Saxenda vs. Qsymia

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

Key Takeaways

  • Saxenda is a daily injectable GLP-1 that slows digestion and reduces appetite, while Qsymia is a daily oral capsule combining a stimulant and an anticonvulsant to suppress appetite.

  • Saxenda most often causes nausea and digestive upset, while Qsymia is more likely to cause tingling, dry mouth, and sleep problems.

  • Qsymia is a controlled substance dispensed only through certified REMS pharmacies, while Saxenda carries a boxed warning for thyroid tumors seen in animal studies.

Saxenda vs. Qsymia Drug Summary

Saxenda

Saxenda (liraglutide) is a GLP-1 receptor agonist that slows stomach emptying and reduces appetite to support weight loss. It's FDA-approved for adults with obesity or overweight plus a weight-related condition, and for adolescents 12-17 with obesity. It's given as a once-daily injection under the skin, with the dose increased gradually over about a month.

Qsymia

Qsymia combines phentermine, a stimulant that curbs appetite, with topiramate, an anticonvulsant that increases feelings of fullness. It's FDA-approved for chronic weight management in adults with obesity or overweight plus a weight-related condition, and in adolescents 12 and older with obesity. It's taken as a once-daily oral capsule, with the dose raised in stages over about four months.

Saxenda vs. Qsymia Side Effects

Saxenda

Most common
nausea (up to 39.3%)
diarrhea (up to 20.9%)
constipation (up to 19.4%)
vomiting (up to 15.7%)

Qsymia

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

Saxenda vs. Qsymia Dosage

Saxenda

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 0.6 mg once daily Week 1
Maximum dose 3 mg once daily Week 5 onward
Dose changes 4 increases Every week

Qsymia

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

Saxenda vs. Qsymia Indications

Saxenda

Saxenda is approved for long-term weight management in adults with obesity, or who are overweight with a related condition like high blood pressure or type 2 diabetes. It's also approved for adolescents ages 12 to 17 with obesity. It isn't approved to treat type 1 or type 2 diabetes directly.

  • Adults with obesity (BMI ≥30)

  • Adults overweight with a weight-related condition

  • Adolescents 12-17 with obesity

  • Used alongside diet and exercise

Qsymia

Qsymia is approved for long-term weight management in adults with obesity, or who are overweight with a related condition such as high blood pressure or high cholesterol. It's also approved for adolescents 12 and older with obesity. It isn't approved for use during pregnancy or in people with glaucoma or hyperthyroidism.

  • Adults with obesity (BMI ≥30)

  • Adults overweight with a weight-related condition

  • Adolescents 12+ with obesity

  • Used alongside diet and exercise

Saxenda vs. Qsymia Pros and Cons

Saxenda

Saxenda has over a decade of real-world use as a weight-loss GLP-1 and is approved for younger adolescents starting at 12. It requires a daily injection, which some people find less convenient than a pill, and its list price is high without insurance coverage.

Pros

  • FDA-approved GLP-1 with long safety track record

  • Approved for adolescents as young as 12

  • Not a controlled substance

  • No REMS enrollment or special pharmacy required

Cons

  • Requires a daily injection, not a pill

  • Common GI side effects like nausea and vomiting

  • Roughly $1,300 to $1,350 per month without insurance

  • Boxed warning for thyroid C-cell tumors

Qsymia

Qsymia is an oral combination pill used for weight loss since 2012, and it typically costs far less out of pocket than injectable options. It's a controlled substance requiring REMS pharmacy dispensing, with risks like mood changes and birth defects requiring monthly pregnancy testing.

Pros

  • Oral capsule, no injections needed

  • Roughly $200 to $350 per month without insurance

  • Longer track record as an oral weight-loss pill

  • No thyroid tumor boxed warning

Cons

  • Schedule IV controlled substance with abuse potential

  • Requires REMS enrollment and certified pharmacy

  • Risk of birth defects; contraindicated in pregnancy

  • Can cause memory or word-finding problems

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