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It comes in four dosage strengths: 3.75 mg phentermine / 23 mg topiramate (starting dose, taken for 14 days) 7.5 mg phentermine / 46 mg topiramate (recommended dose) 11.25 mg phentermine / 69 mg topiramate (titration dose) 15 mg phentermine / 92 mg topiramate (top dose) The dosing follows a gradual escalation