Qsymia Alternatives & Comparison
Qsymia (phentermine and topiramate extended-release) set beside Contrave, Wegovy, Zepbound: how each works, what its trials measured, what it costs, and who sells it.
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Qsymia Alternatives Compared
The main oral combination it gets compared against, also outside the GLP-1 class
Bupropion stimulates hypothalamic pro-opiomelanocortin (POMC) neurons, which release alpha-MSH to reduce appetite, but POMC neurons also release beta-endorphin, which feeds back onto mu-opioid receptors on the POMC neurons themselves and shuts them off — limiting the appetite-suppressing effect.
The comparison insurers force more often than they admit. Qsymia is the more effective of the two — −9.8% to −10.9% at 56 weeks in CONQUER and EQUIP against Contrave's −6.1% in COR-I — and the cheaper, with generic phentermine plus topiramate from about $50 against Contrave's $99 program price. They work differently: Contrave on reward and craving, Qsymia on appetite and satiety. Both carry contraindications a GLP-1 does not.
Full Contrave vs Qsymia comparison →Trials put average weight loss substantially higher for this GLP-1 injection
Wegovy mimics the GLP-1 hormone to signal fullness to the brain, slow stomach emptying, and reduce overall caloric intake.
STEP-1 reported −14.9% at 68 weeks for Wegovy; EQUIP reported −10.9% at 56 weeks for Qsymia at its top 15/92 mg dose — closer than most people expect. Qsymia runs about $100–$200 a month, and generic phentermine plus topiramate can be around $50, against Wegovy's $499. ⚠ Topiramate carries real teratogenic risk, which is why the pregnancy questions on a Qsymia intake are not a formality.
Full Wegovy vs Qsymia comparison →Injection acting on GIP and GLP-1. No approved option averages more weight loss
Zepbound works through tirzepatide's dual GIP/GLP-1 mechanism to reduce appetite through both central brain signals and peripheral metabolic effects.
About −20.9% at 72 weeks for Zepbound in SURMOUNT-1 against roughly −10.9% at 56 weeks for Qsymia in EQUIP, or −9.8% in CONQUER. Zepbound is $349–$499 through LillyDirect; Qsymia is $100–$200, and generic phentermine plus topiramate around $50. Half the effect for a fifth of the price is a real trade rather than a joke — and for someone paying cash indefinitely, it is the trade the arithmetic often favors.
Full Zepbound vs Qsymia comparison →The incretin-class route, if that is what you were after
Liraglutide is an acylated, 97%-homologous analog of native human GLP-1, modified with a fatty-acid side chain that lets it bind albumin and resist DPP-4 degradation — extending its half-life from minutes to about 13 hours.
The pivotal trial was SCALE Obesity and Prediabetes (N=3,731 adults, none diabetic; Pi-Sunyer et al. NEJM 2015, PMID 26132939).
Compare compounded Semaglutide providers
Compounded semaglutide sits at a middle figure of $189/month across 552 price points in the register, spanning $59 to $1,400. The partners below are ordered by our partner economics.
Compare compounded Tirzepatide providers
Compounded tirzepatide sits at a middle figure of $250/month across 490 price points in the register, spanning $69 to $1,400. The partners below are ordered by our partner economics.
Compare every Qsymia provider
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