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
Qsymia
Wegovy vs. Qsymia Dosage
Wegovy
Qsymia
| 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 |
| 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
| 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
| 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
Common Symptoms and Related Diseases You Can Explore
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