Qsymia vs. Jardiance

See how Qsymia and Jardiance compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Qsymia is FDA-approved specifically for chronic weight management, while Jardiance is approved for diabetes, heart failure, and kidney disease, and any weight loss with it is an off-label side effect.

  • Qsymia is a Schedule IV controlled substance dispensed only through certified REMS pharmacies, while Jardiance is a standard prescription tablet with no such restriction.

  • Both are taken orally once daily, but Qsymia requires a slow dose increase over several months while Jardiance starts near its effective dose with only one possible step up.

Qsymia vs. Jardiance Drug Summary

Qsymia

Qsymia combines phentermine, a stimulant that curbs appetite, with topiramate, an anticonvulsant that increases feelings of fullness. It is FDA-approved for chronic weight management in adults with obesity, adults who are overweight with a weight-related condition, and adolescents 12 and older with obesity. It is taken once daily as an extended-release capsule, with the dose raised gradually over about 12 to 16 weeks.

Jardiance

Jardiance (empagliflozin) is an SGLT2 inhibitor that lowers blood sugar by causing the kidneys to remove excess glucose through urine. It is FDA-approved for type 2 diabetes and to reduce the risk of cardiovascular death, heart failure hospitalization, and chronic kidney disease progression. Any weight loss seen with Jardiance is a side effect of glucose excretion, not an FDA-approved use of the drug.

Qsymia vs. Jardiance Side Effects

Qsymia

Most common
paresthesia (up to 21%)
dry mouth (up to 19%)
constipation (up to 16%)
insomnia (up to 11%)

Jardiance

Most common
volume depletion (up to 11.4%)
increased urination (10%)
urinary tract infection (9.3%)
genital yeast infection (5.4%)

Qsymia vs. Jardiance Dosage

Qsymia

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 3.75 mg/23 mg once daily Days 1-14
Maximum dose 15 mg/92 mg once daily Week 17 onward
Dose changes 3 increases As tolerated

Jardiance

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 10 mg once daily At the start
Maximum dose 25 mg once daily If needed
Dose changes 1 increase As tolerated

Qsymia vs. Jardiance Indications

Qsymia

Qsymia is approved only for long-term weight management, not for treating an underlying metabolic disease. It works by pairing an appetite suppressant with a medication that promotes fullness and reduces cravings.

  • Chronic weight management in adults with obesity

  • Chronic weight management in overweight adults with a weight-related condition

  • Chronic weight management in adolescents 12 and older with obesity

Jardiance

Jardiance's approvals center on managing type 2 diabetes and protecting the heart and kidneys, not on weight loss. Using Jardiance solely for weight management is off-label and not supported by its FDA approval.

  • Blood sugar control in type 2 diabetes, ages 10 and older

  • Reducing cardiovascular death risk in adults with type 2 diabetes and heart disease

  • Reducing cardiovascular death and hospitalization in heart failure

Qsymia vs. Jardiance Pros and Cons

Qsymia

Qsymia's clinical profile centers on appetite suppression and satiety, backed by FDA approval for chronic weight management. Its controlled-substance status and pregnancy risks require extra monitoring and REMS pharmacy enrollment, which can affect access and insurance coverage.

Pros

  • FDA-approved specifically for weight loss, with clear efficacy data for that purpose

  • Lower typical list price than Jardiance, roughly $200 to $350 monthly versus $350 to $620

  • Once-daily oral capsule with no injections required

  • No added risk of hypoglycemia since it does not affect insulin or glucose levels

Cons

  • Controlled substance requiring REMS enrollment and dispensing only through certified pharmacies

  • Cannot be used during pregnancy due to birth defect risk, requiring monthly pregnancy tests

  • Carries a warning for suicidal thoughts and behavior

  • Requires months of gradual dose titration before reaching the full effect

Jardiance

Jardiance's clinical profile reflects its role as a diabetes and cardiorenal protection drug, with strong outcomes data for heart and kidney health. It carries genitourinary infection risks and has no approved role in weight management, so any weight loss is incidental rather than the treatment goal.

Pros

  • Approved for multiple serious conditions beyond diabetes, including heart failure and chronic kidney disease

  • Not a controlled substance and has no REMS enrollment requirement

  • Simple two-step dosing with no lengthy titration schedule

  • Extensive outcomes data on reducing cardiovascular death and hospitalization

Cons

  • Not FDA-approved for weight loss; any weight change is a secondary effect of blood sugar control

  • Higher typical list price than Qsymia, roughly $350 to $620 monthly versus $200 to $350

  • Risk of serious genitourinary infections, including a rare flesh-eating infection

  • Can cause diabetic ketoacidosis even without markedly high blood sugar

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