Understanding and Managing the Side Effects of Qsymia


Medications like Qsymia have become popular because of their ability to help people with weight loss achieve and maintain a healthy body weight.

While Qsymia has a number of benefits that can enhance your overall health, this medication is known to cause a number of uncomfortable side effects.

That’s why knowing what to expect before you start using this drug is essential for managing any adverse reactions and seeking professional help when necessary.

In this article, we’ll discuss everything you need to know about the side effects of Qsymia, as well as tips on how you can mitigate any negative reactions related to this drug.

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What is Qsymia and What is it Used for?

Qsymia is an FDA-approved chronic weight management drug used to treat conditions linked to being overweight, and their related health concerns.

The drug is currently approved for use in adults and children aged 12 and older. It’s made up of a combination of two ingredients — phentermine and topiramate.

Phentermine acts as an appetite suppressant, while topiramate is an anticonvulsant believed to enhance satiety.

Together, phentermine and topiramate will make you feel fuller for longer and may reduce compulsive eating habits.

This drug is usually prescribed alongside an approved exercise regime, lifestyle changes, and a reduced-calorie diet to promote sustainable weight loss.

Key Point: Who Should Avoid Using Qsymia?

Although Qsymia treatment is generally safe for most people, certain groups should avoid this medication. This includes:

  • Women who are currently pregnant or planning to fall pregnant
  • Individuals with cardiac or cerebrovascular disease, like high blood pressure
  • People with existing mental health concerns, like depression
  • People with glaucoma
  • Individuals taking monoamine oxidase inhibitors (MAOIs)
  • People who are allergic to any of the ingredients used in Qsymia (phentermine and topiramate)

If you fall into any of these groups, your doctor may recommend an alternative drug that can produce the same results as Qsymia to ensure your safety.

Does Qsymia Cause Any Side Effects?

Qsymia is known to cause a number of side effects, ranging from mild to severe.

Understanding when your reactions are serious is essential to ensure you know when to seek emergency medical attention.

Mild-to-moderate side effects

Experiencing mild-to-moderate side effects of Qsymia are common and may include:

  • Dizziness

  • Drowsiness

  • Dry mouth

  • Constipation

  • Runny nose

  • Trouble sleeping

  • Tiredness

  • Tingling hands or feet

  • Joint pain

  • A metallic taste in the mouth

These side effects usually develop when you first start using the drug and tend to improve as the body adjusts to the dosage.

Serious side effects

Although they are rare, serious side effects may also occur when using Qsymia. These may include:

  • Temporary difficulties concentrating

  • Cognitive impairment

  • Signs of kidney stones, such as painful urination, increased body * temperature, chills, and pink or bloody urine

  • Rapid breathing

  • Irregular heartbeat

  • Severe joint pain

  • Loss of consciousness

  • Changes in sexual ability and interest

  • Unusual bleeding or bruising

  • Mental health issues, including depression, suicidal thoughts, and self-harm attempts

  • Panic attacks

  • Increased risk of mania

  • Serious skin reactions

  • Loss of vision

  • Chest pain

  • Chills

If you notice any of these reactions, it’s important to seek emergency care as soon as possible. These side effects can cause serious complications and may even be fatal if left untreated.

Key Point: Does Qsymia Have a Boxed Warning?

Although Qsymia doesn’t currently have a boxed warning for any severe reactions, it does provide an important set of precautions to be aware of.

Topiramate — one of the ingredients used in Qsymia — is known to increase the risk of suicidal thoughts and depression.

The FDA recommends appropriate medical monitoring of patients to spot new or worsening symptoms of mental health issues.

Stop using Qsymia if you experience any of these thoughts or feelings, and seek prompt medical attention.

Topiramate can also cause a condition called acute angle closure glaucoma — a sudden onset of severe eye pain or headaches associated with blurred vision, nausea, and vomiting — that can result in permanent vision loss.

It’s also recommended to discontinue the use of Qsymia if you experience signs of this condition to prevent further complications.

How Long Does it Take for the Side Effects of Qsymia to Develop?

Understanding when you can expect side effects of Qsymia to develop can help you anticipate and manage any adverse reactions you may experience.

It’s important to note that the onset of these side effects will vary depending on a person’s genetics, overall health, and drug tolerance.

Early-onset side effects

Early-onset side effects are usually mild and tend to appear within the first few days to weeks of starting Qsymia. These may include reactions like:

  • Dry mouth

  • Dizziness

  • A metallic taste in the mouth

These side effects won’t usually have a significant impact on your day-to-day activities, but they can be uncomfortable to deal with.

Luckily, they will typically resolve within a few weeks. If they persist, make an appointment to see your doctor to determine an appropriate way to manage them.

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Delayed-onset side effects

Other side effects — especially those that are more severe — may only develop after you have been taking Qsymia for a long period of time. These delayed adverse effects may include:

  • Mood changes

  • Cognitive impairment

  • Vision problems

  • Heart-related issues

If you are experiencing any of these side effects, contact your doctor immediately.

Developing serious side effects may be an indication that Qsymia isn’t the right medication for you or that you require a significant dose reduction for the medication to be tolerable.

It’s important to carefully monitor your symptoms when using Qsymia and discuss any concerns with your doctor.

This helps them determine if they should recommend alternative medications or if you require additional treatment to help you manage your discomfort.

How Long Do These Side Effects Typically Last?

The duration of Qsymia side effects will vary from person to person. In most cases, side effects will start to resolve within a few weeks or as soon as your body has adjusted to the medication.

Although rare, side effects may persist throughout the duration of your treatment, but should become more tolerable over time.

It’s important to note that side effects may worsen with extended use of Qsymia, so it’s essential to speak to your doctor about how you can manage any discomfort.

Managing Qsymia Side Effects

While it may not be possible to prevent all the side effects of Qsymia, there are a few things you can do to manage them and reduce their impact on your daily life.

Follow dosage guidelines

Following the dosage instructions provided by your doctor is essential for minimizing adverse reactions.

Your dosage will be chosen with your individual health and underlying conditions in mind, so adhering to it is always recommended.

Doing this also helps you avoid overdosing on Qsymia, which can lead to prolonged discomfort and other, more severe symptoms.

Use over-the-counter (OTC) medication

For mild-to-moderate side effects, your doctor may recommend OTC medication to alleviate your discomfort. These can include:

  • Artificial saliva substitutes for dry mouth

  • Stool softeners or laxatives to prevent constipation

  • Topical or oral pain relievers for joint pain

If your doctor hasn’t suggested any OTC medications and you want to use one, it’s important to consult a health care provider first.

This helps to ensure that you avoid negative drug interactions with Qsymia that can cause existing side effects to get worse.

Make lifestyle adjustments

Implementing certain lifestyle changes can also help you manage adverse effects and improve your overall well-being. These may include:

  • Staying well-hydrated to prevent dry mouth and fatigue

  • Making healthier dietary choices to avoid gastrointestinal issues, like metabolic acidosis

  • Practicing stress management techniques and getting regular exercise to help mitigate mood-related reactions

  • Getting enough sleep

  • Avoiding substances like recreational drugs and alcohol that may exacerbate side effects

You can also ask your doctor about any lifestyle changes specific to your circumstances that can help you manage adverse reactions more effectively.

Frequently Asked Questions About Qsymia

Does Qsymia cause anxiety?

Topiramate — one of the ingredients used in Qsymia — can cause mental health issues like anxiety. This may cause you to feel a false or unusual sense of unease, worry, or fear that can vary in intensity.

You may also experience restlessness, irritability, difficulty concentrating, muscle tension, and sleep disturbances.

If you experience any of these symptoms after taking Qsymia, or your symptoms are worsening, it’s important to notify your doctor right away to prevent more serious complications.

How can Qsymia affect pregnancy?

Qsymia is not recommended for pregnant women, because it can be toxic to the fetus. Using this drug during pregnancy can cause cleft lip and palate.

If you suspect you might be pregnant or have had unprotected sex before you start using Qsymia, it’s recommended to take a pregnancy test first, as this birth defect occurs early in pregnancy.

Your doctor may also require you to present a negative pregnancy test before they provide you with a prescription for Qsymia.

While taking Qsymia, it’s also a good idea to take a test every month to ensure that you aren’t pregnant and harm your unborn baby without knowing.

Your doctor will also recommend using birth control pills or other barrier methods to ensure you don’t fall pregnant.

If you do become pregnant while on Qsymia, you should stop taking the drug immediately and tell your healthcare provider right away.

They will have to report this to the FDA MedWatch because of the high risk associated with using Qsymia when pregnant.

Will side effects resolve if I stop taking Qysmia?

In most cases, the side effects of Qsymia should resolve when you stop taking the medication.

However, there is no way to determine how quickly this will happen.

You may still experience some mild discomfort while the drug passes through your system — this can last for a few weeks.

Factors like your overall well-being and drug tolerance can also play a role in how long side effects take to resolve.

Early onset side effects are more likely to subside quickly compared to delayed reactions that are more complex.

Before you stop using Qsymia, it’s recommended to discuss this with your doctor.

They can help by recommending a safe way to discontinue your use without the risk of developing withdrawal symptoms and other health complications.

Who should avoid taking Qysmia?

Qsymia should be avoided by individuals with abnormal heart rhythms. Phentermine — one of its components — is known to elevate blood pressure and heart rate.

When Should You See a Doctor About Qsymia Side Effects?

If you experience severe or life-threatening side effects — such as signs of kidney stones or mood changes — seek immediate medical attention.

Additionally, it's recommended to consult a doctor if you have persistent or worsening side effects that significantly affect your quality of life, even if they are not severe.

You should also see your doctor if you have any concerns about psychological side effects, such as depression or suicidal thoughts.

Where Can I Learn More About Qsymia and Similar Medications?

If you’re concerned about weight loss or want to know more about medications like Qsymia, LifeMD can help.

A team of doctors can provide you with information and guidance on how to effectively maintain a healthy weight and use Qsymia safely — all from the comfort of your home.

LifeMD also offers a Weight Management Program designed to help you get started on a personalized weight loss journey.

Make an appointment today to learn more about how LifeMD can help you manage your weight.

Cara Konzel, MS, RN, ACNP-BC

Cara earned her BA in Biology, BS in Nursing, and MS in Nursing — all from the University of Rochester. Cara's approach to medicine and patient care is grounded in years of experience and extensive knowledge. She combines compassion and personalized attention to ensure her patients feel valued, understood, and empowered to participate in their own health journey. Cara enjoys spending time with her three children, caring for her aging parents, and gardening.

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This article is intended for informational purposes only and should not be considered medical advice. Consult a healthcare professional or call a doctor in the case of a medical emergency.

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