The FDA approved a new weight loss drug combination - Phentermine and Topirmate in July, 2012 for people who are obese or those that are overweight with obesity related medical conditions. Let us look at the evidence, indications, side effects, cost, and how to find a physician that prescribe these medications for you.
What is Phentermine?
Phentermine is one of the oldest weight loss medications and is an appetite suppressant to help reduce weight in obese patients when used short-term and combined with exercise, diet, and behavioral modification. It is typically prescribed for individuals who are at increased medical risk due to their weight.
What is Topiramate?
Topiramate (brand name Topamax) is an anticonvulsant (antiepilepsy) drug. It was most recently approved for weight loss by the FDA in combination with phentermine called Qsymia®.
Why combination medications are used for weight loss?
The appetite and satiety centers in the brain are influenced by a over 50 different neurochemicals with many redundant pathways. If one is blocked, the other can compensate leading to reduced effectiveness of the medication. In combining two medications with different actions, we have a better chance of blocking the pathway thereby increasing the effectiveness of each of these medications.
The combination Phetermine and Qsymia
How should Phentermine and Topirmate or Qsymia® be used?
The recommended daily dose of Qsymia contains 7.5 milligrams of phentermine and 46 mg of topiramate extended-release. Qsymia is also available at a higher dose (15 mg phentermine and 92 mg of topiramate extended-release) for select patients.
What is Phentermine?
Phentermine is one of the oldest weight loss medications and is an appetite suppressant to help reduce weight in obese patients when used short-term and combined with exercise, diet, and behavioral modification. It is typically prescribed for individuals who are at increased medical risk due to their weight.
What is Topiramate?
Topiramate (brand name Topamax) is an anticonvulsant (antiepilepsy) drug. It was most recently approved for weight loss by the FDA in combination with phentermine called Qsymia®.
Why combination medications are used for weight loss?
The appetite and satiety centers in the brain are influenced by a over 50 different neurochemicals with many redundant pathways. If one is blocked, the other can compensate leading to reduced effectiveness of the medication. In combining two medications with different actions, we have a better chance of blocking the pathway thereby increasing the effectiveness of each of these medications.
The combination Phetermine and Qsymia
The combination of the drugs phentermine and topiramate (trade name Qsymia®, formerly Qnexa) is a medication for the treatment of obesity and potentially related conditions such as type 2 diabetes and has been found to lower blood pressure and cholesterol. Qsymia® was developed by Vivus, a California pharmaceutical company. Phentermine and topiramate extended-release (long-acting) capsules are used to help adults who are obese or who are overweight and have weight-related medical problems to lose weight and to keep from gaining back that weight. Phentermine and topiramate extended-release capsules must be used along with a reduced calorie diet and exercise plan. Phentermine is in a class of medications called anorectics. It works by decreasing appetite. Topiramate is in a class of medications called anticonvulsants. It works by decreasing appetite and by causing feelings of fullness to last longer after eating.
On February 22, 2012, U.S. Food and Drug Administration (FDA) advisors voted 20 to 2 to recommend that the FDA adopt phentermine/topiramate as an obesity treatment. Final approval was expected later in 2012, with recommendations for post-market monitoring for cardiovascular risk and an indication against use by pregnant women.
On February 22, 2012, U.S. Food and Drug Administration (FDA) advisors voted 20 to 2 to recommend that the FDA adopt phentermine/topiramate as an obesity treatment. Final approval was expected later in 2012, with recommendations for post-market monitoring for cardiovascular risk and an indication against use by pregnant women.
On July 17, 2012, the U.S. FDA approved Qsymia® as an addition to a reduced-calorie diet and exercise for chronic weight management,for thoses with a BMI of at least 30.
How should Phentermine and Topirmate or Qsymia® be used?
Phentermine and topiramate come as extended-release capsules to take by mouth. The medication is usually taken with or without food once a day in the morning. This medication may cause difficulty falling asleep or staying asleep if it is taken in the evening. Take phentermine and topiramate at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take phentermine and topiramate exactly as directed.
Your doctor will probably start you on a low dose of phentermine and topiramate and increase your dose after 14 days. After you take this dose for 12 weeks, your doctor will check to see how much weight you have lost. If you have not lost a certain amount of weight, your doctor may tell you to stop taking phentermine and topiramate or may increase your dose and then increase it again after 14 days. After you take the new dose for 12 weeks, your doctor will check to see how much weight you have lost. If you have not lost a certain amount of weight, it is not likely that you will benefit from taking phentermine and topiramate, so your doctor will probably tell you to stop taking the medication.
Phentermine and topiramate may be habit forming. Do not take a larger dose, take it more often, or take it for a longer period of time than prescribed by your doctor.
Phentermine and topiramate will help control your weight only as long as you continue to take the medication. Do not stop taking phentermine and topiramate without talking to your doctor. If you suddenly stop taking phentermine and topiramate, you may experience seizures. You have to decrease your dose gradually.
Side Effects Of Phetermine Topiramate
In 2009, Vivus reported that the main side effects during testing phases were dry mouth, a tingling in the fingers and toes and constipation. It should not be taken by pregnant women or women planning to get pregnant.
Cost of Qsymia® Brand name medication for weight loss
The average monthly cost of the brand name Phentermine and Topiramate called Qsymia is approximately $160.00 USD. Since it is relatively new, most insurances have yet to approve this medication.
Cost of Generic Combination similar to the brand
Although it varies depending on where you obtain these prescription only weight loss medications, at W8MD Medical Weight Loss Centers, the average monthly cost for Phentermine is as low as $30.00 and topiramate price varies from $30-60 per month depending on the dosage and number pills used per day.
Generic combination of Phentermine and Topiramate versus brand name Qsymia®
So, you can potentially save up to 40-50 percent in the generic combination compared to the brand name.
How can W8MD Medical Weight Loss Centers in New York City and Greater Philadelphia Help?
W8MD physicians can discuss this medication called Qsymia and advise on whether this medication is
appropriate for you.
In combination with a very low calorie diet, this medication can help you significantly in losing weight.
How much weight am I expected to lose on Phentermine and Topiramate?
How much weight am I expected to lose on Phentermine and Topiramate?
FDA information on this combination of Phentermine and Topirmate
The U.S. Food and Drug Administration today approved Qsymia (phentermine and topiramate extended-release) as an addition to a reduced-calorie diet and exercise for chronic weight management.
The drug is approved for use in adults with a body mass index (BMI) of 30 or greater (obese) or adults with a BMI of 27 or greater (overweight) who have at least one weight-related condition such as high blood pressure (hypertension), type 2 diabetes, or high cholesterol (dyslipidemia).
BMI, which measures body fat based on an individual’s weight and height, is used to define the obesity and overweight categories. According to the Centers for Disease Control and Prevention, more than one-third of adults in the United States are obese.
“Obesity threatens the overall well being of patients and is a major public health concern,” said Janet Woodcock, M.D., director of the FDA’s Center for Drug Evaluation and Research. “Qsymia, used responsibly in combination with a healthy lifestyle that includes a reduced-calorie diet and exercise, provides another treatment option for chronic weight management in Americans who are obese or are overweight and have at least one weight-related comorbid condition."
Qsymia must not be used during pregnancy because it can cause harm to a fetus. Data show that a fetus exposed to topiramate, a component of Qsymia, in the first trimester of pregnancy has an increased risk of oral clefts (cleft lip with or without cleft palate). Females of reproductive potential must not be pregnant when starting Qsymia therapy or become pregnant while taking Qsymia. Females of reproductive potential should have a negative pregnancy test before starting Qsymia and every month while using the drug and should use effective contraception consistently while taking Qsymia.
The safety and efficacy of Qsymia were evaluated in two randomized, placebo-controlled trials that included approximately 3,700 obese and overweight patients with and without significant weight-related conditions treated for one year. All patients received lifestyle modification that consisted of a reduced calorie diet and regular physical activity.
Results from the two trials show that after one year of treatment with the recommended and highest daily dose of Qsymia, patients had an average weight loss of 6.7 percent and 8.9 percent, respectively, over treatment with placebo. Approximately 62 percent and 69 percent of patients lost at least five percent of their body weight with the recommended dose and highest dose of Qsymia, respectively, compared with about 20 percent of patients treated with placebo.
Patients who did not lose at least three percent of their body weight by week 12 of treatment with Qsymia were unlikely to achieve and sustain weight loss with continued treatment at this dose. Therefore, response to therapy with the recommended daily dose of Qsymia should be evaluated by 12 weeks to determine, based on the amount of weight loss, whether to discontinue Qsymia or increase to the higher dose. If after 12 weeks on the higher dose of Qsymia, a patient does not lose at least five percent of body weight, then Qsymia should be discontinued, as these patients are unlikely to achieve clinically meaningful weight loss with continued treatment.
Qsymia must not be used in patients with glaucoma or hyperthyroidism. Qsymia can increase heart rate; this drug’s effect on heart rate in patients at high risk for heart attack or stroke is not known. Therefore, the use of Qsymia in patients with recent (within the last six months) or unstable heart disease or stroke is not recommended. Regular monitoring of heart rate is recommended for all patients taking Qsymia, especially when starting Qsymia or increasing the dose.
Related Links
About W8MD Medical Weight Loss Centers Of America
Our physicians and staff are committed to offering a comprehensive and individualized approach. W8MD physicians partner with each patient to develop a custom weight management program to best meet their individual needs. If you are a bit overweight or obese, take long term medications for cholesterol, blood pressure or diabetes but your doctor has nothing to offer for weight loss other than simply say "lose weight", you may want to consider W8MD!
Under the direction of Dr. Prab Tumpati, W8MD Weight Loss Centers can help you overcome obesity and to make a difference. Dr. Tumpati has passed a written board examination in the field of Bariatric Medicine and is also Board Certified in Sleep Medicine and Internal Medicine. The doctor’s of W8MD partner with each patient to develop a custom weight management program to best meet their individual needs taking into account their medical history, lifestyle and goals.
Since weight and sleep go together, most of the W8MD centers are able to address sleep issues such as snoring, obstructive sleep apnea, narcolepsy, insomnia and restless leg syndrome to name a few.
And the best part of the program is that most insurance’s cover the doctor visits.
Check out our website at www.w8md.com to learn more about us. If you have a little or a lot of weight to lose and want to do it without surgery, set up fees and mandatory meal replacements or appetite suppressants, think W8MD for weight loss.
And, if you are a physician, with an interest in helping your obese or overweight patients, and would like to add a W8MD program at your office, please feel free to contact us.
Weight Loss Success Stories
Under the direction of Dr. Prab Tumpati, W8MD Weight Loss Centers can help you overcome obesity and to make a difference. Dr. Tumpati has passed a written board examination in the field of Bariatric Medicine and is also Board Certified in Sleep Medicine and Internal Medicine. The doctor’s of W8MD partner with each patient to develop a custom weight management program to best meet their individual needs taking into account their medical history, lifestyle and goals.
Since weight and sleep go together, most of the W8MD centers are able to address sleep issues such as snoring, obstructive sleep apnea, narcolepsy, insomnia and restless leg syndrome to name a few.
And the best part of the program is that most insurance’s cover the doctor visits.
Check out our website at www.w8md.com to learn more about us. If you have a little or a lot of weight to lose and want to do it without surgery, set up fees and mandatory meal replacements or appetite suppressants, think W8MD for weight loss.
And, if you are a physician, with an interest in helping your obese or overweight patients, and would like to add a W8MD program at your office, please feel free to contact us.
Weight Loss Success Stories
W8MD weight loss, sleep and medspa locations
Manhattan, NY – 401 E 55th Street New York, NY 10022
W8MD’s NYC Medical Weight Loss, Sleep & MedSpa – Brooklyn, NY
Poly-Tech Sleep, W8MD’s Philadelphia Weight loss & Aesthetics NE Philadelphia
1718 Welsh Road, 2nd Floor, Philadelphia, PA, 19115
1718 Welsh Road, 2nd Floor, Philadelphia, PA, 19115
Poly-Tech Sleep, W8MD Weight Loss & MedSpa – King of Prussia, PA
Coming soon – W8MD Weight Loss, Sleep & Medical Spa Cherry Hill, NJ
Comments
Post a Comment