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Compare Qsymia vs. Contrave

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Qsymia (phentermine/topiramate) and Contrave (naltrexone/bupropion) are both prescription medications used to help with weight loss, but they have some key differences. Qsymia combines a sympathomimetic (phentermine) and an antiepileptic (topiramate) to lower your appetite and make you feel fuller. It's taken once daily and is only available through a special program due to its risk of birth defects. Contrave, on the other hand, combines an opioid antagonist (naltrexone) and a dopamine and norepinephrine reuptake inhibitor (bupropion) to help control your appetite and food cravings. You start with a low dose and gradually increase to a maintenance dose of two tablets twice daily. Unlike Qsymia, Contrave is not a controlled substance. Both medications can cause serious side effects, including mood changes and suicidal thoughts, but Qsymia also has risks like metabolic acidosis and vision problems. Contrave should not be taken with high-fat meals to avoid the risk of seizures. Neither medication is available in a generic form.

drug combination

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Qsymia (phentermine / topiramate ER)
Contrave (naltrexone / bupropion)
Qsymia (phentermine / topiramate ER)
Contrave (naltrexone / bupropion)

Summary of Qsymia vs. Contrave

Summary for Sympathomimetic / Antiepileptic
Prescription only

Qsymia (phentermine / topiramate extended release) is a combination medication used to help with weight loss. It's approved for people over 12 who are considered obese and for some adults who are considered overweight. This medication is a tablet that you take once a day. You should also eat a balanced diet and exercise regularly for best results. Side effects include a "pins-and-needles" feeling, dry mouth, and constipation. You can only get this medication through the Qsymia REMS (Risk Evaluation and Mitigation Strategies) program because of the risk of birth defects if taken during pregnancy.

Summary for Opioid antagonist / Dopamine and norepinephrine reuptake inhibitor
Prescription only

Contrave (naltrexone / bupropion) is used along with a lower-calorie diet and exercise routine to help with weight loss for certain adults. This combination medication is a tablet that's taken by mouth. The dosage is slowly raised over the first 3 weeks of treatment until you reach the maintenance dosage of two tablets twice daily. Common side effects include nausea, constipation, and headache. But it can also have more serious risks, such as unusual changes in behavior.

Indications of Qsymia vs. Contrave

Indications for
•Weight loss and long-term weight management, together with diet and exercise, for certain people:
•People age 12 years and older considered obese
•Adults considered overweight with at least one weight-related condition (e.g., heart disease, high blood pressure, Type 2 diabetes)
Indications for
•Long-term treatment for weight management in adults with a body mass index (BMI) of 30 kg/m2 or greater; or BMI of 27 kg/m2 or greater and a weight-related condition (e.g., high blood pressure, Type 2 diabetes, high cholesterol)

Pros and Cons of Qsymia vs. Contrave

Pros and Const for Sympathomimetic / Antiepileptic
Pros
•A pill that's taken once a day
•Combines two ingredients that help lower appetite into one pill for convenience
•An option for certain children 12 years and older, if diet and exercise aren't enough
Cons
•Can raise the risk of depression or thoughts of self-harm
•Controlled substance and only available through a REMS program
•Not safe during pregnancy
Pros and Const for Opioid antagonist / Dopamine and norepinephrine reuptake inhibitor
Pros
•Is a tablet that's taken by mouth
•Can see results in as early as 4 weeks (when it's taken along with a balanced diet and regular exercise)
•Combines 2 different medications into a single pill to help with weight
Cons
•Must take twice a day (after the dose ramp-up at the beginning)
•Might raise your risk for unusual behavior and thoughts of self-harm
•Not available as a lower-cost generic

Common Side Effects of Qsymia vs. Contrave

Common Side Effects for

Adults:

•Feeling of pins and needles (up to 20%)
•Dry mouth (up to 19%)
•Constipation (up to 16%)
•Upper respiratory tract infection (up to 16%)
•Headache (up to 11%)
•Change in taste (up to 9%)
•Trouble sleeping (up to 9%)
•Dizziness (up to 9%)

Children:

•Depression (up to 4%)
•Nausea (up to 4%)
•Fever (up to 4%)
•Dizziness (up to 4%)
•Joint pain (up to 4%)
Common Side Effects for
•Nausea (33%)
•Constipation (19%)
•Headache (18%)
•Vomiting (11%)
•Dizziness (10%)
•Trouble sleeping (9%)
•Dry mouth (8%)
•Diarrhea (7%)

Warnings of Qsymia vs. Contrave

Common Side Effects for
•Harm to an unborn baby
•Mood problems and suicidal thoughts or behavior
•Fast heart beat
•Vision problems
•Problems concentrating
•Higher level of acid in blood (metabolic acidosis)
•Possible lower kidney function
•Kidney stones
•High body temperature and inability to sweat
•Serious allergic reactions and skin reactions
•Possible slowed growth in children
Common Side Effects for
•Suicidal thoughts and behavior
•Changes in thoughts, behavior, and mood
•Seizures
•Don't take Contrave with opioid medications
•High blood pressure and fast heart rate
•Liver problems
•Extreme enthusiasm or excitement (mania)
•Worsening of glaucoma
•Potential risk for low blood sugar in certain people with Type 2 diabetes

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