Qsymia vs Wegovy

If you are interested in losing weight then there are different types of drugs that you can try. The two familiar options include Qsymia which is made up of Phentermine and Topiramate ER and Wegovy which contains Semaglutide. The two medicines are recommended for use in weight loss when used together with diet and exercise. But distinguishing the best one for you can be a problem and people often get confused between them.

To assist you with a decision on which one might be more appropriate for you, we will contrast Qsymia to Wegovy for weight loss.  

1. Unlike Wegovy, Qsymia has a different mechanism of action for use in reducing weight

Qsymia as well as Wegovy are both FDA specified for use in your daily life to assist with managing your body weight. It moderates your appetite, but the way it does, this is quite different from the way the other does it.

Qsymia contains two medications (phentermine and topiramate) that each work differently to promote weight loss: 

• Phentermine (Adipex-P, Lomaira) should be familiar to you now as a stimulant medication, which also affects how your brain controls your appetite. Phentermine is also used in the form of a mono-therapy for weight loss, but it is prescribed for short-term use.
• Topiramate belongs to the group of medications called anti-seizure drugs, it is sold under the trade name Topamax. Little is known about the mechanism by which topiramate aids in weight loss. But it appears to decrease your hunger level and make you feel full soon after eating or for a longer time after taking your meals. Topiramate is not approved for weight loss even though it is often prescribed as an off label medication.

Wegovy is a group of drugs called glucagon-like peptide-1 receptor agonists. These medicines operate in the same way as GLP-1, a hormone that helps control your hunger. Wegovy makes you feel less hungry and reduces your cravings as compared to normal circumstances. 

It also reduces the rate at which the food is pushed through your digestive system. This can make you feel full faster every time you take your meals and feel full for the longest time.

2.  Wegovy and Qsymia are used in different manners 

Wegovy and Qsymia are different from each other, and one of the most apparent differences is the manner of administration.

Wegovy is sold as the injectable solution for single use with the prefilled pens.  It is administered subcutaneously and you inject it once a week to the lower abdominal region or upper arm or thigh. The dosage used once a week is convenient to anyone who might have issues with remembering to take a drug every day. If it is difficult to swallow pills, then an injectable medicine like Wegovy is also beneficial as well.

Unlike some other Weight-Loss Medicines, Qsymia doesn’t involve an injection. The drug is in the form of an oral capsule and should be taken in the morning for one capsule daily. This may be a preferable method if you are sensitive about needles or the whole concept of injecting yourself.

3. Qsymia may take slightly longer to produce the same results than Wegovy

Wegovy usually begins to show results quite soon. Most people experience major weight loss after 4 weeks of taking the product. It can take between 8 – 12 weeks since you began taking Wegovy before you see your dose rise and be able to lose weight at a faster pace. For the majority of practitioners, dosing will begin with a lower amount gradually rising to the maintenance amount.  This can take about 4 months. However, it is still more advisable not to increase the dosage to be taken in a day than ideal suggested rate. That will just increase your chances of experiencing side effects which include nausea and diarrhea.

Studies have shown that it might take roughly 8 weeks on Qsymia before the body experiences a noticeable loss of weight. If you have lost less than 3% of your initial weight after cutting your dose, your prescriber may increase your dose after 12 weeks. Few may require a greater amount of Qsymia so that they can experience that great difference in weight loss. 

To enhance the efficacy of both drugs, you should follow an exercise regimen and a lower-calorie diet. But remember that losing weight gradually is less stressful to your body and will lead to sustainable weight loss. 

4. You may lose more weight on Wegovy than on Qsymia

So, while it would be ideal to know if either Qsymia is more effective than Wegovy or the other way around, we have no such information because the question has not been tested before. 

In the largest Wegovy study, the participants given Wegovy shed an average of 15 percent of their total body weight over a period of 68 weeks or almost 16 months. It was also found that 86% of participants in the study were losing more than 5% of their initial body weight. Furthermore it was found that 69% of the participants in the study reduced their initial body weight by at least 10%. 

In Qsymia trials, patients on Qsymia tended to lose about 8% to 10% of their weight in 56 weeks (about 13 months). Majority of the participants – 70% – shed at least 5% of their initial body weight after being under the highest dose of Qsymia for one year. And nearly half of the subjects in the study at least shed 10% of their initial weight.

From these outcomes it would seem that Wegovy leads to more overall weight loss than Qsymia. However, both are recognized as very efficient drugs for weight loss.

5. Wegovy may be a better option if you have heart disease

Wegovy is not only a weight loss product, but it has also been shown to be effective for heart health. A clinical trial showed that with Wegovy, the major adverse cardiovascular events (heart attack, stroke, cardiovascular death) can be reduced by 20% in specific patients with heart disease. It has also been demonstrated to be effective in case of some patients with the heart failure.

A single trial showed that Qsymia reduced blood pressure more effectively than the use of phentermine only or a placebo. However, it remains unknown whether it reduces the risk of cardiovascular events. Therefore, in case you are a candidate of heart disease or you are at a high risk, it is appropriate to use Wegovy to reduce your weight.

6. Qsymia and Wegovy have different ways in which they interact

A possible drug interaction may be potential when choosing between Qsymia or Wegovy.

Although it’s not a complete list, the following types of medications can interact with Wegovy:

• Certain diabetes medications: Wegovy is more likely to have low blood glucose (sugar) levels if insulin, sulfonylureas, and meglitinides, also known as “glinides,” are taken together.
• Oral medications: Wegovy helps reduce the speed at which your stomach can empty its contents into the small intestines. This might cause you to not effectively absorb any oral medication that you take including oral contraceptive pills.

Qsymia has more drug interactions to consider, including:

• MAOIs which include phenelzine (Nardil)
• Alcohol
• Benzodiazepines, antihistamines and other sedatives
• Amitriptyline
• Some antiepileptic drugs, for instance phenytoin, Dilantin
• Some types of the Diuretic medications known as the “water pills”, more specifically hydrochlorothiazide etc.

If you are currently taking a different medication that has a major interaction with Qsymia or Wegovy, another weight loss medication maybe safer for you. 

7. Wegovy and Qsymia have different risks and side effects

It is also important to note that Wegovy and Qsymia have different safety considerations as well.

Qsymia is known to comprise phentermine which is a controlled substance. This means that it is capable of being abused and becoming a point of addiction. It is also not the preferred option if you suffer from substance use disorder or have one in your family. Some of the other side effects of Qsymia are having a tingling sensation, dizziness and altered taste sensations. Others have mood swings as well.

Qsymia is claimed to be responsible for birth defects. Therefore if you are able to get pregnant the FDA recommends monthly pregnancy tests and the proper use of birth control as you take it.

Mild side effects that are observed in patients taking Wegovy are stomach upsets such as nausea, vomiting, diarrhoea or constipation. Others are headache, gas and fatigue.

Potential dangers of Wegovy for the long haul include gallbladder issues, an inflamed pancreas – pancreatitis – and blocked intestines – bowel obstruction – among other risks. It also has a boxed warning and is labeled by the FDA as a most serious medication warning because it causes risk of thyroid C-cell tumors. It is not advised for those with family history of medullary thyroid carcinoma, or multiple endocrine neoplasia syndrome type 2.

The Bottom Line

Two medications which are currently available include Qsymia (phentermine / topiramate ER) and Wegovy (semaglutide). Qsymia is a combination of two medicines, phentermine and topiramate that are used to control your hunger and make you feel that you have had enough. Wegovy is similar to GLP-1 or glucagon-like peptide-1, a hormone that plays a major role in controlling your hunger. 

Wegovy comes as an injectable and must be administered weekly; Qsymia comes as an oral capsule, and it must be taken once daily in the morning. They’re also both supposed to be used for a long term. Qsymia and Wegovy also have many side effects and some of drug interactions that should be discussed. It is important that your doctors and other members of your medical care team can analyze your medication list and medical profile to ensure that you fully understand the risks and benefits of each medicine.