Wegovy vs. Qsymia

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

Key Takeaways

  • Wegovy is a weekly injected GLP-1 medicine, while Qsymia is a daily pill combining a stimulant and an anticonvulsant.

  • Wegovy is the only one of the two FDA-approved to reduce major cardiovascular events in adults with heart disease and obesity or overweight.

  • Qsymia requires REMS pharmacy enrollment and monthly pregnancy testing, while Wegovy carries a boxed warning for thyroid tumor risk seen in animal studies.

Wegovy vs. Qsymia Drug Summary

Wegovy

Wegovy is a GLP-1 receptor agonist given as a once-weekly injection under the skin. It is FDA-approved for chronic weight management in adults and adolescents with obesity or overweight plus a weight-related condition, and to lower cardiovascular risk in adults with existing heart disease. Dosing starts low and increases every four weeks to a 2.4 mg maintenance dose.

Qsymia

Qsymia combines phentermine, a stimulant appetite suppressant, with topiramate, an anticonvulsant, in one daily extended-release capsule. It is FDA-approved for chronic weight management in adults with obesity or in adults who are overweight with a weight-related condition, as well as in adolescents 12 and older with obesity. Dosing is titrated over about 16 weeks to a 15 mg/92 mg maintenance dose.

Wegovy vs. Qsymia Side Effects

Wegovy

Most common
nausea (up to 44%)
diarrhea (up to 30%)
constipation (up to 24%)
vomiting (up to 24%)

Qsymia

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

Wegovy vs. Qsymia Dosage

Wegovy

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 0.25 mg once weekly Weeks 1-4
Maximum dose 2.4 mg once weekly Week 17 onward
Dose changes 4 increases Every 4 weeks

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

Wegovy vs. Qsymia Indications

Wegovy

Wegovy is approved for long-term weight management alongside diet and exercise in adults and adolescents 12 and older with obesity, or overweight with a related condition like high blood pressure or type 2 diabetes. It also carries a specific approval to reduce the risk of heart attack, stroke, and cardiovascular death in adults with established heart disease and obesity or overweight. It is not approved to treat diabetes.

  • Chronic weight management in adults and adolescents 12+

  • Obesity, or overweight plus a weight-related condition

  • Reduces risk of heart attack, stroke, and cardiovascular death

Qsymia

Qsymia is approved for chronic weight management alongside diet and exercise in adults with obesity, or in adults who are overweight with a weight-related condition such as high blood pressure or high cholesterol. It also has approval for adolescents 12 and older with obesity. It does not carry a cardiovascular risk reduction indication.

  • Chronic weight management in adults with obesity

  • Overweight adults with a weight-related condition

  • Chronic weight management in adolescents 12+ with obesity

Wegovy vs. Qsymia Pros and Cons

Wegovy

Wegovy has strong trial data for weight loss and is the only medication in this comparison shown to reduce cardiovascular events in people with existing heart disease. It requires a weekly injection rather than a daily pill, and gastrointestinal side effects are common during dose increases.

Pros

  • Only one FDA-approved to reduce cardiovascular events in heart disease

  • Once-weekly dosing instead of a daily pill

  • Not a controlled substance, no abuse potential

Cons

  • Requires a self-administered injection

  • Boxed warning for thyroid C-cell tumor risk seen in animal studies

  • Common GI side effects like nausea and vomiting during titration

  • Typically costs $1,300 to $1,350 per month without insurance

Qsymia

Qsymia offers a daily pill option with a longer track record and a lower list price, but it comes with stricter safety monitoring. It is a controlled substance with abuse potential and is not appropriate for anyone who could become pregnant, or for those with glaucoma or hyperthyroidism.

Pros

  • Oral daily capsule, no injections needed

  • Longer FDA track record, approved since 2012

  • Typically costs $200 to $350 per month without insurance

Cons

  • Requires REMS enrollment and certified pharmacy dispensing

  • Contraindicated in pregnancy, glaucoma, and hyperthyroidism

  • Schedule IV controlled substance with abuse and dependence risk

  • Can cause mood, sleep, and cognitive side effects like memory or word-finding issues

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