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.
