Updated May 2026
Qsymia vs Zepbound
Side-by-side comparison of Qsymia (phentermine + topiramate ER) and Zepbound (tirzepatide (injection)) across efficacy, food restrictions, monthly cost, and Medicare Bridge coverage.
Our pick for most patients
Zepbound
Based on the data below, Zepbound wins on covered under the Medicare GLP-1 Bridge ($50/mo from Jul 1, 2026). 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 | Zepbound |
|---|---|---|
| Route | tablet · daily | injection · weekly |
| Avg weight loss | 7–11% | 18–22% |
| Food restriction | Take in the morning (avoid evening) | No food restriction |
| Cash from | $230/mo | $299/mo |
| Savings card | — | — |
| Medicare Bridge | Tier 3 | $50/mo ✓ |
| A1c reduction | — | — |
| FDA approved | 2012-07 | 2023-11 |
- RouteQsymiatablet · dailyZepboundinjection · weekly
- Avg weight lossQsymia7–11%Zepbound18–22%
- Food restrictionQsymiaTake in the morning (avoid evening)ZepboundNo food restriction
- Cash fromQsymia$230/moZepbound$299/mo
- Savings cardQsymia—Zepbound—
- Medicare BridgeQsymiaTier 3Zepbound$50/mo ✓
- A1c reductionQsymia—Zepbound—
- FDA approvedQsymia2012-07Zepbound2023-11
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're needle-averse
Pick Zepbound if…
- You can't reliably do a fasting window before meds
- You're on Medicare and want the $50/mo Bridge price
- You want the higher peak efficacy (22% vs 11%)
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.