*retail pharmacy and home delivery
$79 is the average retail pharmacy price after copay, calculated between January and June 2022. Source: McKesson Specialty Health 2022. Average price after copay without commercial insurance is $128. As of July 19, 2022, goodrx states that the lowest price for the most frequently prescribed dose of qsymia is around $192.81, which is 17% less than the average retail price of $234.19. source: www.goodrx.com/qsymia. pharmacy prices and fees may vary by location.
$98 home delivery pharmacy price includes 6-week new patient packs, 6-week titration packs and 30-day supply of all prescriptions. for cash patients only. insurance claims will not be processed. additional shipping and handling costs will apply. Limit one new patient package and one titration package per patient for the duration of the program.
qsymia should be used in conjunction with a reduced-calorie diet and increased physical activity for chronic weight management in:
- adults with a baseline body mass index (BMI) of:
- 30 kg/m2 or more (obese), or
- 27 kg/m2 or more (overweight) in the presence of at least one weight-related comorbidity, such as hypertension, type 2 diabetes mellitus, or dyslipidemia
- pediatric patients 12 years of age or older with a baseline BMI at or above the 95th percentile standardized for age and sex
- It is not known if qsymia changes your risk of heart problems or stroke or death due to heart problems or stroke
- It is not known if qsymia is safe and effective when taken with other prescription, over-the-counter, or herbal weight-loss products
limitations of use:
important safety information
qsymia is contraindicated in pregnancy; in patients with glaucoma; in hyperthyroidism; in patients receiving treatment or within 14 days of treatment with monoamine oxidase inhibitors (MAOIs); or in patients with hypersensitivity or idiosyncrasy to sympathomimetic amines, topiramate, or any of the inactive ingredients of qsymia.
The most commonly observed side effects in controlled clinical studies, 5% or more and at least 1.5 times placebo, in adults include paresthesia, dizziness, dysgeusia, insomnia, constipation, and dry mouth. Common side effects in pediatric patients 12 years of age and older at ≥4% and greater than placebo include depression, dizziness, arthralgia, pyrexia, influenza, and ligament sprains.
qsymia can cause fetal harm. Pregnancy registry data and epidemiological studies indicate that a fetus exposed to topiramate, a component of qsymia, in the first trimester of pregnancy is at increased risk of oral clefts (cleft lip with or without cleft palate). Pregnancy testing is recommended prior to initiation of qsymia in patients who can become pregnant and monthly during qsymia therapy. advise patients who may become pregnant of the potential risk to the fetus and to use effective contraception during therapy with qsymia.
qsymia is associated with a reduction in height velocity (centimeters of height gained per year) in obese pediatric patients 12 to 17 years of age. monitor height velocity in pediatric patients treated with qsymia. consider dose reduction or discontinuation of qsymia if pediatric patients are not growing or gaining height as expected.
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qsymia can cause an increase in the resting heart rate. Regular measurement of resting heart rate is recommended for all patients taking qsymia, especially patients with cardiac or cerebrovascular disease or when starting or increasing the dose of qsymia. qsymia has not been studied in patients with recent or unstable cardiac or cerebrovascular disease and therefore its use is not recommended. Patients should notify healthcare providers of palpitations or the sensation of a fast heartbeat while resting during treatment with qsymia. For patients who experience a sustained increase in resting heart rate while taking qsymia, the dose should be reduced or qsymia should be discontinued.
Topiramate, a component of qsymia, increases the risk of suicidal thoughts or behavior in patients taking these medications for any indication. patients should be monitored for the onset or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior. discontinue qsymia in patients experiencing suicidal thoughts or behavior. qsymia is not recommended in patients with a history of suicide attempts or active suicidal ideation.
Acute angle-closure glaucoma has been reported in patients treated with topiramate, a component of qsymia. symptoms include acute onset of decreased visual acuity and/or eye pain. Symptoms usually occur within 1 month of starting topiramate treatment, but may occur at any time during therapy. the main treatment to reverse symptoms is immediate discontinuation of qsymia. Elevated intraocular pressure of any aetiology, if left untreated, can lead to serious adverse events, including permanent vision loss.
qsymia can cause mood disorders, such as depression and anxiety, as well as insomnia. patients with a history of depression may be at increased risk. for clinically significant or persistent symptoms, consider dose reduction or withdrawal of qsymia.
Visual field defects (independent of elevated intraocular pressure) have been reported in clinical trials and post-marketing experience in patients receiving topiramate. in clinical trials, most of these events were reversible after discontinuation of topiramate treatment. if visual problems occur at any time during treatment, consider discontinuing qsymia.
qsymia can cause cognitive dysfunction (eg, impaired concentration/attention, difficulty with memory, and speech or language problems, particularly word finding difficulties). Since qsymia has the potential to impair cognitive function, patients should be cautioned against operating dangerous machinery, including automobiles.
Hyperchloremic metabolic acidosis, without anion gap, has been reported in patients treated with qsymia. Measurement of electrolytes, including serum bicarbonate, is recommended before starting qsymia and during treatment with qsymia. if metabolic acidosis develops and persists, dose reduction or discontinuation of qsymia should be considered.
qsymia may cause an increase in serum creatinine reflecting a decrease in renal function (glomerular filtration rate). in phase 3 trials, maximal increases in serum creatinine were observed after 4 to 8 weeks of treatment. on average, serum creatinine gradually decreased but remained elevated above baseline creatinine values. Changes in serum creatinine (and measured glomerular filtration rate) with short-term treatment with qsymia appear to be reversible with discontinuation of treatment, but the effect of chronic treatment on renal function is unknown. therefore, it is recommended that serum creatinine be measured before starting qsymia and during treatment with qsymia. if persistent increases in creatinine occur while taking qsymia, reduce the dose or stop qsymia.
Serious skin reactions (Stevens-Johnson syndrome [SJS] and toxic epidermal necrolysis ) have been reported in patients receiving topiramate. qsymia should be discontinued at the first sign of a rash, unless the rash is clearly not drug related. if signs or symptoms suggest sjs/ten, use of this drug should not be resumed and alternative therapy should be considered. Inform patients of the signs of serious skin reactions.
Weight loss may increase the risk of hypoglycemia in patients with type 2 diabetes mellitus treated with insulin and/or insulin secretagogues (eg, sulfonylureas). qsymia has not been studied in combination with insulin. Measurement of blood glucose levels is recommended before starting qsymia and during treatment with qsymia in patients with type 2 diabetes. A dose reduction of non-glucose dependent antidiabetic medications should be considered to mitigate the risk of hypoglycemia.
In hypertensive patients treated with antihypertensive drugs, weight loss may increase the risk of hypotension. Blood pressure measurement is recommended before starting qsymia and during treatment with qsymia in patients being treated for hypertension. If a patient develops symptoms associated with low blood pressure after starting qsymia, appropriate changes in antihypertensive drug regimen should be made.
Concomitant use of alcohol or central nervous system (CNS) depressant drugs (eg, barbiturates, benzodiazepines, and sleep aids) with phentermine or topiramate may potentiate the CNS depression or other effects mediated by these agents. therefore, avoid concomitant use of alcohol with qsymia.
In situations where immediate termination of qsymia is medically required, appropriate monitoring is recommended. patients discontinuing qsymia 15 mg/92 mg should be tapered as recommended.
adjust the dose of qsymia for patients with moderate or severe renal insufficiency. qsymia has not been studied in patients with end-stage renal disease on dialysis. avoid use of qsymia in this patient population.
dose adjustment of qsymia for patients with moderate hepatic impairment. qsymia has not been studied in patients with severe hepatic impairment. avoid use of qsymia in this patient population.
Avoid using qsymia with other drugs that inhibit carbonic anhydrase (eg, zonisamide, acetazolamide, or methazolamide). Topiramate use by patients on a ketogenic diet may also result in a physiological environment that increases the likelihood of kidney stone formation. increase fluid intake to increase urine output, which can decrease the concentration of substances involved in kidney stone formation.
Patients treated with qsymia should be advised to monitor for decreased sweating and increased body temperature during physical activity, especially in hot weather. Caution should be exercised when qsymia is prescribed with other drugs that predispose patients to heat-related disorders; These medications include, but are not limited to, other carbonic anhydrase inhibitors and medications with anticholinergic activity.
When prescribing qsymia, patients should be monitored for hypokalemia. Obtaining a biochemical blood profile is recommended at baseline and periodically during treatment.
Phentermine, a component of qsymia, has a known potential for abuse.
To report negative side effects, contact vivus lcc at 1-888-998-4887 or the fda at 1-800-fda-1088 or www.fda.gov/medwatch.
See Important Safety Information, Full Prescribing Information, and Healthcare Provider Advisory Tool for Patients of Reproductive Potential for qsymia.
site references: 1. full prescribing information for qsymia. Campbell, CA: Vivius LLC; 2022. 2. data on file. vivus lcc. 3. contrave [prospectus]. Brentwood, Tennessee; curaxtm pharmaceuticals llc; 2021. 4. saxenda [prospectus]. plainsboro, new jersey: novo nordisk inc; 2022. 5. hillaj et al. appetite. 1991;17(3):187-197. 6. stubbs rj et al. physiological behavior 2001;72(4):615-619. 7. isaksson et al. nourishing food 2008; 52. 8. pelchat ml. appetite. 1997;28(2):103-113. 9. aj hill, heaton-brown l. j psychosom res.1994;38(8):801-814. 10. Garber, AJ, Abrahamson MJ, Barzilay JL, et al. aace comprehensive diabetes management algorithm 2013. endocr pract. 2013; 19(2):327-336.