Oral Medication Overview

Overview

GLP-1 medications have increasingly gained popularity over the last couple of months and have often made news headlines. However, while GLP-1 drugs have gained steam, there have been hundreds of thousands of people who have taken and seen unbelievable results from non-GLP-1 weight-loss medications. 

The Sunrise program has introduced a number of these offerings into our program for a few reasons:

• GLP-1 medications can be expensive ($1k+/month) and inaccessible if you don’t have insurance to cover the cost of medication 
• There have been intermittent supply shortages in GLP-1 medications that have limited access for individuals
• There may be certain situations in which a provider believes that you are a better fit for an oral medication 
• Some insurance plans will ask a patient to take an oral medication as a prerequisite to getting coverage for a GLP-1 medication

These medications work in a variety of ways, including reducing appetite, increasing satiety, and slowing the absorption of food. Below, we will give an overview of some of these medications that are available through the Sunrise program.

Contrave: Contrave is a combination of two medications: bupropion and naltrexone. Bupropion is an antidepressant that helps to reduce cravings. It also also FDA-approved for smoking cessation. Naltrexone is a medication that helps to reduce alcohol and opioid cravings. Contrave is taken as a tablet that starts as one tablet daily and is increased as tolerated to two tablets twice daily. The most common side effects of Contrave include nausea, vomiting, constipation, dry mouth, and headache. Contrave can help with weight loss by doing the following:

• Reducing appetite
• Decreasing cravings 

Within a 56-week clinical study, 62% of study participants taking Contrave lost 5% or more of their body weight. Contrave has demonstrated the ability to help people lose 5-7% of their body weight over a period of 12 months on average. 

Naltrexone & Bupropion: Naltrexone hydrochloride & bupropion hydrochloride are the two active components in Contrave. These two active components are both approved by the FDA - naltrexone to treat alcohol and opioid dependence, and bupropion to treat depression and seasonal affective disorder and as an aid to smoking cessation treatment. Naltrexone & bupropion can help with weight loss by:

• Reducing appetite
• Decreasing cravings 

In one 12-week study, “the percentage of patients who attained 3% weight loss was significantly greater with naltrexone bupropion than with placebo (45.5% vs 0%); weight-loss and binge-eating reductions were significantly correlated in the group that received NB. At 6-month follow-up, outcomes remained improved relative to baseline, with no significant differences between NB and placebo.” In another 56-week study, a combination of naltrexone and bupropion “resulted in 5.0-9.3% weight loss, while the placebo-subtracted weight loss was 3.2-5.2% during 56 weeks of treatment.”

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‍*Note: patients cannot take opiate pain medications while on Contrave or Naltrexone because the naltrexone blocks opiates from working. There is no interaction with OTC pain meds like Tylenol, Ibuprofen, etc.