Saxenda Vs. Qsymia: Drug Comparison

Saxenda^® (liraglutide) is an injectable medication used for chronic weight management in adults with obesity or overweight with at least one weight-related condition, such as hypertension, type 2 diabetes, or high cholesterol. It works by mimicking the hormone glucagon-like peptide-1 (GLP-1), which helps regulate appetite and food intake, leading to reduced caloric consumption and weight loss. Administered once daily, Saxenda is used in conjunction with a reduced-calorie diet and increased physical activity. Common side effects include nausea, diarrhea, and constipation, and it should be used with caution in patients with a history of pancreatitis​.

Qsymia^® (phentermine and topiramate) is a prescription medication used for chronic weight management in adults with obesity or overweight with at least one weight-related condition, such as hypertension, type 2 diabetes, or high cholesterol. It combines two active ingredients: phentermine, an appetite suppressant, and topiramate, which induces a feeling of fullness and reduces appetite. Qsymia is intended to be used alongside a reduced-calorie diet and increased physical activity. Common side effects include dry mouth, constipation, and tingling sensations in the hands and feet. It should be used with caution due to potential risks such as mood changes, increased heart rate, and birth defects if taken during pregnancy.

Glucagon-like peptide-1 (GLP-1) receptor agonist

Phentermine: sympathomimetic amine anorectic

Topiramate: anticonvulsant

Saxenda (liraglutide) is indicated:

• As an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in:

  • Adult patients with an initial body mass index (BMI) of:

    • 30 kg/m² or greater (obese), or

    • 27 kg/m² or greater (overweight) in the presence of at least one weight-related comorbid condition (e.g., hypertension, type 2 diabetes mellitus, or dyslipidemia)

  • Pediatric patients aged 12 years and older with:

    • Body weight above 60 kg and

An initial BMI corresponding to 30 kg/m² for adults (obese) by international cut-offs

Qsymia (phentermine and topiramate) is indicated:

• As an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in:

  • Adults with an initial body mass index (BMI) of:

    • 30 kg/m² or greater (obese) or

    • 27 kg/m² or greater (overweight) in the presence of at least one weight-related comorbidity such as hypertension, type 2 diabetes mellitus, or dyslipidemia

  • Pediatric patients aged 12 years and older with BMI in the 95th percentile or greater standardized for age and sex

• Typically taken as an injection once daily

• Comes in single-patient-use pens that deliver 0.6 mg, 1.2 mg, 1.8 mg, 2.4 mg, or 3 mg per injection

• Typically taken orally once daily

• Comes in 3.75 mg/23 mg, 7.5 mg/46 mg, 11.25 mg/69 mg, and 15 mg/92 mg extended-release capsules

Most common adverse reactions, reported in greater than or equal to 5% are:

• Nausea

• Diarrhea

• Constipation

• Vomiting

• Injection site reactions

• Headache

• Low blood sugar

• Indigestion

• Fatigue

• Dizziness

• Abdominal pain

• Increased lipase

• Upper abdominal pain

• Fever

• Inflammation of the digestive system

Most common adverse reactions in adults (incidence ≥5% and at least 1.5 times placebo) are:

• Tingling sensation

• Dizziness

• Altered taste

• Insomnia

• Constipation

• Dry mouth

Most common adverse reactions in pediatric patients aged 12 years and older (incidence ≥4% and greater than placebo) are:

• Depression

• Dizziness

• Joint pain

• Fever

• Influenza

• Ligament sprain

• Personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2

• Hypersensitivity to liraglutide or any excipients in Saxenda

• Pregnancy

• Drug interactions: Saxenda delays gastric emptying. May impact absorption of concomitantly administered oral medications

• Pregnancy

• Glaucoma

• Hyperthyroidism

• Taking or within 14 days of stopping monoamine oxidase inhibitors

• Known hypersensitivity to any component of Qsymia or idiosyncrasy to sympathomimetic amines

• Drug interactions: Oral contraceptives, central nervous system (CNS) depressants including alcohol, non-potassium sparing diuretics

• Thyroid C-cell tumors

• Acute pancreatitis

• Acute gallbladder disease

• Low blood sugar: Can occur in adults when Saxenda is used with an insulin secretagogue (e.g., a sulfonylurea) or insulin

• Heart rate increase

• Renal impairment

• Hypersensitivity reactions

• Suicidal behavior and ideation

• Embryo-fetal toxicity: Can cause fetal harm

• Increase in heart rate

• Suicidal behavior and ideation

• Risk of ophthalmologic adverse reactions

• Mood and sleep disorders

• Cognitive impairment: May cause disturbances in attention or memory, or speech/language problems

• Slowing of linear growth

• Metabolic acidosis

• Decrease in renal function

• Serious skin reactions

• Breastfeeding: Breastfeeding not recommended

WARNING: RISK OF THYROID C-CELL TUMORS

Liraglutide causes thyroid C-cell tumors at clinically relevant exposures in both genders of rats and mice. It is unknown whether Saxenda causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans, as the human relevance of liraglutide-induced rodent thyroid C-cell tumors has not been determined.

Saxenda is contraindicated in patients with a personal or family history of MTC or in patients with multiple endocrine neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk of MTC and the symptoms of thyroid tumors.

*This information is from the label for brand name Saxenda^®. See the Full Prescribing Information for more complete information. Liraglutide, the active ingredient in Saxenda, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient liraglutide.

*This information is from the label for brand name Qsymia^®. See the Full Prescribing Information for more complete information.