term data and also issues regarding side results consisting of raised heart price, major damaging cardio occasions, as well as birth defects.

The FDA expressed issues concerning the possibility for phentermine/topiramate Emergency Room to trigger abnormality and requested that Vivus evaluate the expediency of examining already existing healthcare databases to determine the historic occurrence of dental cleft in offspring of ladies treated with topiramate for migraine headache treatment (100 mg).

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

On September 18, 2012, Qsymia came to be available on the United States market.

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