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Please note: If you have a promotional code you'll be prompted to enter it prior to confirming your order.If you subscribe to any of our print newsletters and have never activated your online account, please activate your account below for online access. Qsymia phentermine hydrochloride 3.75 mg (base) / topiramate extended-release 23 mg (VIVUS 3.75/23) You may report side effects to VIVUS at 1-888-998-4887 or FDA at 1-800-FDA-1088.Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. "What is the best way to taper off Wellbutrin (bupropion) sr 100 mg daily?" Patients should be informed not to discontinue their combination oral contraceptive if spotting occurs, but to notify their healthcare provider if the spotting is troubling to them.Specific drug interaction studies of Qsymia and alcohol or other CNS depressant drugs have not been performed. When prescribing Qsymia, patients should be monitored for hypokalemia Qsymia was associated with changes in several clinical laboratory analytes in randomized, double-blind, placebo-controlled studies.Obtain a blood chemistry profile that includes bicarbonate, creatinine, potassium, and glucose at baseline and periodically during treatment [s The following important adverse reactions are described below and elsewhere in the labeling:Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical studies of another drug and may not reflect the rates observed in practice.The data described herein reflects exposure to Qsymia in two, 1-year, randomized, double-blind, placebo-controlled, multicenter clinical trials, and two Phase 2 supportive trials in 2318 adult patients (936 [40.4%] patients with hypertension, 309 [13.3%] patients with type 2 diabetes, 808 [34.9%] patients with BMI greater than 40 kg/m Adverse reactions reported in greater than or equal to 2% of Qsymia-treated patients and more frequently than in the placebo group are shown in Table 3.Reports of paraesthesia, characterized as tingling in hands, feet, or face, occurred in 4.2%, 13.7%, and 19.9% of patients treated with Qsymia 3.75 mg/23 mg, 7.5 mg/46 mg, and 15 mg/92 mg, respectively, compared to 1.9% of patients treated with placebo. Significantly lower maternal body weight gain was recorded at these doses in rats and rabbits.A pre- and post-natal development study was conducted in rats with combination phentermine and topiramate treatment. These adverse reactions were comprised primarily of reports of problems with attention/concentration, memory, and language (word finding). Androgens, the family of male sex hormones that includes testosterone, function as a fuel for growth in normal development. We recommend a taper from one dose to another dose to occur every 3 days (e.g. If any of these side effects get worse or last a long time, talk to your doctor.Even though the likelihood is low, some patients do experience serious side effects while taking topiramate. If cognitive dysfunction persists consider dose reduction or withdrawal of Qsymia for symptoms that are moderate to severe, bothersome, or those which fail to resolve with dose reduction.Hyperchloremic, non-anion gap, metabolic acidosis (decreased serum bicarbonate below the normal reference range in the absence of chronic respiratory alkalosis) has been reported in patients treated with Qsymia Conditions or therapies that predispose to acidosis (i.e., renal disease, severe respiratory disorders, status epilepticus, diarrhea, surgery or ketogenic diet) may be additive to the bicarbonate lowering effects of topiramate. Physical dependence manifests by drug-class-specific withdrawal symptoms after abrupt discontinuation or a significant dose reduction of a drug.Limited information on the potential for physical dependence for the individual components of Qsymia is available. Measurement of blood pressure prior to starting Qsymia and during Qsymia treatment is recommended in patients being treated for hypertension.

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