Lorqess vs Qnexa components from Doctor Vig
(Note, I had to use the abbreviation “phen” for one of the components of Qnexa, since writing the full word will not allow me to post the message on the yahoo message board, probably an attempt by Yahoo to limit spam related to “phen”)!
Qnexa low dose consists of 3.75mg of “phen” immediate release and 23mg of topiramate controlled release. Qnexa mid dose consists of 7.5mg of “phen” immediate release and 46mg of topiramate controlled release. Qnexa high dose consists of 15mg of “phen” immediate release and
92mg of topiramate controlled release.
Topamax is available as generic topiramate at 25, 50, 100, or 200mg tablets.
Cleft palate in the newborns of mothers who took topiramate during pregnancy , and kidney stones in male and female patients are possible serious side effects of topiramate.
“ Phen” is available in 8mg, 15mg, 18.75mg, 30mg, and 37.5mg size pills. “Phen” can cause anxiety, insomnia, and a variety of other side effects which would be expected from a “stimulant” type of diet drug.
Adipex – P is a brand name for “phen” as a 37.5mg capsule or tablet.
“Phen” is supposed to be taken one hour before breakfast or 1 to 2 hours after breakfast.
“Phen” is a schedule IV (four) controlled substance, similar to Restoril (temazepam) or Xanax (alprazolam), meaning that the prescription must be printed out (preferably on tamper proof prescription paper), called in to the pharmacy, or faxed to the pharmacy. Current rules do not allow electronic prescriptions from the physicians electronic health record to the pharmacies. (Electronic health record vendors and pharmacies are both working toward a situation where controlled substances can be prescribed electronically directly from the electronic health record to the pharmacy). I believe that Lorqess will not be a controlled substance, and that it will be able to be prescribed electronically from the physicians electronic health record to the pharmacy.
Topiramate is not a controlled substance, and can be prescribed electronically from the electronic health record to the pharmacy. The half life of topiramate is 21 hours, and steady state of topiramate is achieved in 4 days, (so I don’t see any particular advantage of the “controlled release” topiramate component of Qnexa).
What if a physician wanted to prescribe the individual components of Qnexa, instead of the brand name Qnexa. A physician could write one prescription for “phen” 15mg tablet, and another prescription for topiramate 100mg, which would be close to the Qnexa high dose pill.
I called Walgreens and found that 30 pills of “phen” 15mg costed $34 , and the 30 pills of topiramate 100mg costed $162.34.
I am not recommending that doctors prescribe the individual components of Qnexa instead of the brand name Qnexa, but I have heard that some doctors are already prescribing the individual components of Qnexa.
I have prescribed topiramate to try to prevent migraine headaches on some of my patients , and I have tried to limit the dose to 50mg per day to minimize side effects. At higher doses, especially at 100mg or greater doses, I have noticed a higher incidence of tingling in the fingers and of mental side effects, including “word finding” difficulties. One of my patients called the topiramate “my stupid pill”, since it seemed to interfere with her mental facilities, although it did help to prevent her migraine headaches.
If both Qnexa and Lorqess were available to me, there is no question that I
would start with Lorqess in the vast majority of my patients, because of its
better safety profile.
Steven Vig md internal medicine Tucson, Arizona ...