Weight Loss & Metabolic Meds
Qsymia (Phentermine + Topiramate)
Street names: qsymia, Qnexa, phentermine topiramate, qsiva
Overdose? Act now. Call emergency services — say "unresponsive, not breathing". Give naloxone for opioid-like signs. Hotlines
⚡What it does
- Among the strongest approved weight-loss drugs — 8-10% average loss
- Appetite suppression
- Reduced food cravings
⚠Key risks
- Birth defects (cleft palate) — strict pregnancy prevention required
- The EU refused approval over long-term cardiovascular and psychiatric concerns
- Raised heart rate
- Tingling, insomnia, mood changes
- Topiramate can impair memory and concentration
✚Overdose signs
- Severe agitation
- Racing heart
- Confusion
- Rapid breathing
Category comparison — Weight Loss & Metabolic Meds
| Substance | Class | Top risks | Street price |
|---|---|---|---|
| Qsymia (Phentermine + Topiramate) | Schedule IV | Birth defects (cleft palate) — strict pregnancy prevention required; The EU refused approval over long-term cardiovascular and psychiatric concerns | US price roughly $100-200/month |
| Liothyronine (T3) | Rx-only — not controlled | At abuse doses: cardiac arrhythmia, heart failure, bone loss; Muscle catabolism — the 'cut' comes with your muscle | ~$0.50–$2 per tablet grey-market |
| Levothyroxine (T4) | Rx-only — not controlled | Overtreatment = hyperthyroid state: palpitations, anxiety, bone loss; Taking it without hypothyroidism provides little benefit at real risk | ~$0.10–$0.50 per tablet |
| Orlistat (Xenical/Alli) | OTC | Oily stools, urgency, flatulence — the famous GI sides if you eat fatty; Fat-soluble vitamin absorption drops (take a multivitamin) | ~$0.50–$2 per capsule |
| Sibutramine (Meridia) | Withdrawn | WITHDRAWN worldwide for cardiovascular events (strokes, heart attacks in the SCOUT trial); Survives in adulterated supplements — buyers don't know they're taking it | ~$0.50–$2 per capsule illicit |
| Metformin | Rx-only — not controlled | GI upset (diarrhea, nausea) — titrate slowly; Lactic acidosis — rare, dangerous, mostly in kidney disease | ~$0.05–$0.30 per tablet |
Street prices are regional estimates. Potency and cuts vary constantly.
?Frequently asked questions
What does Qsymia (Phentermine + Topiramate) look like?
Extended-release capsules combining phentermine (stimulant) and topiramate (anticonvulsant).
What are the signs of a Qsymia (Phentermine + Topiramate) overdose?
Severe agitation; Racing heart; Confusion Call emergency services immediately.
How addictive is it?
Birth defects (cleft palate) — strict pregnancy prevention required Dependence can develop with regular use.
🔗Sources & further reading
Facts on this page are compiled from these primary sources. External links open in a new tab.