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Wegovy vs Qsymia

Last reviewed: September 2026Based on 2 clinical trials

Wegovy (semaglutide, weekly injection) and Qsymia (phentermine / topiramate ER, daily capsule) are both approved for weight loss in the United States. No head-to-head trial has compared these two drugs. The figures below come from separate trials, each with its own participants, length and comparison group.

At a glance

Wegovy and Qsymia compared on form, trial results, cost and reported side effects
AttributeWegovyQsymia
FormWeekly injectionDaily capsule
How oftenInjection: once-weeklyDaily oral capsule — no injection
Weight loss in trialsUp to 14.9% — STEP 1 (68 weeks)Up to 9.8% — CONQUER (56 weeks)
FDA approved20212012
Made byNovo NordiskVivus
How it worksA GLP-1 analogue with an extended half-life of approximately one week.Phentermine suppresses appetite by triggering the release of adrenaline-like chemicals in the brain's hunger control centre.
Monthly cost, self-pay$349–$399/mowith the manufacturer savings programme; list price ~$1,349$30–$400/mogeneric; brand runs to $400
Most reported reactionNausea 44% (STEP 1)Dry mouth 21% (CONQUER)
Every figure in this table is read from the same trial and label records used everywhere else on this site.

Weight loss in each drug's main trial

No head-to-head trial has compared these two drugs.

Wegovy(semaglutide)14.9%

STEP 1 (68 weeks)

Qsymia(phentermine / topiramate ER)9.8%

CONQUER (56 weeks)

In clinical trials, participants taking semaglutide lost on average up to 14.9% of their starting body weight, and participants taking phentermine / topiramate ER lost on average up to 9.8%. Those numbers come from two different studies: STEP 1 enrolled 1,961 adults with obesity or overweight with comorbidities, no type 2 diabetes over 68 weeks against placebo, while CONQUER enrolled 2,487 adults with obesity and at least 2 weight-related health conditions over 56 weeks against placebo. Who took part, how long each trial ran and what each drug was measured against all move the percentage, so the two figures are not a measured difference between the drugs.

Monthly cost, self-pay

The bar spans the range in each drug's price record — lowest listed price to highest.

Wegovy$349–$399/mo

with the manufacturer savings programme; list price ~$1,349

Self-pay via NovoCare Pharmacy: $349/month for the 0.25–2.4 mg pens, $399/month for the Wegovy HD 7.2 mg pen. New patients pay a $199/month introductory price for the first two months on the 0.25 mg or 0.5 mg starting doses (offer runs through December 31, 2026, then the regular price applies). ~$25/month with eligible commercial insurance, capped at $100/month in savings. List price ~$1,349/month. The Wegovy pill is priced separately (see the oral pill entry). Per wegovy.com and novocare.com on 17 September 2026.

Qsymia$30–$400/mo

generic; brand runs to $400

~$30–$80/month generic; ~$200–$400/month brand (Qsymia).

Self-pay prices are what the manufacturer or the pharmacy lists, not what most people end up paying. Wegovy: $349–$399/month. Qsymia: $30–$400/month. Insurance, dose and pharmacy all change both figures.

Side effects reported in the trials

Both trials reported one reaction in common. Each rate is the percentage of participants who reported it in the trial named beside it, so the two columns are not from the same study.

Constipation
Wegovy · STEP 124%
Qsymia · CONQUER17%
A rate is the share of trial participants who reported that reaction, not a prediction for any one person.

How they differ in practice

How you take it

  • Wegovy — Two forms: once-weekly injection (2.4 mg) OR once-daily pill (25 mg). Same drug, similar results, very different cost and convenience.
  • Qsymia — Once-daily extended-release capsule

Dose build-up

  • Qsymia — 3.75/23 mg → 15/92 mg, titrated over 14 weeks

Where a drug is not listed here, its prescribing information sets out its own dose steps.

How soon it acts

  • Wegovy — Noticeable effects within 4–8 weeks; maximum weight loss typically reached by 60–68 weeks
  • Qsymia — Appetite suppression typically begins within the first week; significant weight loss by 12–16 weeks

Heart and metabolic findings

  • Wegovy — The SELECT trial (n=17,604) showed a 20% reduction in major adverse cardiovascular events against placebo.
  • Qsymia — In CONQUER, there were significant reductions in blood pressure, waist circumference, triglycerides and blood glucose.

As stated in each drug’s trial record — not a claim about which drug protects the heart more.

Other findings recorded

  • Wegovy — 20% reduction in heart attacks and strokes (SELECT trial, established CVD); improved blood pressure and cholesterol across STEP trials
  • Qsymia — Generic now available (from 2025) — significantly lower cost than GLP-1 drugs; improved blood pressure and triglycerides in CONQUER trial

If you stop taking it

  • Wegovy — In STEP 4, stopping semaglutide after a 20-week run-in led to significant weight regain.
  • Qsymia — Weight regain after stopping is expected.

Common questions

Written and maintained by one person · Built with agentic AI tools · Every number checked against the cited trial · Not medical advice

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Medical disclaimer: This website is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider before starting, stopping, or changing any treatment. Prices shown are United States self-pay or list prices and vary by insurance and country.