Contrave (naltrexone/bupropion) is a prescription drug used for weight loss and long-term weight management in certain adults. The drug is prescribed along with diet and exercise. Contrave does not come as a generic drug.
Contrave comes as an extended-release oral tablet. (Extended-release tablets release the medication into your body slowly over a few hours.)
The active ingredients in Contrave are naltrexone and bupropion. Naltrexone belongs to a group of drugs called opioid antagonists. Bupropion belongs to a group of drugs called antidepressants. To learn more about Contrave, see this in-depth article.
Contrave has a boxed warning. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the “What should I know before using Contrave?” section.
Weight loss and long-term weight management are strategies that can help you reach and maintain a healthy body weight.
What’s considered a healthy body weight for you can depend on various factors, such as:
- age
- height
- sex assigned at birth
- ethnicity
- muscle mass
- other health conditions you may have
- your family medical history
Healthcare professionals often reference body mass index (BMI) when discussing body weight. Your BMI is calculated from your weight and height. It gives a simple description of your weight status, which will fall into one of the following categories:
BMI | Weight status |
---|---|
below 18.5 | underweight |
18.5 to 24.9 | healthy weight |
25 to 29.9 | overweight |
30 and above | obesity |
If your BMI indicates overweight or obesity, your doctor may recommend losing weight to benefit your long-term health. For example, in some cases, losing weight can lower the risk of heart disease, stroke, diabetes, joint and mobility problems, and certain cancers.
Following a reduced calorie diet and increasing physical activity can help some people reach and maintain a healthy weight. But for others, diet and exercise alone may not be enough.
If you have obesity, or if you’re overweight and have certain health conditions, your doctor may prescribe Contrave to help with weight loss and long-term weight management. The medication should be used along with a diet and exercise program.
Who is Contrave prescribed for?
Doctors may prescribe Contrave for adults with:
- a BMI of 30 or above
- a BMI of 27 or above and one or more weight-related health conditions, such as high blood pressure, high cholesterol, or type 2 diabetes
Contrave contributes to weight loss and weight management by helping reduce your appetite and manage your cravings.
How does Contrave work?
Contrave contains two active ingredients: naltrexone and bupropion.
Doctors don’t fully understand how naltrexone and bupropion help you lose weight. However, these medications affect certain neurotransmitters in your brain, including dopamine and beta-endorphin. Neurotransmitters are chemicals that help pass messages between nerve cells.
Naltrexone and bupropion target nerve messages sent in two parts of your brain that are tied to cravings and the urge to eat.
The combined effects of naltrexone and bupropion can lead to reduced feelings of hunger. They can also decrease the feelings of pleasure you may experience when eating foods that are high in fat, sugar, or salt. This can help reduce cravings for those foods.
Taking Contrave can help you consume fewer calories. Over time, this can lead to weight loss.
Is Contrave used in children?
No, Contrave is not approved for use in anyone younger than 18 years old. Contrave’s manufacturer has not studied the safety or effectiveness of the drug in children.
Contrave has been shown to be an effective medication for weight loss and long-term weight management.
In clinical studies, using Contrave with diet and exercise was more effective for weight loss than using diet and exercise alone. For more details about how Contrave performed in these studies, see the drug’s prescribing information.
Keep in mind that not everyone will have the same results with Contrave. For more information about how effective Contrave may be for you, talk with your doctor.
Contrave comes as an extended-release oral tablet. (Extended-release tablets release the medication into your body slowly over a few hours.)
What is the usual dosage for Contrave?
Contrave tablets come in one strength. Each tablet contains 8 milligrams (mg) of naltrexone and 90 mg of bupropion.
The following table describes the usual dosing schedule for Contrave:
Week | Morning dose | Evening dose |
---|---|---|
1 | 1 tablet | — |
2 | 1 tablet | 1 tablet |
3 | 2 tablets | 1 tablet |
4 and after | 2 tablets | 2 tablets |
How do you take Contrave?
You should swallow Contrave tablets whole. Do not split, crush, or chew the tablets. If you have trouble swallowing tablets, talk with your doctor or pharmacist. You can also check out this article for tips on swallowing pills.
You can take Contrave either with or without food. But if you take it with food, avoid taking it with meals that are high in fat. High fat foods can increase the amount of Contrave that your body absorbs. This can raise your risk of experiencing side effects from the drug.
How often should I take Contrave?
For the first week of treatment, you’ll take one tablet per day, in the morning. After that, you’ll take Contrave twice daily, in the morning and evening.
Using Contrave for weight loss (its only approved use) may cause side effects in some people. These side effects can be mild or serious.
The following lists include some of the main side effects that have been reported in people taking Contrave. For information about other possible side effects of this medication, talk with your doctor or pharmacist.
You can also learn more from the Contrave side effects article or from the drug’s prescribing information.
What are Contrave’s mild side effects?
Contrave may cause mild side effects in some people. These include:
- nausea and vomiting
- constipation
- diarrhea
- headache
- dizziness
- difficulty sleeping
- dry mouth
- hot flashes
- fatigue
- tremor
In many cases, mild side effects from the drug can be temporary. Some side effects may be easy to manage too. But if side effects last a long time, bother you, or become severe, talk with your doctor or pharmacist.
What are Contrave’s serious side effects?
Taking Contrave may lead to rare but serious side effects. Examples include:
- increased blood pressure
- fast heart rate
- closed-angle glaucoma
- seizures
- liver problems, such as hepatitis
- mental health conditions, such as depression, anxiety, mania, psychosis, and aggression
- suicidal thoughts and behaviors*
Call your doctor right away if you have any serious side effects while taking Contrave. If the side effects seem life threatening or if you think you’re having a medical emergency, call 911 or your local emergency number immediately.
* Contrave has a boxed warning for this side effect. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the “What should I know before using Contrave?” section.
Allergic reactionFor some people, Contrave can cause an allergic reaction. In general, symptoms of allergic reaction can be mild or serious.
What might help
If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should continue Contrave treatment.
If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.
If your doctor confirms you’ve had a serious allergic reaction to Contrave, they may have you switch to a different treatment.
Before you use Contrave, there’s some important information to keep in mind. The drug may not be a safe option for you if you have certain medical conditions or other factors that affect your health. Some of these are mentioned below.
Boxed warning: Suicidal thoughts and behaviors
This drug has a boxed warning about the risk of suicidal thoughts and behaviors. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.
Contrave contains two active ingredients: naltrexone and bupropion. Bupropion is a type of antidepressant.
Clinical studies have shown that antidepressants such as bupropion can increase the risk of suicidal thoughts and behaviors in some people with mental health conditions such as depression. The risk is higher in people younger than 24 years old. It’s also higher at the start of treatment and after a dose change.
In studies of Contrave for weight loss, the medication did not increase the risk of suicidal thoughts or behaviors. However, due to the possible risk related to bupropion, you should watch for changes in your mood, feelings, thoughts, or behavior while taking Contrave. It’s helpful to have people close to you watch for changes as well. See your doctor right away if you notice any changes.
What other warnings should I know about?
In addition to a boxed warning, Contrave has other warnings. If any of the following medical conditions or other health factors apply to you, talk with your doctor before using Contrave:
- if you have high blood pressure
- if you have heart disease
- if you have kidney or liver problems
- if you have a history of seizures
- if you have a history of stroke or head injury
- if you’ve had an eating disorder, such as anorexia or bulimia
- if you’ve had a mental health condition, such as depression or bipolar disorder
- if you take other medications, especially opioids, monoamine oxidase inhibitors (MAOIs), diabetes medications, or other medications containing bupropion, such as Auvelity, Aplenzin, or Wellbutrin
- if you’ve recently stopped taking a benzodiazepine, barbiturate, or seizure medication
- if you are pregnant or breastfeeding
- if you consume alcohol
- if you used to consume alcohol excessively but have recently stopped drinking
- if you’ve had a previous allergic reaction to this drug or any of its ingredients
Help is out there
If you or someone you know is in crisis and considering suicide or self-harm, please seek support:
- Call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
- Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
- Not in the United States? Find a helpline in your country with Befrienders Worldwide.
- Call 911 or your local emergency services number if you feel safe to do so.
If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.
If you’re not in the same household, stay on the phone with them until help arrives.
Find answers to some frequently asked questions about using Contrave.
Are there any foods I should avoid while taking Contrave?
You should avoid taking your doses of Contrave with meals that are high in fat. High fat foods can increase the amount of Contrave that your body absorbs. This can raise your risk of experiencing side effects from the medication.
Examples of high fat foods include:
- eggs
- avocado
- cheese
- certain types of meat, such as bacon, chicken wings, and ribs
While taking Contrave, you should also follow a balanced diet. This will likely mean reducing your intake of sugar, salt, and saturated and trans fats. Your doctor can help you create a diet program that works for you.
Will I see any results from Contrave after 1 month of treatment?
Yes, it’s possible. Contrave typically starts working to help you reduce your calorie intake soon after you start taking it. Consuming fewer calories can lead to weight loss over time.
In clinical studies, most people taking Contrave had lost some weight after 1 month of treatment. They continued to lose weight over the next 8 to 9 months.
Keep in mind that your results with Contrave may vary from those seen in studies. If the medication has not worked well enough for you after 3 to 4 months of treatment, your doctor will likely recommend that you stop taking it. They can discuss other options with you.
The price of Contrave depends on several factors. These can include your treatment plan, your insurance plan, the pharmacy you use, and your location.
Contrave is a brand-name drug that’s not available as a generic. Brand-name drugs usually cost more than generics.
To save money on your Contrave prescription, explore these Optum Perks coupons. (Note: Optum Perks coupons cannot be used with any insurance copays or benefits.)
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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