Compounded semaglutide vs Qsymia (phentermine/topiramate)
Qsymia is the better choice of the two, winning on entry price, regulatory and complaint risk and approved product or compounded copy (halfrx score 7.1 against 1.9).
Computed from the stored fields, so it moves when a price does. Nothing here is written by hand or by a model.
Which is cheaper, Compounded semaglutide or Qsymia (phentermine/topiramate)?
Compounded semaglutide is $129–$349 a month all-in, the range its sellers here charge, oldest read 2026-09-13; Qsymia (phentermine/topiramate) is $66–$75, read from its own page on 2026-09-22. Every axis below is computed from stored fields rather than written by hand, so the comparison moves when a price does. They were last checked on 2026-09-13 and 2026-09-22. Flags recorded here: Compounded semaglutide — not FDA approved, supply risk. Qsymia (phentermine/topiramate) is an FDA-approved product and Compounded semaglutide is a compounded copy made under the pharmacy-compounding exemption, which is a legal status rather than a quality claim. The published formula scores them 1.9 and 7.1 out of 10, arithmetic over the same stored fields rather than an editor's preference. Cost here is scored on what a patient pays once titrated, never on the entry price, because an introductory rate covers the months before anybody has reached the dose they stay on.
Head to head
| What decides it | Compounded semaglutide $129–$349/mo | Qsymia $66–$75/mo |
|---|---|---|
| Entry priceQsymia (phentermine/topiramate) is $63/mo cheaper to start — $66 against $129. | — | ✓ better here |
| Regulatory and complaint riskCompounded semaglutide: 2 serious flags. Qsymia (phentermine/topiramate): none. | — | ✓ better here |
| Approved product or compounded copyQsymia (phentermine/topiramate) supplies an FDA-approved product; Compounded semaglutide supplies a compounded preparation, which the FDA does not review for safety, efficacy or quality and which can stop shipping if its pharmacy is enjoined. | — | ✓ better here |
What separates these two, price aside
- These are different molecules — semaglutide against phentermine and topiramate — so this is a comparison of two treatments, not of two prices for one.
Compounded semaglutide
Pros
- +$129–$349 a month puts semaglutide within reach for people who would otherwise take nothing; branded semaglutide costs $299 a month for the Wegovy pill and $349 for the pens once past the starting doses.[1]
- +Often shipped in vials with flexible dosing, so a provider can titrate in smaller steps than the fixed branded pen doses allow.[1]
Cons
- −Not FDA approved. The agency does not review compounded drugs for safety, efficacy or manufacturing quality — potency and sterility depend entirely on the individual pharmacy.[1]
- −The FDA declared the semaglutide shortage resolved, which removed the legal basis for mass compounding of copies. Providers now rely on 'personalized dose' arguments that Novo Nordisk is actively litigating.[2]
- −Supply can stop mid-titration. A court order or state action against your compounder ends your prescription with no notice — in March 2025 Washington's Pharmacy Commission issued a limited stop-service order against Aequita, the Kirkland pharmacy that then supplied Mochi Health.[3]
- −Some products are semaglutide salts (sodium or acetate) rather than the base molecule studied in trials. The FDA has warned these are different substances.[1]
Qsymia (phentermine/topiramate)
Pros
- +9.8% mean weight loss at the top dose in CONQUER, intention-to-treat — the strongest result available from an oral non-GLP-1 drug.[2]
- +$74.99/mo through Qsymia Engage home delivery for anyone, $65.99 for Costco members, and generic phentermine/topiramate ER runs roughly $50–$100 — an order of magnitude under branded GLP-1 list prices.[1]
- +Approved down to age 12, as Wegovy and Saxenda are; Zepbound is for adults only.[2]
Cons
- −Topiramate raises the risk of oral clefts when taken in the first trimester. The label recommends a negative pregnancy test before starting and every month during treatment, with effective contraception, and Qsymia is dispensed only through pharmacies certified under an FDA REMS.[6]
- −Phentermine is a controlled substance with cardiovascular contraindications.[2]
- −Cognitive side effects — word-finding difficulty and trouble concentrating — are common enough to be a frequent reason people stop.[2]
- −Its 9.8% in CONQUER is under half the 20.9% tirzepatide reached in SURMOUNT-1 on Zepbound's label, a separate trial in a different population, so this is not a head-to-head result.[7]
Sources
- [1] Qsymia Engage home delivery pricing, qsymia.com
- [2] Qsymia REMS: pregnancy testing and contraception requirements (FDA)
- [3] CONQUER: phentermine plus topiramate, phase 3 (The Lancet)
- [4] Qsymia CONQUER trial results (manufacturer HCP site)
- [5] Assessment of the REMS for phentermine–topiramate (Annals of Internal Medicine)
- [6] FDA prescribing information for QSYMIA
- [7] FDA prescribing information for ZEPBOUND
Comparisons are computed from the fields on each card, not written by hand or by a model, so they change when the data does. Information only, not medical advice. halfrx may earn a commission from some links, which never changes what a comparison says.
Everything on Compounded semaglutide
- Compounded semaglutide price and terms →
- Compounded semaglutide cost without insurance →
- Alternatives to Compounded semaglutide →
- Which labels record what happens when you stop →
- Hair loss: which of the labels name it →
- Alcohol: what the labels say, and what they do not →
- semaglutide at Strut Health: the price →
- semaglutide: every product and price →
- Ivim Health: the seller →
- Mochi Health: the seller →
- CVS MinuteClinic: the seller →
- Henry Meds: the seller →
- Noom Med: the seller →
- Shed: the seller →
- Walgreens Weight Management: the seller →
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Everything on Qsymia
- Qsymia price and terms →
- What is Qsymia? →
- Qsymia cost without insurance →
- Alternatives to Qsymia →
- Qsymia coupons and savings cards →
- Qsymia Engage →
- Qsymia side effects →
- Does Qsymia cause constipation? →
- Does Qsymia make you dizzy? →
- Does Qsymia keep you awake? →
- Does Qsymia cause dry mouth? →
- Qsymia dose schedule →
- How to take Qsymia →
- How long Qsymia takes to work →
- Which labels record what happens when you stop →
- Hair loss: which of the labels name it →
- Alcohol: what the labels say, and what they do not →
- phentermine: every product and price →
- Phentermine: the drug →
The registers and documents behind both sides
Two cards compared on the same checks. These are the registers those checks were run against, and the FDA's own pages where either side is a compounded product.
- Compounding and the FDA: questions and answers — What a compounded drug is, and what the FDA does and does not review before it is sold.
- Medications containing semaglutide marketed for type 2 diabetes or weight loss, FDA — The FDA's own notice on compounded semaglutide and what it has not evaluated.
Compounded semaglutide against Qsymia, answered
- Is Compounded semaglutide or Qsymia better for weight loss?
- Only Qsymia has a trial figure recorded here: 9.8% average weight loss, from its own label trial. Compounded semaglutide has none on this site — a compounded preparation has no trial of its own, so the two cannot be compared on effect and this page does not pick one on it.
- Which is cheaper, Compounded semaglutide or Qsymia?
- Qsymia starts lower, at $66 a month against $129. For Compounded semaglutide ($129–$349) only a starting price is published, not one for the maintenance dose, so which costs less once titrated cannot be worked out here.
- Can you switch between Compounded semaglutide and Qsymia?
- They are different molecules, so this is a change of medication rather than of brand, and the one you move to is started on its own dosing schedule.