Qsymia vs. Wegovy: Differences, similarities & side effects

In this article:

• Qsymia vs. Wegovy: Key differences
• Qsymia vs. Wegovy: Conditions treated
• Is Wegovy better than Qsymia?
• Qsymia vs. Wegovy: Insurance coverage and cost comparison
• Qsymia vs. Wegovy side effects
• Qsymia and Wegovy drug interactions
• Qsymia and Wegovy drug warnings
• Can you take Qsymia and Wegovy together?

In this article

• Qsymia vs. Wegovy: Key differences
• Qsymia vs. Wegovy: Conditions treated
• Is Wegovy better than Qsymia?
• Qsymia vs. Wegovy: Insurance coverage and cost comparison
• Qsymia vs. Wegovy side effects
• Qsymia and Wegovy drug interactions
• Qsymia and Wegovy drug warnings
• Can you take Qsymia and Wegovy together?

Choosing a weight loss medication with your healthcare provider can be challenging with so many options available. Qsymia and Wegovy are two brand-name prescription drugs you might consider for managing your weight. They have both been shown to be effective for weight loss. However, they are different medications with different active ingredients. They also differ in how they’re administered, how much they cost, and their side effects and drug interactions. 

Qsymia vs. Wegovy: Key differences

Qsymia is an older drug than Wegovy, with the Food and Drug Administration (FDA) approving it in 2012. It contains a combination of two active ingredients: phentermine, an anorectic, and topiramate, an anticonvulsant. Wegovy was approved in 2021 for weight loss and contains the active ingredient semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist.

Mechanism of action

The phentermine in Qsymia stimulates the central nervous system (CNS) to reduce appetite. While the exact way topiramate works to suppress appetite is unknown, it is believed to affect the brain to increase satiety. 

Wegovy works as a GLP-1 receptor agonist that mimics a hormone that reduces hunger and can also improve blood sugar control.

Dosing and dosage forms

Qsymia is taken as an oral capsule once daily in the morning. Wegovy is administered as a once-weekly injection, which may be more convenient for some people. Both drugs are typically started at a low dose and then gradually increased to help prevent side effects. 

Qsymia vs. Wegovy: Conditions treated

Qsymia and Wegovy are both approved for chronic weight management in people with obesity who have a body mass index (BMI) of 30 or higher. They are also prescribed for people who are overweight with a BMI of 27 or higher and who have at least one weight-related health issue, such as high blood pressure, high cholesterol, or diabetes. 

Both medications can help control cravings and reduce appetite. However, they are recommended to be used alongside a reduced-calorie diet and regular physical activity. 

In addition to weight loss, Wegovy is also FDA approved to reduce the risk of heart disease-related death, heart attacks, and strokes in people with obesity or who are overweight with heart disease. 

Is Wegovy better than Qsymia?

Wegovy and Qsymia are effective obesity medications. However, clinical trials have shown that individuals may lose more weight with the 2.4 mg weekly dose of Wegovy than with the 3.75/23 mg daily dose of Qsymia after around a year of treatment. However, individuals taking the higher 15/92 mg dose of Qsymia lost nearly as much weight as those who took the 2.4 mg weekly dose of Wegovy. 

The STEP 1 trial evaluated 1,961 adults taking Wegovy who were overweight or who had obesity but did not have Type 2 diabetes. On average, people who took the treatment lost 14.9% of their body weight from baseline to week 68, while those who took a placebo lost only 2.4% of their body weight. 

A study called the EQUIP trial lasted for one year and evaluated the effects of Qsymia. Of the 1,267 adult participants with obesity who took part in the trial, the mean weight loss percentages were as follows by 56 weeks:

• For those who took a placebo: 2.1%
• For those who took a 3.75/23 mg dose: 6.7%
• For those who took a 15/92 mg dose: 14.4%

Participants in both clinical trials involved diet and exercise as part of their treatment plan.

When choosing a weight loss drug, it is important to consult a healthcare provider. They can help determine the most effective medication based on your overall medical condition and potential drug interactions.

Qsymia vs. Wegovy: Insurance coverage and cost comparison

Most commercial insurance and Medicare plans rarely cover weight-loss medications like Qsymia and Wegovy. However, insurance plans may be more likely to cover Wegovy when it’s prescribed to reduce the risk of heart attacks and strokes. 

Without insurance, the costs of Qsymia and Wegovy can vary. There are no generic versions of Qsymia and Wegovy, which can make them more expensive than generic alternatives. Qsymia costs an average retail price of around $270 for a 30-day supply, while Wegovy costs an average retail price of almost $2,000 for the same supply. 

You may be able to use discount programs like those from SingleCare to save on prescription costs. For example, coupons from SingleCare may help reduce the out-of-pocket expense for both Qsymia and Wegovy by up to 80%.

Qsymia vs. Wegovy side effects

Qsymia and Wegovy have overlapping side effects, especially gastrointestinal ones, like nausea, vomiting, diarrhea, constipation, and indigestion. However, Wegovy is more likely to cause these digestive issues than Qsymia. 

Qsymia is likely to have more side effects overall, as it combines two different active ingredients. In addition to digestive side effects, common side effects of Qsymia may include CNS stimulant effects, such as heart palpitations and anxiety. 

This may not be a complete list of adverse effects that can occur. Please refer to your healthcare provider to learn more.

Source: DailyMed (Qsymia), DailyMed (Wegovy) 

Qsymia and Wegovy drug interactions

While both drugs have interactions, their specifics vary. Qsymia mainly interacts with medications that affect the CNS, while Wegovy interacts with drugs used to manage diabetes.

Qsymia should not be taken with monoamine oxidase inhibitors (MAOIs), a class of antidepressants, because it can cause a dangerous increase in blood pressure. Also, using Qsymia with birth control pills might cause more frequent spotting, but it doesn’t make the pill less effective. 

Additionally, combining Qsymia with other drugs that make you sleepy can increase dizziness and affect your ability to drive or use machines safely. Qsymia can also affect potassium levels when taken with certain diuretics (water pills) and can interfere with anticonvulsants or anti-seizure medications, sometimes causing serious side effects like low body temperature or increased ammonia in the blood.

Wegovy may also interact with other medications but in different ways. For instance, Wegovy can affect how your body absorbs any medication taken by mouth. For people with Type 2 diabetes, Wegovy can also interact with insulin, sulfonylureas, and meglitinides. These interactions may result in low blood sugar levels, severe dizziness, or fainting episodes.

This is not a complete list of drug interactions. Please consult your healthcare provider before taking these medications.

Qsymia and Wegovy drug warnings

Qsymia and Wegovy have overlapping warnings for the following:

• Low blood sugar: Both medications can cause low blood sugar when used with insulin or insulin-boosting drugs. You may need to adjust your insulin dose.
• Mental health: Both medications can cause depression or suicidal thoughts. Stop using them if these symptoms occur.
• Allergic reactions: Severe allergic reactions can occur with both medications. Seek immediate medical help if you experience hives, rash, swelling of the face or throat, or trouble breathing.

In addition to these warnings, Qsymia carries the following warnings:

• Pregnancy risk: Qsymia can harm an unborn baby. Women who can become pregnant should have a negative pregnancy test before starting Qsymia and take one monthly during treatment. Effective birth control is recommended.
• Heart rate increase: Qsymia can raise your heart rate. Monitor heart rate, especially if you have heart or blood vessel disease.
• Eye problems: Qsymia can cause vision problems like acute myopia and glaucoma. 
• Mood and sleep disorders: Qsymia can cause mood swings and sleep problems. The dosage may need to be reduced or stopped entirely if these issues persist.
• Cognitive problems: Qsymia may cause attention, memory, or speech problems. Be cautious when driving or operating machinery.
• Growth issues in children: Qsymia can slow growth in children. The dosage may need to be reduced or stopped entirely if these issues persist.
• Metabolic acidosis: Qsymia can cause metabolic acidosis. Check electrolyte levels before and during treatment. The dosage may need to be reduced or stopped entirely if this condition develops.
• Kidney function: Qsymia can affect kidney function. Check creatinine levels before and during treatment. 
• Skin reactions: Stop using Qsymia at the first sign of a rash unless it is clearly not related to the medication.

Wegovy may also have warnings for the following:

• Thyroid cancer risk: Animal studies suggest Wegovy may cause thyroid tumors. People with a history of thyroid tumors or multiple endocrine neoplasia syndrome type 2 (MEN 2) should not use Wegovy.
• Pancreatitis: Wegovy can cause inflammation of the pancreas. 
• Gallbladder problems: Wegovy can cause issues with the gallbladder.
• Kidney injury: Wegovy can cause kidney problems. If you have severe stomach issues or kidney impairment, your kidney function may need to be monitored.
• Eye problems: Wegovy may worsen diabetic eye disease. People with a history of eye problems should be monitored.
• Heart rate increase: Wegovy can increase your heart rate. Regular monitoring is recommended.

Can you take Qsymia and Wegovy together?

Qsymia and Wegovy work in different ways and aren’t known to interact with each other. However, taking Qsymia and Wegovy together is not generally recommended, as both medications are used for weight loss and combining them may increase the risk of side effects. It’s important to consult a healthcare provider to determine the best and safest weight loss treatment plan.