Updated May 2026
Qsymia vs Rybelsus
Side-by-side comparison of Qsymia (phentermine + topiramate ER) and Rybelsus (semaglutide (oral)) across efficacy, food restrictions, monthly cost, and Medicare Bridge coverage.
Our pick for most patients
Qsymia
Based on the data below, Qsymia wins on lower cash price ($230/mo vs $998/mo). Your situation may differ — try the personalized matcher on the homepage or compute your real out-of-pocket with the cost calculator on each medication's detail page.
Qsymia
phentermine + topiramate ER · Vivus LLC
Take in the morning (avoid evening)
Full Qsymia guide → | Field | Qsymia | Rybelsus |
|---|---|---|
| Route | tablet · daily | tablet · daily |
| Avg weight loss | 7–11% | 8–10% |
| Food restriction | Take in the morning (avoid evening) | 30-min fast required |
| Cash from | $230/mo | $998/mo |
| Savings card | — | — |
| Medicare Bridge | Tier 3 | Tier 4 |
| A1c reduction | — | −1.4% |
| FDA approved | 2012-07 | 2019-09 |
- RouteQsymiatablet · dailyRybelsustablet · daily
- Avg weight lossQsymia7–11%Rybelsus8–10%
- Food restrictionQsymiaTake in the morning (avoid evening)Rybelsus30-min fast required
- Cash fromQsymia$230/moRybelsus$998/mo
- Savings cardQsymia—Rybelsus—
- Medicare BridgeQsymiaTier 3RybelsusTier 4
- A1c reductionQsymia—Rybelsus−1.4%
- FDA approvedQsymia2012-07Rybelsus2019-09
Pick Qsymia if…
- You can't reliably do a fasting window before meds
- Cash pay matters more than peak weight loss ($230/mo cheaper)
- You want the higher peak efficacy (11% vs 10%)
Pick Rybelsus if…
Not sure which fits?
The 30-second matcher on the homepage scores every 2026 GLP-1 against your goals + preferences and recommends the best fit.