Contrave™: Uses, Side Effects, and More

  • Contrave™ is a FDA-approved prescription medication that is used in combination with a healthy diet and exercise to assist certain adults with weight loss.
  • Contrave™ is a medication that contains two active ingredients: naltrexone and bupropion. Naltrexone belongs to a class of drugs called opioid antagonists, which work by blocking certain receptors in the brain. Bupropion belongs to a class of drugs called antidepressants, which work by affecting the activity of neurotransmitters in the brain.
  • Contrave™ is a prescription medication that is taken orally in the form of an extended-release tablet. Contrave™ is available in one strength: 8 milligrams (mg) of naltrexone and 90 mg of bupropion per tablet.

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Contrave® Medication

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Contrave™ is a brand-name FDA-approved prescription medication that combines bupropion, an antidepressant that may also reduce appetite, and naltrexone, a drug typically used to help treat addiction to opioids or alcohol. It is classified as an anorexiant and is used to assist in weight management for obese or overweight adults with weight-related health issues. It should be used in conjunction with a healthy diet and exercise plan, but it is not intended to treat any specific weight-related medical conditions, such as high blood pressure, diabetes, or high cholesterol.

What does Contrave™ cost with Sunrise?

Our subscription fee is for access to online medical consultations, insurance advocacy, and other plan benefits. If appropriate, a licensed physician will prescribe a prescription treatment as part of your personalized treatment plan. If you have insurance, your co-pay will not be more than $25. Sunrise will give you an itemized receipt for out-of-network reimbursement. The medications prescribed are are HSA and FSA-eligible.

How Sunrise works with Contrave™

Our board-certified physician will review your information and speak with you to create a customized treatment plan. Based on your medical history, our physician may prescribe medications that specifically address your biological needs while also reducing your out-of-pocket expenses. We commonly prescribe 7 or more FDA-approved weight loss medications, including Wegovy, Ozempic, Mounjaro, and Contrave. You can pick up your medications at a local pharmacy or have them delivered directly to your home.

What is Contrave’s dosage?

The dosage of Contrave that your doctor prescribes will depend on various factors, including the type and severity of the condition being treated, any other medical conditions you may have, and any other medications you may be taking. Your doctor will typically start you on a low dosage and adjust it gradually to reach the recommended daily dosage. It is important to follow the specific dosage prescribed by your doctor, as they will determine the appropriate dosage for your individual needs.

The following information provides a general guide to commonly used or recommended dosages, but it is important to follow your doctor's instructions.

Drug forms and strengths

Contrave is available in extended-release tablets, which release the medication slowly into the body over a longer period of time. It is only available in one strength, which contains 8 milligrams (mg) of naltrexone and 90 mg of bupropion. This means that each tablet of Contrave contains 8 mg of naltrexone and 90 mg of bupropion. It is important to follow your doctor's instructions for taking Contrave and to use the medication exactly as prescribed.

Dosage for weight loss & weight management

When you begin treatment with Contrave, your doctor will start you on a low dosage and gradually increase the dosage over time until you reach the recommended daily dose. After approximately 4 weeks of treatment, you will typically be instructed to take two tablets of Contrave in the morning and two tablets in the evening. This will be your dosage for the remainder of your treatment period.

Your dosage schedule may look like this:

Week 1: 1 tablet in the morning, 1 tablet in the evening
Week 2: 1 tablet in the morning, 2 tablets in the evening
Week 3: 2 tablets in the morning, 2 tablets in the evening
Week 4 and beyond: 2 tablets in the morning, 2 tablets in the evening

How is Contrave™ taken?

It is important to take Contrave™ exactly as directed by your doctor or other healthcare professional. Contrave™ is available in the form of oral tablets that you swallow. When starting treatment with Contrave™, your doctor will typically follow a specific schedule to gradually increase your dosage. For more information on this dosing schedule, refer to the "Contrave™ dosage" section above.

After about four weeks of treatment, you will likely be instructed to take two tablets of Contrave twice per day. This will be your dosage until your doctor advises you to stop taking the medication. Be sure to follow your doctor's instructions for taking Contrave to ensure that you get the most benefit from the medication.

What are Contrave’s side effects?

Contrave can cause both mild and serious side effects. While taking Contrave, you may experience some of the following side effects. This list is not exhaustive and does not include all possible side effects. If you have any concerns about the side effects of Contrave, you should discuss them with your doctor or pharmacist. They can provide you with advice on how to manage any side effects that may be problematic or bothersome.

Mild side effects

Contrave can cause mild side effects, including:

  • Nausea or vomiting
  • Headache
  • Dizziness
  • Insomnia (difficulty sleeping)
  • Dry mouth
  • Diarrhea or constipation
  • Hot flashes

These side effects are usually temporary and may resolve within a few days or weeks. However, if they become severe or persist, you should speak with your doctor or pharmacist. They can help you manage these side effects and offer advice on how to cope with them.

Serious side effects

While serious side effects from Contrave are rare, they can occur. If you experience any serious side effects, it is important to contact your doctor immediately. If you are experiencing symptoms that feel life-threatening or if you believe you are having a medical emergency, call 911 or your local emergency number.

Possible serious side effects of Contrave and their associated symptoms include:

  • Increased blood pressure or heart rate. Symptoms may include lightheadedness, rapid heart rate, and headache.
  • Seizures. Symptoms may include loss of consciousness, muscle spasms, and drooling or frothing at the mouth.
  • Allergic reaction. Symptoms may include rash, itching, swelling, difficulty breathing, or chest tightness.
  • Liver damage or hepatitis. Symptoms may include yellowing of the skin or whites of the eyes, dark urine, and abdominal pain.
  • Suicidal thoughts and behaviors. Symptoms may include feelings of hopelessness, thoughts of death or suicide, and an increase in reckless or dangerous behavior.
  • Angle-closure glaucoma. Symptoms may include severe headache, eye pain, and blurred vision.

How does Contrave™ work?

Contrave™ is a prescription medication used to assist with weight loss in adults in combination with a healthy diet and exercise. It contains the active ingredients bupropion and naltrexone and is available in the form of extended-release tablets, which slowly release the active ingredients over a longer period of time.

Bupropion belongs to a class of drugs called aminoketone antidepressants, which work by affecting the activity of the neurotransmitters norepinephrine and dopamine in the brain. These chemicals play a role in regulating mood and how nerve cells communicate with each other. It is not fully understood how bupropion works, but it may help prevent norepinephrine and dopamine from being reabsorbed back into nerve cells in the brain, allowing for better communication between these cells.

Naltrexone is an opioid antagonist, meaning it blocks certain receptors on brain cells. When naltrexone blocks these receptors, it helps prevent dopamine from being released. It is not entirely clear how naltrexone aids in weight loss, but it may affect areas of the brain that control food intake and feelings of satisfaction after eating.

Together, bupropion and naltrexone can target two areas of the brain involved in cravings and appetite. They may help control the pleasure associated with eating and reduce appetite. This can help manage food cravings and decrease overall food intake.

What should be considered before taking Contrave™?

Contrave should not be used during pregnancy as weight loss during this time can harm an unborn baby, even if the mother is overweight. If you become pregnant while taking Contrave, inform your doctor immediately.

You should not use Contrave if you are allergic to bupropion or naltrexone, or if you have:

  • Untreated or uncontrolled high blood pressure
  • An eating disorder (anorexia or bulimia)
  • A history of seizures
  • Opioid addiction or withdrawal (or if you take methadone or buprenorphine)
  • Other forms of bupropion (Wellbutrin, Aplenzin, Budeprion, Forfivo, Zyban, etc.)
  • Suddenly stopped using alcohol, seizure medication, or a sedative (Xanax, Valium, Fiorinal, Klonopin, etc.)

Do not use opioid medication for at least 7 to 10 days before starting Contrave. Do not use an MAO inhibitor (isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, tranylcypromine, etc.) within 14 days before or after taking Contrave, as this can cause a dangerous drug interaction.

Before taking Contrave, inform your doctor if you have any of the following conditions:

  • Depression, bipolar disorder, or other mental illness
  • Suicidal thoughts or actions
  • A head injury
  • A tumor or infection in the brain or spinal cord
  • Diabetes or low blood sugar
  • Low sodium levels
  • Liver or kidney disease
  • Heart disease, high blood pressure, heart attack, or stroke
  • Drug addiction or a history of heavy alcohol use

It is important to be aware that some young people may experience thoughts of suicide when starting treatment with bupropion. It is therefore important for your doctor to regularly monitor your progress and for your family or caregivers to be alert for any changes in your mood or symptoms.

Contrave™ should not be used by breastfeeding women as it can pass into breast milk and potentially harm a nursing infant.

This medication is also not approved for use by individuals under the age of 18.

How do I store Contrave™?

The shelf life of a medication can vary based on a range of factors, including storage conditions. It is important to store Contrave™ tablets at a temperature between 68°F and 77°F (20°C and 25°C) in a tightly sealed container, away from light. Do not store this medication in damp or wet areas, such as bathrooms. Proper storage can help ensure that the medication remains effective for as long as possible.