What is mid-dose phentermine-topiramate?

• A. 3.75 mg/23 mg
• B. 15 mg/92 mg
• C. 7.5 mg/46 mg
• D. 1 mg/8 mg

Answer: (C)

Mid-dose phentermine-topiramate is 7.5 mg of phentermine combined with 46 mg of topiramate. This is the middle strength offered for this combination, sitting between the low-dose option (3.75 mg/23 mg) and the high-dose option (15 mg/92 mg). The mid-dose is used when a patient has had some response to the low-dose but still needs more effect, while aiming to balance efficacy with tolerability. Phentermine reduces appetite through a sympathomimetic effect, and topiramate adds weight loss through appetite suppression and other metabolic effects. Start with the lowest dose and titrate up to the mid-dose as tolerated, then to the high-dose if needed and tolerated, all while monitoring for side effects such as sensory changes, dry mouth, constipation, insomnia, and cognitive or mood effects.