ABSTRACT
Phentermine/Topiramate ER (Phen/TPM) combines two medications that promote weight loss via different mechanisms and produce weight reduction in an additive manner. When used as directed, the medication is well-tolerated and safe and appears to be second only to semaglutide 2.4 mg/week in efficacy for weight loss. Phen/TPM should be considered when strong effectiveness is required to achieve ~ 10% weight loss in conjunction with lifestyle intervention. Based on clinical trial data, Phen/TPM is among the most effective obesity medications in ameliorating obstructive sleep apnea, preventing diabetes, treating T2D, reducing blood pressure in hypertension, improving binge eating syndrome, increasing the quality of life, and accentuating weight loss accompanying bariatric surgery. It is also important to consider the contraindications, warnings, and side effects of Phen/TPM in individualizing obesity pharmacotherapy. Given the attractive therapeutic profile of Phen/TPM, this medication is highly underutilized in the treatment of obesity.
