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 lossAnticonvulsantOral
Topiramate
Oral topiramate, an anticonvulsant used off-label for weight loss. Topiramate may reduce appetite and increase satiety, supporting gradual, steady weight loss.
- Off-label for appetite reduction and weight support
- Oral daily medication, no injections
- Gradual weight loss with lifestyle changes
- Monthly$99/mo
- Every 3 months$237 billed up front$79/mo
- Every 6 monthsBest value$414 billed up front$69/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 tablets
- Strengths
- 2 options · 25–50 mg
What is Topiramate?
(anticonvulsant, carbonic anhydrase inhibitor)
Topiramate is approved for seizures and migraines. Off-label use for weight loss is based on its appetite-suppressing effects. Mechanism likely involves carbonic anhydrase inhibition and effects on GABA signaling, which may reduce hunger and increase fullness.
What's in it
- TopiramateReduces cravings
Modest to moderate
average 5–9% weight loss with topiramate plus lifestyle
Topiramate produces modest to moderate weight loss, generally less than GLP-1 medications but more than metformin alone. Results depend heavily on diet and activity. Cognitive side effects (difficulty concentrating, word-finding) occur in some users.
Is it right for you?
Who it's for
People who snack at night or binge, and for whom stimulants are not an option.
What sets it apart
Not a stimulant. It works on cravings; tingling in the fingers and a duller taste for soda are common.
Worth knowing before you start
Drink plenty of water: it raises the risk of kidney stones.
What to expect
Weight loss
steady but modest; depends on diet and activity
Appetite change
reduced hunger or improved fullness is common
Energy and metabolism
gradual improvement with weight loss and diet
Medical oversight
your physician monitors for side effects and efficacy
How oral weight-loss medications work
Day 1
A US-licensed physician reviews your health, metabolism, and why an oral medication may help you. Explains the medication's mechanism and what to expect.
1Week 1–2
Start your dose. You may feel appetite changes within days, or changes may take weeks. GI effects (metformin) or mood changes (naltrexone) are possible early on.
2Weeks 3–6
Your appetite and eating patterns shift. Fullness comes sooner. Your physician checks in and may adjust your dose based on response and tolerability.
3Months 2–3
Steady, gradual weight loss. Metabolism and appetite remain improved. Your physician monitors for any side effects and adjusts dosing.
4Beyond
Maintenance: your physician works with you to hold results or adjust as your body changes. Long-term monitoring ensures ongoing safety.
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 tablet (25 mg)
- How often
- Once a day
- When
- At bedtime
- Each shipment
- 30 tablets
- Pharmacy label
- Take 1 tablet (25 mg) by mouth once daily at bedtime for 30 days.
A sample week
- M
- T
- W
- T
- F
- S
- S
Once a day
Strengths the pharmacy carries
- 25 mg
- 50 mg
The science of oral weight-loss medications
Topiramate in randomized trials produces average 5–9% weight loss, often combined with phentermine for larger effect. Off-label use for weight loss alone is supported by mechanism and clinical experience.
Weight loss is gradual (weeks to months). Some users experience cognitive effects ('topiramate fog'); these often improve with dose adjustment.
Learn moreImportant safety information and common side effects
Oral weight-loss medications (metformin, naltrexone, topiramate) have different safety profiles. Metformin: GI side effects (nausea, diarrhea) common, especially initially; not for severe kidney disease. Naltrexone: generally well-tolerated; headache or dizziness possible. Topiramate: cognitive effects ('topiramate fog', difficulty concentrating, word-finding) in 10–15%; kidney stones possible. All are off-label for weight loss; efficacy and safety are not FDA-approved for this use. Tell your physician about all medications, kidney disease, and any history of kidney stones (topiramate). Stop and seek care for severe GI pain (metformin), severe headache, allergic reactions, or eye pain (topiramate).
Every plan includes
- Personalized, physician-guided plan
- Monthly, 3-month and 6-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.
Topiramate 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 Topiramate?
Taken by mouth, once a day, at bedtime. The starting prescription is 1 tablet (25 mg) each time. Your physician sets your own dose and it is printed on your label.
What strengths does Topiramate come in?
The pharmacy carries 2: 25 mg, 50 mg. Your physician chooses which one you get.
How much arrives in each shipment?
30 tablets at the starting strength, shipped to your door from a licensed US pharmacy.
Does topiramate really help with weight loss?
Yes, moderately. Topiramate reduces appetite and increases fullness in many users. Results are smaller and slower than GLP-1 drugs but real, especially with diet and exercise. Your physician monitors for cognitive side effects and adjusts doses if needed.
Why are these off-label?
These medications are FDA-approved for other conditions (diabetes, seizures, addiction) but not specifically for weight loss. Off-label use is legal and common; your physician prescribes based on research and experience.
Which one should I choose?
That depends on your health profile, goals, and what side effects you can tolerate. Metformin is gentlest but least effective. Naltrexone is experimental. Topiramate is moderate. Your physician will recommend based on your individual needs.
Can I combine these with GLP-1 drugs?
Yes, some combinations are used; for example, topiramate plus phentermine. However, combining multiple weight-loss medications requires careful physician oversight.
What if these don't work?
If you see minimal effect after 8–12 weeks, your physician may increase the dose, switch medications, or recommend GLP-1 drugs like semaglutide or tirzepatide for stronger effect.
Oral weight loss, gradual and supported.
Semaglutide + B12
A weekly GLP-1 injection that quiets cravings and supports steady, sustainable weight loss, paired with vitamin B12 for energy.
Injection
from $129/mo
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.
Injection
from $129/mo
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
Metformin and weight loss: a systematic review of non-diabetic use.
Obes Surg, 2017 - 2
Topiramate for weight loss: clinical efficacy and safety review.
Drugs Today, 2019
Topiramatefrom $69/mo