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The usual total daily dose is 200 mg to 400 mg in two divided doses. Some patients may require doses up to 800 mg per day which is the maximum dose. It is recommended that therapy be initiated at a low dose, followed by titration to an effective dose.
Recommended dose: Qsymia 3.75 mg/23 mg (phentermine 3.75 mg/topiramate 23 mg extended-release) daily for 14 days; then increase to 7.5 mg/46 mg daily (2.1) Discontinue or escalate dose (as described) if 3% weight loss is not achieved after 12 weeks on 7.5 mg/46 mg dose (2.1) Discontinue Qsymia if 5% weight loss is not achieved after 12 weeks on maximum daily dose of 15 mg/92 mg (2.1) Discontinue 15 mg/92 mg dose gradually (as described) to prevent possible seizure (2.1) Do not exceed 7.5 mg/46mg dose for patients with moderate or severe renal impairment or patients with moderate hepatic impairment (2.2, 2.3)