Tirzepatide + B12
A weekly dual-action GLP-1/GIP injection for meaningful weight loss and appetite control, paired with vitamin B12 for energy.
Injection
from $208/mo
Taken by mouth · Once a day
Weight lossControlledExtended-release
Phentermine + Topiramate
FDA-approved combination (Qsymia) of phentermine plus topiramate extended-release for long-term weight loss. Stronger than phentermine alone; requires careful medical screening and ongoing monitoring. Teratogenic; not for pregnancy.
- FDA-approved for long-term weight loss
- Stronger effect than phentermine or topiramate alone
- Extended-release formulation
- Monthly$149/mo
- Every 3 monthsBest value$387 billed up front$129/mo
- Free, discreet shipping
- Licensed U.S. pharmacy
- Board-certified physicians
Disclaimer: Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Products are compounded by a licensed pharmacy. The FDA has not reviewed or approved compounded products for any use for safety, efficacy, or quality. Compounded medications are not FDA-approved brand-name products.
- How
- Taken by mouth
- How often
- Once a day
- Each shipment
- 30 capsules
- Strengths
- 2 options · 15–30 mg phentermine / 12.5 mg topiramate
What is Phentermine + Topiramate ER?
(Qsymia, controlled appetite suppressant + anticonvulsant)
Qsymia is an FDA-approved combination of phentermine (appetite suppressant) and topiramate (anticonvulsant) in extended-release form. It produces greater weight loss than either drug alone. Long-term use is approved, but requires medical screening for cardiovascular disease, glaucoma, and psychiatric conditions. Teratogenic in pregnancy.
What's in it
- PhentermineAppetite suppressant (controlled)
- TopiramateReduces cravings
Long-term
FDA-approved combination with extended-release; teratogenic in pregnancy
Phentermine/topiramate ER produces mean 10% weight loss at the higher dose in clinical trials. Extended-release allows longer use than phentermine alone. Cognitive side effects and increased heart rate are possible. Absolutely not for pregnancy or women of childbearing potential without strict contraception.
Is it right for you?
Who it's for
People who did well on phentermine and need help with cravings as well as hunger.
What sets it apart
Two medicines in one capsule: phentermine cuts appetite, topiramate dulls cravings. The same pairing as the brand Qsymia.
Worth knowing before you start
Topiramate can cause birth defects. Use reliable contraception and stop it at once if you become pregnant.
Results you can feel
Rapid weight loss
3–5 kg in 12 weeks (phentermine); up to 10% body weight (combination)
Energy boost
increased alertness and motivation (stimulant effect)
Cardiovascular monitoring
blood pressure and heart rate require close tracking
Psychiatric vigilance
mood, anxiety, and sleep need supervision
How controlled weight-loss therapy works
Day 1
Video consultation with a US-licensed physician. Medical screening: blood pressure, heart rate, ECG may be required. Detailed discussion of risks, benefits, and contraindications. Informed consent required.
1Week 1
Start your dose (low dose for phentermine). Appetite suppression often noticeable within days. Energy increases. Monitor for jitteriness, heart palpitations, or insomnia.
2Weeks 2–4
Weight loss accelerates. Appetite remains suppressed. Your physician checks in weekly or biweekly to monitor cardiovascular and psychological effects.
3Weeks 5–12
Steady, significant weight loss. Physician continues close monitoring. At week 12 (or sooner if phentermine alone), plan for pause or switch to longer-term option.
4Week 12+
Maintenance or transition: if using phentermine alone, pause it (cannot use continuously). Phentermine/topiramate ER may continue if tolerated. Your physician guides next steps.
5
Individual results vary. Benefits reflect what Zepym Health members commonly report to their physician at check-ins; they are not the results of a clinical trial.
How you use it
This is the starting dose the pharmacy prints on the label. Your physician sets yours and adjusts it with you.
- How
- Taken by mouth
- Dose
- 1 capsule (15 mg phentermine / 12.5 mg topiramate)
- How often
- Once a day
- When
- In the morning
- Each shipment
- 30 capsules
- Pharmacy label
- Take 1 capsule (15 mg phentermine / 12.5 mg topiramate) by mouth once daily in the morning for 30 days.
A sample week
- M
- T
- W
- T
- F
- S
- S
Once a day
Strengths the pharmacy carries
- 30 mg / 12.5 mg
- 15 mg / 12.5 mg
The science of controlled appetite suppressants
In clinical trials, phentermine/topiramate ER produced mean 10% weight loss, nearly double that of phentermine alone. Effects persist for a year of continuous use.
The combination is potent but requires careful screening for heart disease, glaucoma, and psychiatric conditions. Cognitive effects ('topiramate fog') and increased heart rate occur in some users.
Learn moreImportant safety information and common side effects
Phentermine and phentermine/topiramate are controlled medications with significant risks. Do not use with uncontrolled high blood pressure, heart disease, recent heart attack or stroke, glaucoma, or history of substance abuse. Cardiovascular effects include increased heart rate, elevated blood pressure, and palpitations. Neurological effects include anxiety, insomnia, tremor, and (with topiramate combination) cognitive impairment. Phentermine/topiramate is absolutely teratogenic (causes birth defects); women of childbearing potential must use strict contraception. Tell your physician about all medications, cardiovascular disease, psychiatric conditions, and any history of drug or alcohol abuse. Stop and seek care for chest pain, severe headache, palpitations, shortness of breath, or psychiatric symptoms.
Every plan includes
- Personalized, physician-guided plan
- Monthly and 3-month plans
- Dispensed by a US-licensed compounding pharmacy
- Unlimited protocol adjustments and messaging
- Ongoing support and check-ins
- Pause or cancel anytime
- Reviewed by our in-house physicians
How it works
1.Connect with a physician
Answer a few questions online and a US-licensed physician reviews your health, history and goals to make sure treatment is right for you. 100% online. No in-person visit required.
2.Get your discreet shipment
If approved, your treatment is compounded by a US-licensed, LegitScript-certified pharmacy, inspected for quality, and shipped discreetly to your door.
3.Receive continuous support
Start with one goal, then keep building over time. Unlimited physician messaging, easy refills and dose adjustments, all from the Zepym Health app.
Phentermine + Topiramate ER educational content reviewed by our physician
Scott Nass, MDDoctor of Medicine, board-certified in Family Medicine
Charles R. Drew University and David Geffen School of Medicine at UCLA. Family Medicine residency at Ventura County Medical Center.
Frequently asked questions
How do I take Phentermine / Topiramate?
Taken by mouth, once a day, in the morning. The starting prescription is 1 capsule (15 mg phentermine / 12.5 mg topiramate) each time. Your physician sets your own dose and it is printed on your label.
What strengths does Phentermine / Topiramate come in?
The pharmacy carries 2: 15 mg / 12.5 mg, 30 mg / 12.5 mg. Your physician chooses which one you get.
What exactly is in it?
Phentermine, Topiramate.
How much arrives in each shipment?
30 capsules at the starting strength, shipped to your door from a licensed US pharmacy.
Is it a controlled substance?
Yes. The law requires a live video visit with the physician before it can be prescribed.
Why is this stronger than phentermine alone?
Topiramate adds appetite suppression and metabolic support. Together, they produce more weight loss than either alone. The extended-release form also allows longer use (beyond 12 weeks) while monitoring for side effects.
Why are these medications controlled?
Phentermine is similar to amphetamine; it stimulates the central nervous system and carries risks of dependence, cardiovascular effects, and psychiatric symptoms. Schedule IV reflects these risks. Strict medical supervision is required.
Can I use phentermine longer than 12 weeks?
Continuous phentermine use is FDA-approved only for 12 weeks or less. After that, tolerance develops and risks increase. Your physician may pause (typically 2–4 weeks) and restart, or switch to the combination (phentermine/topiramate ER, which is approved for longer use).
Potent short-term weight loss, with careful oversight.
Semaglutide + B12
A weekly GLP-1 injection that quiets cravings and supports steady, sustainable weight loss, paired with vitamin B12 for energy.
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Tirzepatide + Glycine
A weekly dual-action GLP-1/GIP injection for meaningful weight loss and appetite control, paired with glycine for better tolerance.
Injection
from $208/mo
Semaglutide + Glycine
A weekly GLP-1 injection that quiets cravings and supports steady, sustainable weight loss, paired with glycine for better tolerance.
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The above statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Individual results vary.
Sources
- 1
Phentermine efficacy and cardiovascular safety: randomized controlled trials.
Obesity, 2019 - 2
Phentermine/topiramate ER for long-term weight loss (Qsymia): efficacy and safety.
Lancet, 2012 (Gadde KM et al.)
Phentermine + Topiramatefrom $129/mo