Mixed
The fixed-dose combination of phentermine and extended-release topiramate (Qsymia) produces synergistic, robust, and sustained weight loss in obese adults, with a significant proportion achieving ≥10% weight loss.
For adults with obesity (BMI ≥35, or ≥27 with comorbidities), the combination of phentermine and extended-release topiramate is a clinically approved option that can produce significant, sustained weight loss (often >10% of body weight) when combined with a caloric deficit. It is designed to be taken once daily, starting at a low dose and titrating up to maximize tolerance. This approach addresses the limitation of short-term monotherapies by offering a long-term management strategy with a favorable risk-benefit profile for many patients, though it requires monitoring for specific side effects like paresthesia or cognitive changes.
This fixed drug combination offers synergistic potential for effective, robust and sustained weight loss with mean weight loss of at least 10% of baseline achieved and sustained for up to 2 years in over 50% of subjects treated.
Why this rating
Based on multiple Phase III randomized controlled trials (EQUIP, CONQUER, SEQUEL) with large sample sizes and long durations (up to 2 years).
Source
Phentermine and topiramate for the management of obesity: a review
Gabriel I. Uwaifo et al. · Drug Design Development and Therapy · 2013
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