Is Qsymia or Wegovy pill better for weight loss?

Qsymia reports 9.8% average weight loss and Wegovy pill 13.6%, each from its own trial. The two were not compared against each other, so the higher figure is not a result of a head-to-head and this page does not present it as one. What is comparable is what each costs, below.

Which is cheaper, Qsymia or Wegovy pill?

Qsymia, at $75 a month against $299 — a difference of $224 a month, or $2,688 over a year counting the twelve 30-day bottles a year holds. Both figures are the maintenance price rather than an introductory rate.

Can you switch between Qsymia and Wegovy pill?

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.

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Qsymia (phentermine/topiramate) vs Wegovy pill (oral semaglutide 25 mg)

Verdict

Qsymia is the better choice of the two, winning on entry price (halfrx score 7.1 against 6.5).

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, Qsymia (phentermine/topiramate) or Wegovy pill (oral semaglutide 25 mg)?

Qsymia (phentermine/topiramate) is $66–$75 a month all-in, read from its own page on 2026-09-22; Wegovy pill (oral semaglutide 25 mg) is $149–$299, read from its own page on 2026-09-10. At the maintenance dose the gap is $224 a month, which is $2,688 across a year, counting 12 fills. Trial weight loss was 9.8% against 13.6%, from separate trials with different populations, so the gap is not a measured difference between the two. 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 2026-09-22 and 2026-09-10. Neither carries an FTC action, a state action, a BBB F grade or an FDA warning letter. The published formula scores them 7.1 and 6.5 out of 10, arithmetic over the same stored fields rather than an editor's preference.

Head to head

Qsymia (phentermine/topiramate) against Wegovy pill (oral semaglutide 25 mg), one row per axis, with the side that wins each axis marked.
What decides it	Qsymia $66–$75/mo	Wegovy pill $149–$299/mo
Entry priceQsymia (phentermine/topiramate) is $83/mo cheaper to start — $66 against $149.	✓ better here	—
Regulatory and complaint riskNeither carries a lawsuit, an FDA warning letter or a supply-risk flag.	tied	tied
Average weight loss in trialsQsymia (phentermine/topiramate) reports 9.8% and Wegovy pill (oral semaglutide 25 mg) 13.6%, each from its own trial. They were not compared against each other, and the populations, durations and endpoints differ, so the higher number is not a better result — it is a different study.	not comparable	not comparable

What the trials, the titration and a year actually say

Axis	Qsymia	Wegovy pill
Mean weight loss in the cited trial	9.8%	13.6%
The trial that figure comes from	CONQUER, Study 2 on the label, 56 weeks: 9.8% mean weight loss at the 15 mg/92 mg dose against 1.2% on placebo, intention-to-treat.	Study 7 on the label (NCT05564117), 64 weeks: 13.6% mean weight loss on 25 mg once daily against 2.4% on placebo, intention-to-treat.
Maintenance dose	7.5 mg / 46 mg daily	25 mg once daily
Earliest week you reach it	week 3	week 13
Year one at the published price of every step	No titration prices recorded	$3,338

Trial percentages are quoted from the label or the named trial beside them. They are not a head-to-head result: different populations, different durations, different endpoints. That is why the comparison above scores this axis as not comparable rather than awarding it to the higher number. The year-one figures walk each titration step at its published price and count the twelve 30-day bottles a year holds. The full arithmetic is published.

Go to Qsymia ↗Go to Wegovy pill ↗

Read the price gap carefully: these two are not the same purchase

These are different molecules — phentermine and topiramate against semaglutide — so this is a comparison of two treatments, not of two prices for one.
Against every medication on this site with a verified maintenance price, Qsymia (phentermine/topiramate) is the 1st cheapest of 9 and Wegovy pill (oral semaglutide 25 mg) the 3rd — the cheapest of them all is $75.

Vivus

Qsymia (phentermine/topiramate)

7.1

$66–$75/mo all-in

verified 2026-09-22

Weaker moleculeREMS restrictedControlled substance

Novo Nordisk

Wegovy pill (oral semaglutide 25 mg)

6.5

$149–$299/mo all-in

verified 2026-09-10

Newly approvedStrict dosing rulesBoxed warning

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

Wegovy pill (oral semaglutide 25 mg)

Pros

+13.6% mean weight loss on the label's own 64-week trial, intention-to-treat — the strongest result of any oral weight-loss drug approved to date.[5]
+No injections, no needle disposal, no refrigeration.[4]
+Self-pay from roughly $149/mo direct from Novo Nordisk, against $1,349 list for the injection.[3]
+Same molecule as Wegovy injection, which has years of post-marketing safety data behind it.[4]

Cons

−The $149 headline is the 1.5 mg starting month only. The 4 mg month is $199, and every month from 9 mg up — including the 25 mg dose you stay on — is $299, twice the advertised figure.[1]
−Oral semaglutide has strict dosing conditions — taken on an empty stomach with a small sip of water and nothing else for 30 minutes. Adherence in the real world is worse than in trials, which is why this site uses the label's intention-to-treat 13.6%, counting everyone randomized, and not the 16.6% the paper reports for those who kept taking it.[5]
−Telehealth programs add a membership on top of the drug — Ro and Hims both charge $149 a month on a monthly plan — while Novo sells the pill direct at $149 to $299 depending on dose.
−Its 13.6% in the label's 64-week trial is below the 20.9% tirzepatide reached in SURMOUNT-1 on Zepbound's label; these were separate trials, not a head-to-head.[8]

Sources

Qsymia side effects →Wegovy pill side effects →Qsymia dosage →Wegovy pill dosage →

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 Qsymia

Everything on Wegovy pill

Qsymia against Wegovy pill, answered

Is Qsymia or Wegovy pill better for weight loss?: Qsymia reports 9.8% average weight loss and Wegovy pill 13.6%, each from its own trial. The two were not compared against each other, so the higher figure is not a result of a head-to-head and this page does not present it as one. What is comparable is what each costs, below.
Which is cheaper, Qsymia or Wegovy pill?: Qsymia, at $75 a month against $299 — a difference of $224 a month, or $2,688 over a year counting the twelve 30-day bottles a year holds. Both figures are the maintenance price rather than an introductory rate.
Can you switch between Qsymia and Wegovy pill?: 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.