| Obesity
Qsymia vs Xenical
Side-by-side clinical, coverage, and cost comparison for obesity.Deep comparison between: Qsymia vs Xenical with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsXenical has a higher rate of injection site reactions vs Qsymia based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Xenical but not Qsymia, including UnitedHealthcare
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Category
Qsymia
Xenical
At A Glance
Oral
Once daily
Sympathomimetic amine anorectic combination
Oral
Three times daily
Gastrointestinal lipase inhibitor
Indications
- Obesity
- Obesity
Dosing
Obesity Start 3.75 mg/23 mg orally once daily in the morning for 14 days, then increase to 7.5 mg/46 mg once daily; may escalate to 11.25 mg/69 mg then 15 mg/92 mg based on weight loss response; maximum dose 7.5 mg/46 mg in moderate or severe renal impairment or moderate hepatic impairment; avoid in severe hepatic impairment and end-stage renal disease on dialysis.
Obesity One 120-mg capsule three times a day with each main meal containing fat (during or up to 1 hour after the meal); distribute daily fat, carbohydrate, and protein over three main meals.
Contraindications
- Pregnancy
- Glaucoma
- Hyperthyroidism
- Concomitant use or within 14 days of stopping a monoamine oxidase inhibitor (MAOI)
- Known hypersensitivity to phentermine, topiramate, or any excipient in QSYMIA, or idiosyncrasy to sympathomimetic amines
- Pregnancy
- Chronic malabsorption syndrome
- Cholestasis
- Known hypersensitivity to XENICAL or to any component of this product
Adverse Reactions
Most common (>=5%) Paraesthesia, dizziness, dysgeusia, insomnia, constipation, dry mouth
Serious Embryo-fetal toxicity, suicidal behavior and ideation, acute angle-closure glaucoma, mood and sleep disorders, cognitive impairment, metabolic acidosis, decreased renal function, seizure with abrupt withdrawal, kidney stones, oligohydrosis and hyperthermia, hypokalemia, DRESS/multiorgan hypersensitivity, serious skin reactions, anaphylaxis and angioedema
Postmarketing Suicidal ideation, suicidal behavior, acute angle closure glaucoma, increased intraocular pressure, urticaria, elevation of blood pressure, ischemic events, euphoria, psychosis, tremor, anaphylaxis, angioedema, bullous skin reactions (erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis), pancreatitis, hepatic failure, hyperammonemia with or without encephalopathy, maculopathy
Most common (>=5%) Oily spotting, flatus with discharge, fecal urgency, fatty/oily stool, oily evacuation, increased defecation, fecal incontinence
Postmarketing Hepatitis, hepatic failure, hypersensitivity reactions (pruritus, rash, urticaria, angioedema, bronchospasm, anaphylaxis), bullous eruption, leukocytoclastic vasculitis, acute oxalate nephropathy, pancreatitis, lower gastrointestinal bleeding
Pharmacology
Phentermine, a sympathomimetic amine, reduces appetite via hypothalamic catecholamine release; topiramate enhances satiety and suppresses appetite through GABA augmentation, voltage-gated ion channel modulation, AMPA/kainate glutamate receptor inhibition, and carbonic anhydrase inhibition, though the precise mechanism of action for weight reduction is not fully established for either component.
Orlistat is a reversible inhibitor of gastrointestinal lipases that forms a covalent bond with the active serine residue site of gastric and pancreatic lipases, preventing hydrolysis of dietary triglycerides into absorbable free fatty acids and monoglycerides, resulting in a caloric deficit that may have a positive effect on weight control.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Qsymia
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (6/12)
Xenical
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (4/12) · Qty limit (9/12)
UnitedHealthcare
Qsymia
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (0/8) · Qty limit (0/8)
Xenical
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Qsymia
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Xenical
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Qsymia.
No savings programs available for Xenical.
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QsymiaView full Qsymia profile
XenicalView full Xenical profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.