Phentermine (generic) vs Qsymia (phentermine/topiramate)
Qsymia (phentermine/topiramate) is the better choice of the two (halfrx score 6.9 against 3.1).
Computed from the stored fields, so it moves when a price does. Nothing here is written by hand or by a model.
Qsymia (phentermine/topiramate) or Phentermine (generic): which publishes a price?
Only one of these two publishes a verified all-in price, which settles the comparison before any other axis is reached: Qsymia (phentermine/topiramate) at $70–$98, and no figure at all for the other. Qsymia (phentermine/topiramate) is the better choice of the two (halfrx score 6.9 against 3.1). Every axis below is computed from stored fields rather than written by hand, so the comparison moves when a price does. Neither carries an FTC action, a state action, a BBB F grade or an FDA warning letter. One is generic and the other brand, which is the difference between an FDA-approved product and a copy made under the compounding exemption. The published formula scores them 3.1 and 6.9 out of 10, arithmetic over the same stored fields rather than an editor's preference.
Head to head
| What decides it | Phentermine price unverified | Qsymia $70–$98/mo |
|---|---|---|
| Entry priceNot comparable — Phentermine (generic) publishes no verified all-in price. | not comparable | not comparable |
| Regulatory and complaint riskNeither carries a lawsuit, state action or FDA-approval flag. | level | level |
| Brand vs compoundedQsymia (phentermine/topiramate) supplies FDA-approved branded medication; Phentermine (generic) supplies compounded, which the FDA does not review for safety, efficacy or quality and which can stop shipping if its pharmacy is enjoined. | level | level |
Read the price gap carefully: these two are not the same purchase
- They share phentermine but not its legal status: Qsymia (phentermine/topiramate) supplies the FDA-approved product and Phentermine (generic) supplies a generic version, so the cheaper figure is not the same purchase.
Phentermine (generic)
Pros
- +The cheapest drug in the category by two orders of magnitude: $0.068 a tablet at pharmacy acquisition cost against $263 for one Zepbound pen.[2]
- +Covered by more Medicaid programmes than any GLP-1 — seven states cover an older weight-loss agent while covering no GLP-1 at all.[3]
- +One tablet each morning, no injection, no titration schedule beyond a possible half dose.[1]
Cons
- −Approved for a few weeks only. Every monthly subscription selling it as ongoing therapy is using it off the label's own duration.[1]
- −Schedule IV controlled substance, chemically related to the amphetamines, with the dependence warnings that follow from that.[1]
- −Stopping after prolonged high dosing brings extreme fatigue and depression, per the label — which is a hard exit from a subscription that sold it as maintenance.[1]
- −No cardiovascular outcome data of the kind the GLP-1s now carry, and contraindicated where blood pressure is uncontrolled.[1]
Qsymia (phentermine/topiramate)
Pros
- +6.6–8.6% mean weight loss depending on dose — the strongest result available from an oral non-GLP-1 drug.[2]
- +$98/mo through Qsymia Engage, and generic phentermine/topiramate ER runs roughly $50–$100 — an order of magnitude under branded GLP-1 list prices.[3]
- +Approved down to age 12, where the newer agents have narrower labels.[2]
Cons
- −Topiramate raises the risk of oral clefts when taken in the first trimester. Qsymia is restricted under an FDA REMS requiring a negative pregnancy test before starting and monthly thereafter, plus effective contraception.[1]
- −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]
- −Even at the top dose it trails tirzepatide by more than half.[2]
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.