Dose of Qsymia: detailed dosage of guidelines and administration information
The patient will not be able to lose weight if he uses the same dose of Qsymia throughout the treatment period of obesity. The anorectic dose should be increased in direct proportion to the duration of anti-obesity therapy. The total duration of obesity treatment with Qsymia can take 3 to 6 months.
Each Qsymia capsule contains two active ingredients – Phentermine and Topiramate.
For anti-obesity therapy, you can use capsules with four different doses of active ingredients:
- 3.75 mg / 23 mg
- 7.5 mg / 46 mg
- 11.25 mg / 69 mg
- 15 mg / 92 mg.
Obese patients with such comorbid diseases as diabetes or high blood pressure undergo two stages of anti-obesity therapy.
- starting dose of Qsymia makes one 3.75 mg / 23 mg capsule once daily for two weeks;
- usual therapeutic dose of Qsymia makes one 7.5 mg / 46 mg capsule once daily for ten weeks.
After 3 months of anti-obesity therapy, it is necessary to evaluate qualitative results that were achieved with Qsymia. If the patient has not lost at least 3% of the initial body weight, he can go to the second stage of anti-obesity therapy with increasing Qsymia doses.
- one 11.25 mg / 69 mg capsule once daily for two weeks;
- one 15 mg / 92 mg capsule once daily for ten weeks.
If the patient has not lost at least 5% of the initial body weight during additional 3-month therapy, he should stop using this anorectic.
One 15 mg / 92 mg capsule per day is the highest dose of Qsymia. Exceeding the maximum dosage or frequency of Qsymia application increases risk of serious side effects.
Not all patients can follow the recommended dosage schedule of this anorectic. A dose of Qsymia should be selected with caution for patients with renal or hepatic insufficiency.
Qsymia is excreted by the kidneys. Therefore, drug substances are retained in the body that increases risk of toxic effects in patients with impaired renal function.
Use of Qsymia in patients with renal insufficiency can be accompanied with negative consequences for the body for several reasons:
- therapeutic effect of Qsymia decreases in kidney function decline;
- impaired excretion of Phentermine or Topiramate can lead to intoxication;
- sensitivity to Phentermine or Topiramate rises even if their elimination is not violated.
Many of these problems can be avoided if patients with impaired renal function take no more than one Qsymia 7.5 mg / 46 mg capsule per day.
Patients with renal insufficiency are not the only candidates for whom a dose of Qsymia should be selected with caution. Liver is the main organ in which Qsymia is metabolized.
Therefore, liver diseases are accompanied with:
- change in effect of the “first passage” of Qsymia, that is, systemic bioavailability of this anorectic increases;
- increase of half-life period: Qsymia half-life is 20-65 hours in healthy people, but in patients with hepatic insufficiency – it is increased by 35-60%;
- disturbance of Qsymia metabolic mechanisms that may cause formation of toxic compounds in the body.
Thus, pharmacokinetic parameters of Qsymia change in patients with liver diseases. Therefore, the maximum dose of Qsymia, the same as for patients with impaired renal function – one 7.5 mg / 46 mg capsule per day, should not be taken.
Elderly patients over 65 years old can follow the same Qsymia dosage schedule as younger patients. There is no convincing reasons to believe that age in itself is a factor that increases the number of Qsymia side effects. The risk of undesired reactions can be related to the number of diseases and the number of drugs used by elderly patients, but not with age as such.
One missed dose of Qsymia does not affect effectiveness of anti-obesity therapy. However, the patient should go back to the regular dosing schedule from the next day of treating obesity. Do not take extra dose of this anorectic to make up the missed one.