QSYMIA

Phentermine Hydrochloride 3.75mg, Topiramate 23mg, Oral capsule, extended release

Alcohol

· Severity: Major

· Notes for Consumers: Do not drink alcoholic beverages for 6 hours before or after taking Trokendi XR. You should avoid alcoholic beverages while taking other forms of Topiramate. Alcohol can affect seizure control and interfere with the drug treatment and may increase the risk of serious side effects. Decreased alertness, drowsiness, falls, or other side effects may occur. Do not drive or operate machinery if you are drinking alcohol-containing beverages. If you notice slurred speech, confusion, severe weakness, or difficulty breathing, contact your health care provider immediately.

· Notes for Professionals: Avoid alcohol with topiramate. Topiramate is a CNS depressant. Concomitant administration of topiramate with alcohol can result in significant CNS depression. Trokendi XR is contraindicated with recent alcohol use (i.e., within 6 hours before and 6 hours after use). In the presence of alcohol, the pattern of topiramate release from Trokendi XR is significantly altered. As a result, plasma concentrations of topiramate may be markedly higher soon after dosing and subtherapeutic later in the day.

Phentermine Hydrochloride 3.75mg, Topiramate 23mg, Oral capsule, extended release

Marijuana

· Severity: Moderate

· Notes for Consumers: The effects of marijuana may be increased and side effects may get worse if it is combined with this medicine. Do not drive or operate machinery until you know how this combination will affect you. Contact your health care provider right away if you notice slurred speech, confusion, severe drowsiness, increased heart rate, or any other new or unusual side effects.

· Notes for Professionals: Topiramate may influence the pharmacokinetic profile of cannabinoids in Marijuana and may also influence the pharmacodynamic profile. This may result in an altered adverse event profile of one or both drugs. Topiramate is an inducer of CYP3A4, an isoenzyme partially responsible for the metabolism of marijuana's most psychoactive compound, delta-9-tetrahydrocannabinol (THC). More study is needed to determine the magnitude and clinical significance of any pharmacokinetic or pharmacodynamic interactions. Additive drowsiness and CNS depression is possible. Monitor for changes in moods or behaviors, or for other CNS effects.

Phentermine Hydrochloride 3.75mg, Topiramate 23mg, Oral capsule, extended release

Caffeine-containing Foods/Beverages

· Severity: Moderate

· Notes for Consumers: Limit Caffeine intake (examples: coffee, teas, colas, chocolate, and some herbal supplements) while taking Phentermine. Also avoid medicines containing additional Caffeine whenever possible. Side effects from Phentermine may get worse if you take excessive Caffeine. Taking a high amount of Caffeine can increase the risk of nausea, nervousness, palpitations, problems with sleep, rapid heartbeat, or other side effects.

· Notes for Professionals: Caffeine is a CNS-stimulant and such actions are expected to be additive when coadministered with other CNS stimulants or psychostimulants.

<b>DISCLAIMER:</b><em> This drug information content is provided for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Patients should always consult their physician with any questions regarding a medical condition and to obtain medical advice and treatment. Drug information is sourced from GSDD (Gold Standard Drug Database ) provided by Elsevier.</em>