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

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

Trulicity

Most common
nausea (up to 21.1%)
diarrhea (up to 13%)
vomiting (up to 13%)
abdominal pain (up to 13%)

Qsymia vs. Trulicity 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

Trulicity

Dosage
Dosage Table
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

Common Symptoms and Related Diseases You Can Explore

Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.