Skip to main content
Qsymia is the United States brand name for a capsule that combines phentermine and topiramate, approved there in July 2012. Hi-Doctor does not prescribe it: it has no EU-wide marketing authorisation, so in most member states — including Spain — a doctor cannot prescribe it for weight loss.

​
What is Qsymia?

Qsymia is a once-daily capsule combining phentermine, which dampens appetite, with a slow-release form of topiramate — an epilepsy and migraine medicine that also reduces how much people want to eat.
In Europe the same product is called Qsiva.

​
Why it is not marketed across the EU

There is no EU-wide approval. The European Medicines Agency refused the Europe-wide application in 2013 because of concerns about long-term effects on the heart, on mood, and on memory and attention. The manufacturer later obtained national approvals through a separate route led by Sweden, and the product is on the market in a small number of northern European countries — Sweden, Denmark, Finland and Poland, plus Norway and Iceland.
Qsymia has no EU marketing authorisation for weight loss in most member states, including Spain. No doctor there — including ours — can prescribe it for this use. It may be an approved medicine for something else, or approved in another country, but that does not make it prescribable here.

​
What the studies reported

Every NCT identifier links to its ClinicalTrials.gov record. A readout is not the same as peer-reviewed publication.
The CONQUER trial ran for 56 weeks across 93 centres in the United States only. When the EMA reviewed this programme, it judged that a cardiovascular outcomes trial would be needed before it could accept the long-term safety of the combination — and that trial has not been published.

​
What has been reported

Figures are from the CONQUER trial. The EU product information also lists constipation, dizziness, insomnia, depression and anxiety as reported effects, along with effects on the heart and circulation, and a risk in pregnancy — none of these are quantified in the harvested source for this page.
  • EMA — Qsiva: refusal of marketing authorisation (EMEA/H/C/002350)
  • EMA — Questions and answers on the refusal of the marketing authorisation for Qsiva
  • Swedish Medical Products Agency — Qsiva Public Assessment Report, procedure SE/H/1963/01-04/DC, finalised 22 December 2020
  • VIVUS — commercialisation of QSIVA in Sweden, Denmark, Finland, Iceland, Norway and Poland (October 2024)
  • Lancet — CONQUER trial
  • FDA — Qsymia prescribing information
  • ClinicalTrials.gov · NCT00553787

​
Why buying Qsymia online is not a shortcut

A medicine bought online without an EU marketing authorisation and without a doctor’s review carries risks the CONQUER trial and the EMA’s own assessment flag directly — including the unresolved cardiovascular question that led to the EU refusal. Check for the EU common logo on any online pharmacy before buying medication anywhere.

​
What can I take instead?

Semaglutide is approved in the EU, has published peer-reviewed trial results, and can be prescribed today if a doctor decides it suits you. A licensed doctor decides case by case — Hi-Doctor never prescribes without evaluation.

Semaglutide (Wegovy / Ozempic)

Weekly GLP-1 receptor agonist. A doctor may prescribe it if your BMI and history match the indications. Requires follow-up.

Tirzepatide (Mounjaro)

Dual GLP-1/GIP agonist. Assessed by the doctor based on comorbidities and BMI.

Liraglutide (Saxenda)

Daily GLP-1 agonist. Indicated in selected patients with elevated BMI after medical evaluation.

Orlistat 120mg

Fat-absorption inhibitor. A non-GLP-1 alternative a doctor may consider based on your history.
Rybelsus (oral semaglutide) is a once-daily tablet authorised for type 2 diabetes; any use in weight management is an individual medical decision and may be off-label.
You pay for any medication separately at the pharmacy you choose. Hi-Doctor does not sell medications.

​
Common questions

Qsymia is a once-daily capsule combining phentermine, which dampens appetite, with a slow-release form of topiramate — an epilepsy and migraine medicine that also reduces how much people want to eat. In Europe the same product is called Qsiva.
The European Medicines Agency refused the Europe-wide application in 2013 because of concerns about long-term effects on the heart, on mood, and on memory and attention. The manufacturer later obtained national approvals through a separate route led by Sweden.
The product is on the market in a small number of northern European countries — Sweden, Denmark, Finland and Poland, plus Norway and Iceland. In most EU countries, including Spain, it is not authorised for weight loss.
CONQUER ran for 56 weeks across 93 centres in the United States only. When the EMA reviewed this programme, it judged that a cardiovascular outcomes trial would be needed before it could accept the long-term safety — and that trial has not been published.
Semaglutide is approved in the EU, has published peer-reviewed trial results, and can be prescribed today if a doctor decides it suits you. Other options include tirzepatide, liraglutide and orlistat. A licensed doctor decides case by case.
Dry mouth was reported by 21% on the higher dose and 13% on the lower dose in CONQUER, versus 2% on placebo. Pins and needles (paraesthesia) was reported by 21% on the higher dose and 14% on the lower dose, versus 2% on placebo. Constipation, dizziness, insomnia, depression and anxiety were also reported.

​
How Hi-Doctor handles it

Weight-loss treatment runs as an ongoing plan, with a first consultation and doctor-reviewed renewals. See the full set of available options on the treatment areas page, and pricing for how the plan is billed.

​
Start a consultation

Weight-loss consultation

Answer the weight-loss questionnaire and a registered doctor reviews it. They decide whether treatment is appropriate, which one, and at what dose — and declining is a normal outcome. See what it costs and how the review works.
This page is reference information, not medical advice and not a prescription. Whether a medicine is appropriate for you is decided by a registered doctor after reviewing your consultation.