Phentermine and Topiramate

Pediatric Medication
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This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Qsymia

What is this drug used for?

  • It is used to help with weight loss in certain people.

What do I need to tell the doctor BEFORE my child takes this drug?

  • If your child is allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell the doctor about the allergy and what signs your child had.
  • If your child has any of these health problems: Glaucoma or overactive thyroid disease.
  • If your child has or has ever had depression or thoughts of suicide.
  • If your child has any of these health problems: Kidney disease or liver disease.
  • If your child is taking any of these drugs: Acetazolamide, dichlorphenamide, methazolamide, or zonisamide.
  • If your child has taken certain drugs for depression or certain other health problems in the last 14 days. This includes isocarboxazid, phenelzine, or tranylcypromine. Very high blood pressure may happen.
  • If your child is taking any of these drugs: Linezolid or methylene blue.
  • If the patient is a child younger than 12 years of age. This drug is not approved for use in children younger than 12 years of age.

If your child is pregnant or breast-feeding a baby:

  • Do not give this drug to your child during pregnancy.
  • Be sure your child does not breast-feed a baby while taking this drug.

This is not a list of all drugs or health problems that interact with this drug.

Tell the doctor and pharmacist about all of your child’s drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe to give this drug with all of your child’s other drugs and health problems. Do not start, stop, or change the dose of any drug your child takes without checking with the doctor.

What are some things I need to know or do while my child takes this drug?

  • Tell all of your child’s health care providers that your child is taking this drug. This includes your child’s doctors, nurses, pharmacists, and dentists.
  • Have your child avoid tasks or actions that call for alertness until you see how this drug affects your child. These are things like riding a bike, playing sports, or using items such as scissors, lawnmowers, electric scooters, toy cars, or motorized vehicles.
  • Do not stop giving this drug to your child all of a sudden without calling the doctor. Your child may have a greater risk of seizures. If your child needs to stop this drug, you will want to slowly stop it as told by the doctor.
  • Check blood pressure and heart rate as the doctor has told you.
  • Have blood work checked as you have been told by the doctor. Talk with the doctor.
  • Alcohol may interact with this drug. Be sure your child does not drink alcohol.
  • Talk with your child’s doctor before your child uses marijuana, other forms of cannabis, or prescription or OTC drugs that may slow your child’s actions.
  • If your child has high blood sugar (diabetes) and takes drugs to lower blood sugar, talk with the doctor. Weight loss may raise the chance of low blood sugar if your child takes drugs to lower blood sugar. Call the doctor right away if your child has signs of low blood sugar like dizziness, headache, feeling sleepy or weak, shaking, a fast heartbeat, confusion, hunger, or sweating.
  • If your child is being treated for high blood pressure, talk with the doctor. Weight loss may raise the chance of low blood pressure in people who are treated for high blood pressure. Call the doctor right away if your child has signs of low blood pressure like severe dizziness or passing out.
  • This drug may cause an acid blood problem (metabolic acidosis). The chance may be higher in children and in people with kidney problems, breathing problems, or diarrhea. The chance may also be higher if your child takes certain other drugs, has surgery, or is on a diet high in fat called a ketogenic diet. Over time, metabolic acidosis can cause kidney stones, bone problems, or growth problems in children.
  • Have your child follow the diet and workout plan your child’s doctor told you about.
  • If your child is allergic to tartrazine (FD&C Yellow No. 5), talk with your child’s doctor. Some products have tartrazine.
  • Sweating less and high body temperatures have happened with this drug. Sometimes, this has led to the need for treatment in a hospital. Have your child be careful in hot weather and while being active. Call your child’s doctor right away if your child has a fever or does not sweat during activities or in warm temperatures.
  • This drug may affect growth in children and teens in some cases. They may need regular growth checks. Talk with the doctor.
  • If your child is of childbearing age, a pregnancy test will need to be done before starting this drug to make sure your child is not pregnant.

If your child is or may be sexually active:

  • This drug may cause harm to an unborn baby. Your child must use birth control while taking this drug. If your child gets pregnant, call your child’s doctor right away.

If your child has menstrual periods:

  • If your child takes birth control, monthly periods (menstrual bleeding) may change while taking this drug. Talk with the doctor if this happens.

What are some side effects that I need to call my child’s doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your child’s doctor or get medical help right away if your child has any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of too much acid in the blood (acidosis) like confusion; fast breathing; fast heartbeat; a heartbeat that does not feel normal; very bad stomach pain, upset stomach, or throwing up; feeling very sleepy; shortness of breath; or feeling very tired or weak.
  • Signs of low potassium levels like muscle pain or weakness, muscle cramps, or a heartbeat that does not feel normal.
  • Signs of a urinary tract infection (UTI) like blood in the urine, burning or pain when passing urine, feeling the need to pass urine often or right away, fever, lower stomach pain, or pelvic pain.
  • Fast or abnormal heartbeat.
  • Feeling confused, not able to focus, or change in behavior.
  • Memory problems or loss.
  • Trouble speaking.
  • Trouble sleeping.
  • Not able to pass urine or change in how much urine is passed.
  • Back pain, belly pain, or blood in the urine. May be signs of a kidney stone.
  • Patients who take this drug may be at a greater risk of having thoughts or actions of suicide. The risk may be greater in people who have had these thoughts or actions in the past. Call the doctor right away if signs like depression, nervousness, restlessness, grouchiness, panic attacks, or changes in mood or actions are new or worse. Call the doctor right away if any thoughts or actions of suicide occur.
  • This drug may cause very bad eye problems. If left untreated, this can lead to lasting eyesight loss. Call the doctor right away if your child has new eye signs like blurred eyesight or other changes in eyesight, eye pain, or eye redness.
  • A severe skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis) may happen. It can cause severe health problems that may not go away, and sometimes death. Get medical help right away if your child has signs like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in the mouth, throat, nose, or eyes.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your child’s doctor or get medical help if any of these side effects or any other side effects bother your child or do not go away:

  • Headache.
  • Diarrhea or constipation.
  • Dry mouth.
  • Numbness or tingling.
  • Feeling dizzy, tired, or weak.
  • Change in taste.
  • Upset stomach.
  • Signs of a common cold.
  • Nose or throat irritation.
  • Back pain.
  • Joint pain.

These are not all of the side effects that may occur. If you have questions about side effects, call your child’s doctor. Call your child’s doctor for medical advice about side effects.

You may report side effects to your national health agency.

How is this drug best given?

Give this drug as ordered by your child’s doctor. Read all information given to you. Follow all instructions closely.

  • Take with or without food.
  • To prevent sleep problems, avoid giving this drug late in the day.
  • Have your child drink lots of noncaffeine liquids unless told to drink less liquid by your child’s doctor.

What do I do if my child misses a dose?

  • Skip the missed dose and go back to your child’s normal time.
  • Do not give 2 doses at the same time or extra doses.

How do I store and/or throw out this drug?

  • Store at room temperature in a dry place. Do not store in a bathroom.
  • Keep lid tightly closed.
  • Store this drug in a safe place where children cannot see or reach it, and where other people cannot get to it. A locked box or area may help keep this drug safe. Keep all drugs away from pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

General drug facts

  • If your child’s symptoms or health problems do not get better or if they become worse, call your child’s doctor.
  • Do not share your child’s drug with others and do not give anyone else’s drug to your child.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your child’s doctor, nurse, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2022-07-07

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Last Updated