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The most commonly reported side effect is temporary nausea, which can often be managed by setting alarms to eat small, frequent meals throughout the day

Drug Abuse and Dependence 9.1 Controlled Substance QSYMIA contains phentermine, a Schedule IV controlled substance, and topiramate, which is not a controlled substance

Notably, these metabolic effects were uncoupled from changes in energy balance considerations, as food intake and weight gain remained unchanged

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Blood Pressure Acetyl-L-carnitine (500 to 1,000 mg taken twice daily) for a period of months may modestly reduce systolic blood pressure in people with high blood pressure, although it does not appear to lower diastolic blood pressure [7]

Occasional vomiting during dose escalation is common