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 5’4” woman who weighs above 180 pounds, or a 5’8” 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 ise 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 mg of Phentermine and 23 mg 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 11.25mg/69mg and then in another two weeks increased again to a maximum dosage of 15mg/92mg. 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. Weight loss averages between 5 and 10 percent of total body weight in the studies. For the 200 pound woman, that is a loss of 10 – 20 pounds.

Qysmia is to be taken in the morning (with or without food) and ideally taken for no more than 24 weeks. Blood markers for electrolytes, liver and kidney may need to be checked throughout treatment.

There are only certain pharmacies that are certified to dispense Qysmia so do not expect it to be carried everywhere.

The pharmaceutical company that makes Qysmia also strongly recommends that patients reduce their intake of food by 500 calories per day, increase their water (helps with the dry mouth and to flush the body) and participate in a regular exercise program.

Keep in mind the American Heart Association recommends 30 minutes of moderate physical activity five times per week.

Again, this is not a magic weight loss pill and may not be the right course for you, given the long list of serious side effects.

It is not for the person looking to lose a quick pound before a wedding, reunion or vacation. However, it may be a great option for the person who has strictly followed a healthy diet and exercise program plus has addressed their thyroid, adrenal and female hormones and still cannot lose weight.

It is important to remember that fat loss (clothes are looser, losing inches) may be different and happen independently from loss on the scale –– so don’t just focus on those numbers when you step on the scale.

References:

1) http://www.qsymia.com/hcp Accessed Nov. 4, 2012.

2) http://www.topiramate.com Accessed Nov. 4, 2012.

3) http://www.heart.org Accessed Nov. 4, 2012.

Reviewed November 5, 2012
by Michele Blacksberg RN
Edited by Jody Smith