Contrave is a prescription weight-management medicine that combines two drugs: naltrexone and bupropion.
- What it’s for
- Chronic weight management in adults with a body mass index (BMI) of 30 or higher, or 27 or higher with at least one weight-related condition (like high blood pressure, type 2 diabetes, or high cholesterol).
- Must be used with a reduced-calorie diet and increased physical activity.
- How it works (in simple terms)
- Naltrexone blocks opioid receptors and may help reduce cravings.
- Bupropion affects neurotransmitters involved in hunger and reward.
- The combination targets appetite and cravings to aid weight loss.
- How to take (typical titration; always follow your doctor’s instructions)
- Each Contrave tablet contains naltrexone 8 mg and bupropion 90 mg.
- Week 1: 1 tablet in the morning.
- Week 2: 1 tablet in the morning + 1 tablet in the evening (2 tablets daily).
- Week 3: 2 in the morning + 1 in the evening (3 tablets daily).
- Week 4 and onward: 2 in the morning + 2 in the evening (4 tablets daily, the full dose).
- Do not chew or crush the tablets; swallow them whole.
- Take as prescribed, with or without food.
- Who shouldn’t take it (key precautions)
- Do not take if you are pregnant.
- Do not take if you have uncontrolled high blood pressure.
- Do not take if you have a seizure disorder or a condition that increases seizure risk.
- Do not take if you have a current or past diagnosis of bulimia or anorexia nervosa.
- Do not take if you are using or recently used an opioid or are dependent on opioids (naltrexone can precipitate withdrawal and block opioid effects).
- Do not take with monoamine oxidase inhibitors (MAOIs) or if you’ve used an MAOI in the last 14 days.
- Use with caution (and discuss with your doctor) if you have liver or kidney problems, or a history of depression or mood disorders.
- Common side effects (may vary)
- Nausea, constipation, headache, dizziness, vomiting, dry mouth, insomnia, fatigue.
- Important risks to discuss with your clinician
- Mood changes or suicidal thoughts/behavior (especially in young people or if you have a history of depression or suicidality).
- Increases in blood pressure and heart rate.
- Seizures (risk increases with dose and with certain risk factors).
- Potential interactions with alcohol (can increase seizure risk; avoid heavy drinking).
- Possible interactions with other medicines, especially those affecting the central nervous system or opioids.
- What to do if you’re considering Contrave
- Talk with a healthcare provider to see if it’s appropriate for you, discuss your health history, current medications, and any concerns.
- They’ll monitor blood pressure, mood, and weight loss progress, and adjust or discontinue if needed.
If you’d like, tell me about your health history, current meds, and what you’re hoping to achieve with weight loss, and I can help assess how Contrave might fit or suggest questions to ask your clinician.