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
Jardiance
Qsymia vs. Jardiance Dosage
Qsymia
Jardiance
| 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 |
| 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
| 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
| 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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