QSYMIA (PHENTERMINE HCL/TOPIRAMATE)
- Weight loss management for obese patient (bmi >= 30)
- Wt loss mgmt, pt with bmi 27-29 & wt-related comorbidity
11.25 mg-69 mg capsule, extended release
- 1 capsule by oral route once daily in the morning for 14 days
15 mg-92 mg capsule, extended release
- 1 capsule by oral route once daily in the morning
3.75 mg-23 mg capsule, extended release
- 1 capsule by oral route once daily in the morning for 14 days
7.5 mg-46 mg capsule, extended release
- 1 capsule by oral route once daily in the morning
Weight loss management for obese patient (bmi >= 30)
- 1 capsule by oral route once daily in the morning
- 1 capsule by oral route once daily in the morning for 14 days
Wt loss mgmt, pt with bmi 27-29 & wt-related comorbidity
- 1 capsule by oral route once daily in the morning
- 1 capsule by oral route once daily in the morning for 14 days
- isocarboxazid
- Marplan
- Matulane
- methylene blue (antidote)
- Nardil
- Parnate
- phenelzine
- procarbazine
- tranylcypromine
Contraindicated
- acetazolamide
- acetazolamide sodium
- Altavera (28)
- Alyacen 1/35 (28)
- Alyacen 7/7/7 (28)
- Amethia
- Amethia Lo
- Amethyst
- amitriptyline
- amitriptyline-chlordiazepoxide
- amoxapine
- Amrix
- Anafranil
- Apri
- Aranelle (28)
- Aubra
- Aviane
- Azilect
- Azopt
- Azurette (28)
- Balziva (28)
- Beyaz
- Brevicon (28)
- Briellyn
- brinzolamide
- brinzolamide-brimonidine
- bromocriptine
- cabergoline
- Cafergot
- Camila
- Camrese
- Camrese Lo
- Caziant (28)
- Chateal
- clomipramine
- Compound 347
- Cosopt
- Cosopt Pf
- Cryselle (28)
- Cyclafem 1/35 (28)
- Cyclafem 7/7/7 (28)
- Cyclessa (28)
- cyclobenzaprine
- cyclobenzaprine with msm
- Cycloset
- D.h.e.45
- Dasetta 1/35 (28)
- Dasetta 7/7/7 (28)
- Datscan
- Daysee
- desipramine
- desog-e.estradiol/e.estradiol
- Desogen
- desogestrel-ethinyl estradiol
- Diamox Sequels
- dihydroergotamine
- dorzolamide
- dorzolamide-timolol
- dorzolamide-timolol (PF)
- doxepin
- drospirenone-e.estradiol-lm.FA
- drospirenone-ethinyl estradiol
- Eldepryl
- Elinest
- Emoquette
- enflurane
- Enpresse
- Enskyce
- ergoloid
- Ergomar
- ergotamine tartrate
- ergotamine-caffeine
- Errin
- Estarylla
- estradiol valerate-dienogest
- Estrostep Fe-28
- ethynodiol diac-eth estradiol
- etonogestrel
- etonogestrel-ethinyl estradiol
- Falmina (28)
- Femcon Fe
- Forane
- Generess Fe
- Gianvi (28)
- Gildagia
- Gildess
- Gildess Fe
- Heather
- imipramine HCl
- imipramine pamoate
- Introvale
- ioflupane I 123
- isoflurane
- Jencycla
- Jolessa
- Jolivette
- Junel 1.5/30 (21)
- Junel 1/20 (21)
- Junel Fe 1.5/30 (28)
- Junel Fe 1/20 (28)
- Kariva (28)
- Kelnor 1/35 (28)
- Kurvelo
- L norgest&E estradiol-E estrad
- Larin 1/20 (21)
- Larin Fe
- Leena 28
- Lessina
- Levonest (28)
- levonorg-eth estrad triphasic
- levonorgestrel
- levonorgestrel-ethinyl estrad
- Levora 0.15/30 (28)
- Levora-28
- linezolid
- Lo Loestrin Fe
- Loestrin 1.5/30 (21)
- Loestrin 1/20 (21)
- Loestrin Fe 1.5/30 (28)
- Loestrin Fe 1/20 (28)
- Lomedia 24 Fe
- Loryna (28)
- Loseasonique
- Low-ogestrel (28)
- Lutera (28)
- Lyza
- maprotiline
- Marlissa
- methazolamide
- methylergonovine
- Microgestin 1.5/30 (21)
- Microgestin 1/20 (21)
- Microgestin Fe 1.5/30 (28)
- Microgestin Fe 1/20 (28)
- Migergot
- Migranal
- Minastrin 24 Fe
- Mircette (28)
- Mirena
- Modicon (28)
- Mono-linyah
- Mononessa (28)
- My Way
- Myzilra
- Natazia
- Necon 0.5/35 (28)
- Necon 1/35 (28)
- Necon 1/50 (28)
- Necon 10/11 (28)
- Necon 7/7/7 (28)
- Neptazane
- Nexplanon
- Next Choice One Dose
- Nor-qd
- Nora-be
- norelgestrom-ethinyl estradiol
- noreth-ethinyl estradiol-iron
- norethin-e.estradiol triphasic
- norethin-eth estrad biphasic
- norethindrone (contraceptive)
- norethindrone ac-eth estradiol
- norethindrone-e.estradiol-iron
- norethindrone-ethin estradiol
- norethindrone-mestranol
- norgestimate-ethinyl estradiol
- norgestrel-ethinyl estradiol
- Norinyl 1+35 (28)
- Norinyl 1+50 (28)
- Norpramin
- Nortrel 0.5/35 (28)
- Nortrel 1/35 (21)
- Nortrel 1/35 (28)
- Nortrel 7/7/7 (28)
- nortriptyline
- Nuvaring
- Ocella
- Ogestrel (28)
- Orsythia
- Ortho Evra
- Ortho Micronor
- Ortho Tri-cyclen (28)
- Ortho Tri-cyclen Lo (28)
- Ortho-cept (28)
- Ortho-cyclen (28)
- Ortho-novum 1/35 (28)
- Ortho-novum 7/7/7 (28)
- Ovcon-35 (28)
- Pamelor
- Parlodel
- perphenazine-amitriptyline
- Philith
- Pimtrea (28)
- Pirmella
- Plan B One-step
- Portia
- Previfem
- protriptyline
- Prudoxin
- Quartette
- Quasense
- rasagiline
- Reclipsen (28)
- Safyral
- Seasonique
- selegiline HCl
- sevoflurane
- Silenor
- Simbrinza
- Skyla
- Sojourn
- Sprintec (28)
- Sronyx
- Surmontil
- Syeda
- Tabradol
- Terrell
- Tilia Fe
- Tofranil
- Tofranil-pm
- Tri-estarylla
- Tri-legest Fe
- Tri-linyah
- Tri-norinyl (28)
- Tri-previfem (28)
- Tri-sprintec (28)
- trimipramine
- Trinessa (28)
- Trivora (28)
- Trusopt
- Ultane
- Velivet Triphasic Regimen (28)
- Vestura (28)
- Viorele (28)
- Vivactil
- Vyfemla (28)
- Wera (28)
- Wymzya Fe
- Yasmin (28)
- Yaz 28
- Zarah
- Zelapar
- Zenchent (28)
- Zenchent Fe
- Zeosa
- Zonalon
- Zovia 1/35E (28)
- Zovia 1/50E (28)
- Zyvox
Severe
Moderate
- Brisdelle
- Celexa
- citalopram
- Cymbalta
- Depacon
- Depakene
- Depakote
- Depakote Er
- Depakote Sprinkles
- desvenlafaxine
- desvenlafaxine fumarate
- desvenlafaxine succinate
- divalproex
- duloxetine
- Effexor Xr
- escitalopram oxalate
- Fetzima
- fluoxetine
- fluvoxamine
- Khedezla
- levomilnacipran
- Lexapro
- Luvox Cr
- milnacipran
- olanzapine-fluoxetine
- paroxetine HCl
- paroxetine mesylate
- Paxil
- Paxil Cr
- Pexeva
- Pristiq
- Prozac
- Prozac Weekly
- Sarafem
- Savella
- sertraline
- Stavzor
- Symbyax
- valproate sodium
- valproic acid
- valproic acid (as sodium salt)
- venlafaxine
- Viibryd
- vilazodone
- Zoloft
- 30 day risk period post-myocardial infarction
- Angina
- Cardiac arrhythmia
- Chronic heart failure
- Drug abuse
- Glaucoma
- History of cerebrovascular accident
- Hyperthyroidism
- Lactating mother
- Pregnancy
- Secondary angle-closure glaucoma
- Severe uncontrolled hypertension
Contraindicated
- Acute confusion
- Alcoholism
- Chronic kidney disease stage 3A (moderate) GFR 45-59
- Chronic kidney disease stage 3B (moderate) GFR 30-44
- Chronic kidney disease stage 4 (severe) GFR 15-29 ml/min
- Chronic kidney disease stage 5 (failure) GFr<15 ml/min
- Concentration difficulty
- Depression
- Fever
- Kidney disease with likely reduction in GFR
- Memory impairment
- Metabolic acidosis
- Ocular hypertension
- Pregnancy
- Psychotic disorder
- Reduced visual acuity
- Suicidal ideation
Severe
Moderate
- Arginase deficiency
- Arginosuccinate lyase deficiency
- Carbamoyl phosphate synthetase deficiency
- Citrullinemia
- Diabetes mellitus
- Diarrhea
- Disease of liver
- Hyperammonemia in n-acetylglutamate synthase deficiency
- Kidney disease with reduction in GFR
- Kidney stone
- Mild hypertension
- Ornithine carbamoyltransferase deficiency
- Paresthesia
QSYMIA (PHENTERMINE HCL/TOPIRAMATE)
- Weight loss management for obese patient (bmi >= 30)
- Wt loss mgmt, pt with bmi 27-29 & wt-related comorbidity
- Hypertension
- Acute abdominal pain
- Acute confusion
- Anorexia
- Behavioral disorders
- Bradykinesia
- Concentration difficulty
- Diplopia
- Dizziness
- Drowsy
- Dysarthria
- Dysgeusia
- Dysmenorrhea
- Fatigue
- Fever
- Flushing
- General weakness
- Hypesthesia
- Insomnia
- Irregular menstrual periods
- Mastalgia
- Memory impairment
- Nausea
- Nervousness
- Nystagmus
- Paresthesia
- Weight loss
- Xerostomia
More Frequent
Severe
Less Severe
- Allergic dermatitis
- Cardiac arrhythmia
- Infection
- Kidney stone
- Leukopenia
- Urticaria
- Acute abdominal pain
- Aggressive behavior
- Agitation
- Alopecia
- Altered mental status
- Arthralgias
- Ataxia
- Back pain
- Blurred vision
- Bronchitis
- Chest pain
- Constipation
- Cough
- Depression
- Diarrhea
- Dizziness
- Dysgeusia
- Dyspepsia
- Dysuria
- Ecchymosis
- Edema
- Epistaxis
- Euphoria
- Flushing
- Gastroenteritis
- Gingivitis
- Headache disorder
- Hemorrhage
- Hypertonia
- Involuntary muscle movement
- Libido changes
- Limb pain
- Mood changes
- Palpitations
- Pharyngitis
- Premature ejaculation
- Purpura
- Rhinitis
- Sinusitis
- Skin rash
- Symptoms of anxiety
- Tachycardia
- Tinnitus
- Tremor
- Upper respiratory infection
- Urinary tract infection
- Viral infection
- Vomiting
- Xerostomia
Less Frequent
Severe
Less Severe
Rare / Very Rare
Severe
- Anemia
- Asthma
- Bullous dermatitis
- Decreased sweating
- Drug-induced psychosis
- Encephalopathy
- Eosinophilia
- Erythema multiforme
- Hallucinations
- Hepatic failure
- Hepatitis
- Hyperammonemia
- Hypotension
- Hypothermia
- Kidney disease with reduction in GFR
- Maculopathy
- Metabolic acidosis
- Myocardial ischemia
- Myopia
- Nephrocalcinosis
- Ocular hypertension
- Pancreatitis
- Pemphigus
- Pneumonia
- Pulmonary hypertension
- Scotomata
- Secondary angle-closure glaucoma
- Stevens-johnson syndrome
- Suicidal
- Suicidal ideation
- Toxic epidermal necrolysis
- Valvular heart disease
Less Severe
- Abnormal vaginal bleeding
- Acne vulgaris
- Chills
- Conjunctivitis
- Dysphoric mood
- Dyspnea
- Dysuria
- Erectile dysfunction
- Flu-like symptoms
- Gastroesophageal reflux disease
- Gingival bleeding
- Headache disorder
- Hematuria
- Hyperhidrosis
- Increased urinary frequency
- Myalgias
- Nausea
- Ocular pain
- Ocular redness
- Orthostatic hypotension
- Polydipsia
- Pruritus of skin
- Skin rash
- Syncope
- Urinary incontinence
- Vertigo
- Visual changes
- Visual field defect
- Vulvovaginal candidiasis
Contraindicated
None
Severe Precaution
Topiramate_Phentermine
Risks include acidosis, hyperammonemia, decreased sweating, attention or memory disturbance, suicidal ideation. Manufacturer does not recommend use in pediatrics.
- 1 Day – 18 Years
- Risks include acidosis, hyperammonemia, decreased sweating, attention or memory disturbance, suicidal ideation. Manufacturer does not recommend use in pediatrics.
Management or Monitoring Precaution
None
Phentermine
- Severity Level:
X
- Additional Notes: Serious adverse effects possible
Topiramate
- Severity Level:
D
- Additional Notes: Data from pregnancy registry show increased risk of orofacial cleft
Contraindicated
Phentermine
Insuff data avail; mw low, excretion possible; other amphetamines excreted
General | Excretion Potential | Effect on Infant | Notes |
Drug should not be given to breast feeding mothers | Unknown | Not known; no or inclusive data | Insuff data avail; mw low, excretion possible; other amphetamines excreted |
Precaution Exists
Topiramate
Monitor for signs of toxicity; may cause sedation,irritability,feeding problm
General | Excretion Potential | Effect on Infant | Notes |
Evaluate use carefully | Excreted | Not known; no or inclusive data | Monitor for signs of toxicity; may cause sedation,irritability,feeding problm |
No Known Risk
None
General | Excretion Potential | Effect on Infant | Notes |
None |
Contraindicated
None
Precaution Exists
Phentermine
Cardiovascular-Limited usage data in the elderly. Contraindicated in severe hypertension, coronary insufficiency or peripheral vascular disease. Renal-Urinary excretion of 62-85%. Use caution with renal impairment to minimize adverse events. Neuro/Psych-May worsen insomnia. Ocular-Contraindicated in patients with glaucoma.
Renal-Decrease dose for CrCl < 70 mL/min. to minimize CNS toxicities. Neuro/Psych-Can cause cognitive impairment, ataxia, impaired psychomotor function, syncope, and increase risk for additional falls in those predisposed. Vision-Visual field defects have been reported in patients receiving topiramate independent of elevated intraocular pressure. In clinical trials, most of these events were reversible after topiramate discontinuation.
Organ / System | HEP | REN | CARD | ENDO | NEURO / PSYCH | PULM |
Increased Risk / Adverse Effects | Y | N | Y | Y | N | N |
BEERS: N HEDIS: N STOPP: N
Topiramate
Cardiovascular-Limited usage data in the elderly. Contraindicated in severe hypertension, coronary insufficiency or peripheral vascular disease. Renal-Urinary excretion of 62-85%. Use caution with renal impairment to minimize adverse events. Neuro/Psych-May worsen insomnia. Ocular-Contraindicated in patients with glaucoma.
Renal-Decrease dose for CrCl < 70 mL/min. to minimize CNS toxicities. Neuro/Psych-Can cause cognitive impairment, ataxia, impaired psychomotor function, syncope, and increase risk for additional falls in those predisposed. Vision-Visual field defects have been reported in patients receiving topiramate independent of elevated intraocular pressure. In clinical trials, most of these events were reversible after topiramate discontinuation.
Organ / System | HEP | REN | CARD | ENDO | NEURO / PSYCH | PULM |
Increased Risk / Adverse Effects | Y | N | N | Y | N | N |
BEERS: Y HEDIS: Y STOPP: Y
No Known Risk
None
- None
Weight loss management for obese patient (bmi >= 30) | |
E66 | Overweight and obesity |
E66.0 | Obesity due to excess calories |
E66.01 | Morbid (severe) obesity due to excess calories |
E66.09 | Other obesity due to excess calories |
E66.1 | Drug-induced obesity |
E66.2 | Morbid (severe) obesity with alveolar hypoventilation |
E66.8 | Other obesity |
E66.9 | Obesity, unspecified |
Z68.3 | Body mass index (BMi) 30-39, adult |
Z68.30 | Body mass index (BMi) 30.0-30.9, adult |
Z68.31 | Body mass index (BMi) 31.0-31.9, adult |
Z68.32 | Body mass index (BMi) 32.0-32.9, adult |
Z68.33 | Body mass index (BMi) 33.0-33.9, adult |
Z68.34 | Body mass index (BMi) 34.0-34.9, adult |
Z68.35 | Body mass index (BMi) 35.0-35.9, adult |
Z68.36 | Body mass index (BMi) 36.0-36.9, adult |
Z68.37 | Body mass index (BMi) 37.0-37.9, adult |
Z68.38 | Body mass index (BMi) 38.0-38.9, adult |
Z68.39 | Body mass index (BMi) 39.0-39.9, adult |
Z68.4 | Body mass index (BMi) 40 or greater, adult |
Z68.41 | Body mass index (BMi) 40.0-44.9, adult |
Z68.42 | Body mass index (BMi) 45.0-49.9, adult |
Z68.43 | Body mass index (BMi) 50.0-59.9, adult |
Z68.44 | Body mass index (BMi) 60.0-69.9, adult |
Z68.45 | Body mass index (BMi) 70 or greater, adult |
Wt loss mgmt, pt with bmi 27-29 & wt-related comorbidity | |
E66.3 | Overweight |
Z68.27 | Body mass index (BMi) 27.0-27.9, adult |
Z68.28 | Body mass index (BMi) 28.0-28.9, adult |
Z68.29 | Body mass index (BMi) 29.0-29.9, adult |
0-9 | A-Z |
---|---|
E66 | Overweight and obesity |
E66.0 | Obesity due to excess calories |
E66.01 | Morbid (severe) obesity due to excess calories |
E66.09 | Other obesity due to excess calories |
E66.1 | Drug-induced obesity |
E66.2 | Morbid (severe) obesity with alveolar hypoventilation |
E66.3 | Overweight |
E66.8 | Other obesity |
E66.9 | Obesity, unspecified |
Z68.27 | Body mass index (BMi) 27.0-27.9, adult |
Z68.28 | Body mass index (BMi) 28.0-28.9, adult |
Z68.29 | Body mass index (BMi) 29.0-29.9, adult |
Z68.3 | Body mass index (BMi) 30-39, adult |
Z68.30 | Body mass index (BMi) 30.0-30.9, adult |
Z68.31 | Body mass index (BMi) 31.0-31.9, adult |
Z68.32 | Body mass index (BMi) 32.0-32.9, adult |
Z68.33 | Body mass index (BMi) 33.0-33.9, adult |
Z68.34 | Body mass index (BMi) 34.0-34.9, adult |
Z68.35 | Body mass index (BMi) 35.0-35.9, adult |
Z68.36 | Body mass index (BMi) 36.0-36.9, adult |
Z68.37 | Body mass index (BMi) 37.0-37.9, adult |
Z68.38 | Body mass index (BMi) 38.0-38.9, adult |
Z68.39 | Body mass index (BMi) 39.0-39.9, adult |
Z68.4 | Body mass index (BMi) 40 or greater, adult |
Z68.41 | Body mass index (BMi) 40.0-44.9, adult |
Z68.42 | Body mass index (BMi) 45.0-49.9, adult |
Z68.43 | Body mass index (BMi) 50.0-59.9, adult |
Z68.44 | Body mass index (BMi) 60.0-69.9, adult |
Z68.45 | Body mass index (BMi) 70 or greater, adult |