Mind and Body

Qysmia: Is the new weight-loss drug right for you?

There is a new weight loss drug on the market and it is known now as Qysmia (formerly titled Qnexa).

It is a combination of two other drugs, Phentermine (one of the Phen’s in the former weight loss drugs known as Fen-Phen) and topiramate, which is also known as Topomax for epilepsy.


For many of you hoping for a miracle weight loss drug, this is not it, but it has been shown to be helpful.

Qysmia is strongly recommended only for those who meet the following criteria.
First, if someone (man or woman) has a body mass index (BMI) of 30 or greater they qualify. As an example, a 5-foot, 4-inch woman who weighs above 180 pounds, or a 5-foot,’8-inch woman who weighs above 200 pounds meets the criteria.

Second, if someone (man or woman) has a BMI of 27 or greater and has high blood pressure, type 2 diabetes and/or high cholesterol, they would qualify.

It is not recommended at all for women who are pregnant or breastfeeding, for those who have glaucoma, have an overactive thyroid (hyperthyroidism). It's also not for someone who is taking an MAOI type of anti-depressant, or who has an unstable heart condition such as irregular heart rates.

Typical side effects of Phentermine are rapid heart rate, anxiety, nervousness, insomnia, and cottonmouth or dry mouth. The most common side effects of  topiramate are numbness and tingling in the limbs, diarrhea dizziness, depression, nausea, memory problems and slowed movements.

Both medications cause loss of appetite which is why they work so well for weight loss.

Health care providers are advised to start with the lowest dose of Qysmia which is 3.75 milligrams of Phentermine and 23 milligrams of topiramate for two weeks. At that time depending on the input from the provider and patient, the dose may be doubled.

After two more weeks the dose can be increased again to 11.25 milligrams / 69 milligrams and then in another two weeks increased again to a maximum dosage of 15 milligrams / 92 milligrams. If weight loss is not achieved, then the patient must wean off Qysmia to reduce risk of seizures before stopping it completely.

Some patients may choose to stay at lower doses depending on side effects.