What you’ll learn:
- Qsymia® is an FDA-approved weight loss medication for adults designed to help support sustainable weight management.
- You’ll start with a low dose that gradually increases based on how your body responds and how much weight you’re losing.
- When combined with healthy lifestyle changes, Qsymia® can be even more effective by tackling both the physical and mental sides of weight loss.
If you’ve ever tried to lose weight and felt like you were doing everything right—eating better, moving more—only to see the scale barely budge, you’re not alone. For many people, lifestyle changes can only take you so far if your body’s own signals are working against you. That’s where medications like Qsymia® can help.
Qsymia® is a once-daily pill that is FDA-approved for weight loss. GLP-1 medications like Wegovy® and Zepbound® have become well-known, but Qsymia® is another option that’s been approved since 2012.
It’s a blend of two medications: phentermine, which helps reduce your appetite, and topiramate, which also reduces appetite and makes you feel full sooner. Together, they help tip the odds in your favor for long-term weight management.
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Getting the dose of Qsymia® that works best for you is part of the process. The dose you start with won’t be the dose you stay on. Just like with GLP-1 medications, finding the dose that gives you the best weight loss balance with the fewest side effects is key.
This titration process is designed to help you lose weight at a safe pace, minimize side effects, and give you the best chance at sticking with the medication. So, how does that process work, and what can you expect? Let’s break it down.
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Stay on top of your wellness journey with the latest Noom news, thoughtful articles, and a healthy dose of inspiration delivered right to your inbox.Why does Qsymia® cause side effects?
Qsymia® can help you lose weight, but it can come with some side effects. The two ingredients, phentermine and topiramate, each target different systems, and those changes can lead to some reactions.
Let’s break it down.
- Phentermine is a stimulant. It tells your brain to release more norepinephrine and dopamine, which ramps up your energy and cuts down your hunger. So what does that mean for your body?
- Your brain stays “on”: Since it’s stimulating your nervous system, some people feel jittery, anxious, or have trouble sleeping. Some also experience headaches, dizziness, or dry mouth.
- Your heart works harder: Phentermine can raise your heart rate and blood pressure.
- Topiramate was originally used to treat seizures and prevent migraines, but it also lowered appetite. It works by calming overactive brain signals and changing the way a person responds to cravings, as well as the way food tastes. How does this lead to side effects?
- It affects brain chemistry, which can lead to brain fog. Some people find themselves struggling to find words, think clearly, or remember things.
- You might feel tingling in your fingers or toes: This is a nerve-related side effect of topiramate.
- Taste can get weird: Some people say food tastes off or metallic.
- Mood changes can occur: Because topiramate alters brain chemistry, it may affect your mood, especially if you’re prone to anxiety or depression.
How the doses of Qsymia® are increased
When you start Qsymia®, your healthcare provider will start you at the lowest dose to reduce the impact of side effects.
- Starting dose: Everyone begins with a daily dose of 3.75 mg phentermine / 23 mg topiramate. You’ll take this once a day for the first 14 days.
- Maintenance dose: After the two weeks, if you’re tolerating the medicine well, your dose will increase to 7.5 mg phentermine / 46 mg topiramate once daily. This is considered the standard maintenance dose and is where many people begin to see steady progress in their weight management.
- Dose escalation schedule: If you haven’t lost at least 3% of your starting body weight after being on the maintenance dose for 12 weeks, your provider may recommend a gradual increase. Here’s how that typically looks:
- Step-up dose: Take 11.25 mg phentermine / 69 mg topiramate once daily for 14 days.
- Maximum dose (If tolerated well): Then, increase to the maximum recommended dose of 15 mg phentermine / 92 mg topiramate once daily.
- Step-up dose: Take 11.25 mg phentermine / 69 mg topiramate once daily for 14 days.
That said, this higher dose isn’t for everyone and usually comes with more careful monitoring. Your provider will weigh the benefits against any potential side effects before making this decision. Here’s how the titration schedule typically looks based on prescribing information:
Dose timing & administration tips for best weight loss results
You take Qsymia® once a day in the morning. When taking Qysmia, it’s important to swallow the capsule whole; don’t chew, crush, or split it. Since it is an extended-release medication, it’s specially designed to release its ingredients slowly throughout the day.
To store Qsymia, keep it in a tightly closed container to protect it from moisture and keep its temperature between 68°F and 77°F.
To get the best results from Qsymia®, establishing a routine that works for you is key. The right timing, food choices, and adjustments can help reduce side effects and improve the medication’s effectiveness.
Let’s break down some tips to make your Qsymia® schedule as smooth and effective as possible.
| Tip | Details |
|---|---|
| Optimal time of day | Take Qsymia® at the same time each morning. Whether it’s before your first cup of coffee or before your workout, consistency helps keep the medication’s effects steady throughout the day. Be mindful of the energizing phentermine component, which might disrupt your sleep if taken later. |
| With or without food | Qsymia® can be taken with or without food. Choose what works best for your routine; some find it easier to take it with breakfast, while others prefer it on an empty stomach. |
| Reducing side effects | Adjusting when or how you take Qsymia® can help reduce side effects. For example, taking it with a meal can help avoid nausea. |
What happens if you miss a dose?
If you accidentally skip your dose of Qsymia®. Skip the missed dose and resume your normal schedule the next morning. Don’t double up or take it later in the day. Again, taking Qsymia® too late in the day can interfere with sleep.
What if you miss multiple doses?
If you miss several doses in a row, it’s important to contact your healthcare provider. Missing multiple doses can reduce the effectiveness of Qsymia® and make it harder to get back on track. Your provider can help you determine whether you should restart your treatment or adjust the dosage.
How much weight can I lose on Qsymia®?
Here’s what people lose on average by dose, based on studies:
| Dose | Average percentage of body weight lost |
|---|---|
| Qsymia® 7.5 mg/46 mg | 8% |
| Qsymia® 15/92 mg | 10% |
What’s the best dose of Qsymia® for weight loss?
Finding the right dose that works for you is the most important thing with Qsymia®. Here are a few things to keep in mind.
- Higher doses don’t always lead to more weight loss: While some people may need the maximum dose (15 mg/92 mg) to reach their goals, others see success with lower doses. Your healthcare provider will assess your health (like blood pressure, heart rate, and other health metrics) to help decide whether a higher dose is beneficial or if a lower dose would be just as effective.
- Personalized dosing plan: Everyone’s body is different, so your Qsymia® dose might look different from someone else’s. The goal is to use the lowest effective dose that helps you reach your weight loss goal while minimizing side effects.
The bottom line: Taking Qsymia® for weight loss
Qsymia® combines two medications—phentermine and topiramate—that work together to curb appetite, help you feel full sooner, and make it easier to stick to a lower-calorie eating plan. On average, people can lose about 8–10% of their body weight while taking Qsymia®. It’s FDA-approved for adults and works best when paired with healthy habits like balanced eating, regular movement, quality sleep, and stress management.
Finding the dose that works best for you is important. Some people see success on the standard maintenance dose, while others benefit from a higher dose.
If you’re interested in exploring weight loss medication, see if you qualify for Noom Med. You’ll be paired with a clinician who can find the right medication for you, prescribe it if needed, and design a plan that works. You’ll also get access to all of Noom’s tools and trackers to help you reach your goals at a healthy pace.
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