Phentermine and topiramate extended-release (long-acting) capsules are used to help adults who are obese or who are overweight and have weight-related medical problems to lose weight and to keep from gaining back that weight. Phentermine and topiramate extended-release capsules must be used along with a reduced calorie diet and exercise plan. Phentermine is in a class of medications called anorectics. It works by decreasing appetite. Topiramate is in a class of medications called anticonvulsants. It works by decreasing appetite and by causing feelings of fullness to last longer after eating.
Phentermine and topiramate come as extended-release capsules to take by mouth. The medication is usually taken with or without food once a day in the morning. This medication may cause difficulty falling asleep or staying asleep if it is taken in the evening. Take phentermine and topiramate at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take phentermine and topiramate exactly as directed.
Your doctor will probably start you on a low dose of phentermine and topiramate and increase your dose after 14 days. After you take this dose for 12 weeks, your doctor will check to see how much weight you have lost. If you have not lost a certain amount of weight, your doctor may tell you to stop taking phentermine and topiramate or may increase your dose and then increase it again after 14 days. After you take the new dose for 12 weeks, your doctor will check to see how much weight you have lost. If you have not lost a certain amount of weight, it is not likely that you will benefit from taking phentermine and topiramate, so your doctor will probably tell you to stop taking the medication.
Phentermine and topiramate may be habit forming. Do not take a larger dose, take it more often, or take it for a longer period of time than prescribed by your doctor.
Phentermine and topiramate will help control your weight only as long as you continue to take the medication. Do not stop taking phentermine and topiramate without talking to your doctor. If you suddenly stop taking phentermine and topiramate, you may experience seizures. Your doctor will tell you how to decrease your dose gradually.
Phentermine and topiramate is not available at retail pharmacies. This medication is available only through specific mail order pharmacies. Ask your doctor if you have any questions about how you will receive your medication.
Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with phentermine and topiramate and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website ( Web Site) or the manufacturer's website to obtain the Medication Guide.
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
Before taking phentermine and topiramate,
tell your doctor if you are pregnant or plan to become pregnant. If you take phentermine and topiramate during pregnancy, your baby may develop a birth defect called cleft lip or cleft palate. Your baby may develop this birth defect very early in the pregnancy, before you know that you are pregnant. You must use birth control to prevent pregnancy during your treatment. You must take a pregnancy test before you begin your treatment and once every month during your treatment. If you become pregnant while taking phentermine and topiramate, stop taking the medication and call your doctor immediately.
tell your doctor if you are breast-feeding.
Drink extra fluids during your treatment with phentermine and topiramate.
Unless your doctor tells you otherwise, continue your normal diet.
Skip the missed dose and take your usual dose the next morning. Do not take a double dose to make up for a missed one.
Phentermine and topiramate may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment:
Phentermine and topiramate may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online ( Web Site ) or by phone (1-800-332-1088).
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).
Store phentermine and topiramate in a safe place so that no one else can take it accidentally or on purpose. Keep track of how many capsules are left so you will know if any are missing.
Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website ( Web Site) for more information if you do not have access to a take-back program.
It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. Web Site
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at Web Site. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.
Symptoms of overdose may include the following:
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to phentermine and topiramate.
Do not let anyone else take your medication. Giving or selling phentermine and topiramate to others may harm them and is against the law. Phentermine and topiramate is a controlled substance. Prescriptions may be refilled only a limited number of times; ask your pharmacist if you have any questions.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
AHFS® Consumer Medication Information. © Copyright, The American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.
Selected Revisions: January 15, 2017.