Qsymia vs. Trulicity
See how Qsymia and Trulicity compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Qsymia is a once-daily oral capsule combining phentermine and topiramate for chronic weight management, while Trulicity is a once-weekly injectable GLP-1 agonist approved for type 2 diabetes.
Qsymia requires REMS enrollment and monthly pregnancy testing due to birth defect risk, while Trulicity carries a boxed warning for thyroid C-cell tumors seen in animal studies.
Using Trulicity for weight loss alone is off-label, since it is FDA-approved specifically for blood sugar control and cardiovascular risk reduction in type 2 diabetes.
Qsymia vs. Trulicity Drug Summary
Qsymia
Qsymia is a once-daily oral capsule combining phentermine, a stimulant appetite suppressant, with topiramate, an anticonvulsant, for chronic weight management in adults and adolescents 12 and older with obesity. It is dispensed only through certified pharmacies under a REMS program because of pregnancy-related risks.
Trulicity
Trulicity is a once-weekly injectable GLP-1 receptor agonist approved to control blood sugar in people with type 2 diabetes ages 10 and older and to lower cardiovascular risk in adults with heart disease or multiple risk factors. It is sometimes prescribed off-label for weight loss in people without diabetes.
Qsymia vs. Trulicity Side Effects
Qsymia
Trulicity
Qsymia vs. Trulicity Dosage
Qsymia
Trulicity
| 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 | 0.75 mg once weekly | Weeks 1-4 |
| Maximum dose | 4.5 mg once weekly | If needed |
| Dose changes | 3 increases | Every 4 weeks |
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 |
Trulicity
| STAGE | DOSE | WHEN |
| Starting dose | 0.75 mg once weekly | Weeks 1-4 |
| Maximum dose | 4.5 mg once weekly | If needed |
| Dose changes | 3 increases | Every 4 weeks |
Qsymia vs. Trulicity Indications
Qsymia
Qsymia is approved for chronic weight management in adults with obesity, in overweight adults with a weight-related condition like high blood pressure, and in adolescents 12 and older with obesity. It works by combining appetite suppression with effects on satiety through two different drug mechanisms.
Chronic weight management in adults with obesity
Weight management in overweight adults with a related condition
Weight management in adolescents 12+ with obesity
Not approved during pregnancy or with glaucoma or hyperthyroidism
Trulicity
Trulicity is approved to improve blood sugar control in adults and children 10 and older with type 2 diabetes, and to reduce major cardiovascular events in adults with type 2 diabetes and heart disease or multiple risk factors. It is not FDA-approved for weight loss, though some clinicians prescribe it off-label for that purpose.
Blood sugar control in type 2 diabetes, ages 10+
Reduces cardiovascular risk in adults with type 2 diabetes and heart disease
Off-label use for weight loss (not FDA-approved for this)
Not approved for type 1 diabetes or diabetic ketoacidosis
Qsymia vs. Trulicity Pros and Cons
Qsymia
Qsymia is an oral pill taken once a day, which some patients prefer over injections, and it typically costs less out of pocket than GLP-1 medications. Because it contains a controlled substance and carries risks of birth defects, it requires REMS enrollment and careful monitoring.
Pros
Oral daily capsule, no injections needed
Roughly $200 to $350 per month, less than Trulicity's list price
No boxed warning for thyroid tumor risk
Full titration completed within 17 weeks
Cons
Requires REMS enrollment and certified pharmacy dispensing
Contraindicated in pregnancy, glaucoma, and hyperthyroidism
Schedule IV controlled substance with abuse potential
Not approved for blood sugar control or diabetes
Trulicity
Trulicity offers once-weekly dosing and is one of the few GLP-1 drugs approved for pediatric type 2 diabetes, but it carries a boxed warning and comes without a generic option. Its higher list price can be a barrier for patients paying out of pocket.
Pros
Once-weekly injection, less frequent than a daily pill
Approved for pediatric type 2 diabetes management
Reduces cardiovascular risk in high-risk patients with diabetes
No REMS program or controlled substance restrictions
Cons
Roughly $987 to $1,065 per month, more than Qsymia's list price
Boxed warning for thyroid C-cell tumors seen in animal studies
Requires self-injection with a prefilled pen
No generic version available, limiting cost savings
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