Should You Still Take Contrave for Weight Loss? A Quick Review

Written by Marixie Ann Obsioma, MT, undergrad MD on February 09, 2022

Contrave (naltrexone and bupropion) one of the most popular prescription drugs used to treat chronic (long-term) obesity in individuals with at least one other weight-related disorder.

It comprises naltrexone and bupropion. Naltrexone is an opiate antagonist. Antidepressant Bupropion Contrave's components target the brain's hunger and reward centers. They curb hunger and curb cravings.

Contrave is a sustained-release tablet. This weight loss drug is commonly used orally.

Drug Facts

Generic Name: Naltrexone and bupropion
Brand Name(s): Contrave
Drug Availability: Prescription
Administration Route: Oral
Therapeutic Classification: Anti-obesity agent
Available Generically: No
Controlled Substance: N/A
Active Ingredient: Naltrexone and bupropion
Dosage Form: Extended-release tablet

What Is Contrave?

The FDA authorized Contrave to treat individuals who are:

Obese (Body Mass Index of 30 kg/m2 or higher)

Overweight other weight-related disorders, such as uncontrolled high blood pressure, high cholesterol, or type 2 diabetes (Body Mass Index of 27 kg/m2).

Contrave suppresses appetite and cravings. If you take Contrave, your doctor will likely also recommend diet and exercise to help you lose weight.

Contrave has not been evaluated with other diet pills or supplements.

How to Take Contrave?

Read the patient information that comes with your Contrave prescription. If you have questions about the medication, ask your doctor or pharmacist.

Prescription drugs like Contrave are taken in two-tablet doses twice daily. Take Contrave as prescribed. Your doctor will give you a dosing schedule.

Remember when taking Contrave to:

Never take two pills at once.
Do not chew, crush, or break the tablets (swallow the tablets whole)
Avoid taking it with a high-fat meal to avoid seizures.

Similar to other weight loss drugs, Contrave may need to be stopped if your doctor recommends prescription pain pills or opioid pain medicines. Ask your doctor for advice. Contrave may alter the outcome of a urine drug test. Tell the lab personnel you take Contrave.

Also, let your doctor know if you haven't lost 5% of your starting weight after 16 weeks of treatment.

Storage

Keep Contrave away from heat, light, and moisture. Keep Contrave out of reach of children and dogs. 3

How Fast Does Contrave Work?

Many Contrave users lose weight after four weeks. After 12–16 weeks of treatment, your doctor will assess your progress. Of course, this must be coupled with a reduced calorie diet and exercise.

What Are Contrave's Side Effects?

Other side effects may arise. A doctor can advise you about side effects. If you have other side effects, contact your pharmacist or doctor. The FDA accepts reports at www.fda.gov/medwatch or 800-FDA-1088.

Contrave, like other over the counter medicines, has side effects. Inform your doctor about any side effects that worsen or do not disappear.

Symptoms

Common Contrave side effects include:

Constipation, nausea, vomiting, or diarrhea
Headache
Dizziness
Insomnia
Mundane
Increased heart rate and blood pressure
Palpitations
Anxiety
Flushing
Tiredness
Tremor
Flu
Ear ringing (tinnitus)
UTI (UTI)
Over sweating
Irritability
Nose change
Muscle Rash

Severe side effects:

If you experience significant adverse effects, contact your doctor. Call 911 if you have life-threatening symptoms or a medical emergency.

Serious side effects and symptoms include:

Symptoms of anaphylaxis include hives, swelling of the lips, tongue, face, and difficulty breathing. If you have these symptoms, call 911.
Stevens-Johnson syndrome, which includes rash, blistering or peeling skin, sore throat, fever, and burning eyes. This one is an emergency.
Changes in mood or behavior. Contrave does not treat depression. In fact, it can worsen anxiety, panic attacks, insomnia, agitation, and suicidal or self-harming thoughts. It can trigger homicidal impulses. If you experience any of these symptoms, stop taking Contrave and call your doctor or go to the hospital.
Slower breathing. Contrave depresses the CNS (CNS). Slow breathing, excessive drowsiness, or difficulties waking up require immediate medical intervention.
Symptoms include upper stomach pain, fatigue, yellowing of the skin or eyes, and black urine.
Confusion, jerking movements, and loss of consciousness are symptoms of seizures.
Severe hypertension causes severe headaches, blurred vision, rapid heartbeat, and pounding in the neck or ears.
Glaucoma symptoms include tunnel vision, light haloing, and eye pain or swelling.
Increased risk of manic episodes include racing thoughts, increased energy, extreme happiness, risk-taking behavior, and unusual irritability or chattiness.
Langerzeit-Effekte

Mild side effects:

Cramping
Knee ache
Irregular periods
Anxiety
Flu
Ear ringing
Excess sweating
Irritability
Balding

Moderate long-term or delayed impacts include:

Constipation
Memory issues
Sexual issues (erectile dysfunction)
Dehydration
Uterine bleed
Hepatitis

Side effects can be severe if delayed or long-term. Increased risk of the following:

Affliction
Seizures
Skin reactions
Eye pressure Gallbladder inflammation
Thinking and acting suicidally

If you encounter any odd issues while taking this drug, call your doctor.

What Contrave Dosage Should I Take?

The dose varies depending on the patient. Obey your doctor's or the label's instructions. The following information only includes average amounts. Change your dose only if your doctor advises you to.

The amount of medicine you take depends on the medicine's strength. The number of daily doses, the time between doses, and the duration of treatment vary depending on the medical condition.

Oral (extended-release tablets):

Weight Loss for adults:

Week 1: One tablet in the morning. In week 2, your doctor will raise your dose to one morning and one evening tablet. Week 3: two tablets in the morning and one in the evening.

Week 4: 2 pills morning and two tablets evening.

Note: Not for use by children.

Modifications

Your doctor may adjust your Contrave dosage in specific instances. Contrave may have substantial medication interactions, requiring dosage modifications. Consult with your healthcare provider and make them aware of all medications you may be taking.

If you are:

Age 65 or older
Have mild renal issues
Have a mild liver issue

Contrave may not be suitable for you if you are:

Under 18: Contrave has not been examined in youngsters.

Pregnant or nursing: Contact your doctor if you become pregnant while taking Contrave or are breastfeeding.

Whenever You Miss A Dose

If you miss a dose of Contrave, try to catch up quickly. If the following amount is almost due, skip the missed one. Do not take two doses together. Take no more than four tablets per day.

Overdose: What Happens If I Take Too Much Contrave?

Symptoms of overdose may include:

Seizure
Loss of consciousness
thumping heart
Seeing things or hearing voices that do not exist
Don't take opioid pain medications, methadone, or heroin while taking Contrave! The combination could be dangerous and cause coma and death.

How Do I Overdose on Contrave?

Contrave overdoses should be reported to your doctor or the Poison Control Center at 800-222-1222.

Call 911 if someone collapses or experience severe chest pain and stops breathing after taking Contrave.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

Your doctor must check your progress at regular visits to make sure this medicine is working correctly and to check for unwanted effects.

You are using this drug while pregnant can harm the unborn child. During therapy, use effective birth control to avoid pregnancy. Inform your doctor if you think you've gotten pregnant while taking this drug.

Avoid taking naltrexone and bupropion with MAO inhibitors (e.g., isocarboxazid [Marplan®], phenelzine [Nardil®], selegiline [Eldepryl®], tranylcypromine [Parnate®]).

Do not start naltrexone and bupropion within two weeks of stopping an MAO inhibitor. Take an MAO inhibitor two weeks after stopping naltrexone and bupropion. A sudden rise in body temperature, a rapid rise or uncontrolled high blood pressure, or severe seizures may result from taking them together or not waiting two weeks.

Use naltrexone and bupropion only if you are not taking Zyban®, Aplenzin®, or Wellbutrin® to treat depression. There are no narcotics (e.g., buprenorphine, methadone, or other habit-forming painkillers) within 7-10 days.

This medicine may cause agitation, irritability, or other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed.

Notify your doctor if you have trouble sleeping, are easily upset, have a lot of energy, or become reckless. Tell your doctor if you feel nervous, angry, restless, violent, or scared. Notify your doctor if you or your caregiver notice any of these symptoms.

Using heroin or other narcotics while taking naltrexone and bupropion increases your risk of accidental overdose, serious injury, or death. Also, naltrexone prevents the effects of heroin.

Do not stop taking this medicine without checking first with your doctor. Your doctor may advise you to reduce your dosage before stopping altogether gradually.

If you have agitation, anxiety, dizziness, the constant movement of yourself or your surroundings, headaches, increased sweating or nausea, trembling or shaking when you stop taking medicine, this will help.

High blood pressure while you are using this medicine. It may cause headaches, dizziness, and hazed vision. You may need to do this at home. Call your doctor if you have a severely high blood pressure.

This medication may trigger anaphylaxis, a life-threatening allergic reaction that requires emergency medical intervention. Swelling of the face, tongue, or throat with difficulty breathing or chest pain should be reported immediately.

It has been linked to severe skin responses (Stevens-Johnson syndrome). Check with your doctor if you have blistering, peeling, or loosening of the skin, red skin lesions, severe acne or skin rash, sores or ulcers, or fever or chills with this medicine.

Call your doctor right away if you have upper stomach pain or tenderness, pale stools, dark urine, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a severe liver problem.

You should report any change in eyesight during or after therapy to your doctor. Your doctor may refer you to an ophthalmologist (eye doctor).

This drug may cause hypoglycemia (low blood sugar) in people with diabetes. You must treat low blood sugar to avoid fainting (unconsciousness). Symptoms of low blood sugar vary. Learn your symptoms so you can treat them quickly. Check your blood sugar levels before and during therapy.

Drinking alcoholic beverages should be limited or avoided, if possible, with this medicine.

Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of some tests may be affected by this medicine.

You should only take other medicines after consulting your doctor. This one includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Why Shouldn't I Take Contrave?

Contrave isn't for everyone. You should not take Contrave if you are allergic to naltrexone, bupropion, or any of the inactive ingredients in Contrave.

Contrave is also risky for other reasons. Among them are:

Use of monoamine oxidase inhibitors (MAOIs) within 14 days
End-stage kidney disease
Uncontrolled hypertension (hypertension)
Seizure disorder or history of seizures
Anorexia or bulimia (eating disorders) (eating disorders)
Opioid abuse, addiction, or withdrawal
Use of a bupropion-containing medication (such as Wellbutrin)
Alcohol use
Stopping alcohol, benzodiazepine, sedative, or antiepileptic medication use
With other medical conditions, you may still be able to use Contrave with caution. In some circumstances, your doctor may closely monitor your treatment. Talk to your doctor about your medical history. They will determine whether you can safely use Contrave.

Interactions: What Other Medications Should I Avoid?

Tell your doctor about all your medications, including prescription and OTC drugs, vitamins, and supplements, before taking Contrave.

Contrave has known MAOI and opioid pain medication interactions.

Combining Contrave with an MAOI can cause hypertension. Separate taking these drugs by at least 14 days.

If opioid medication is required, your healthcare provider may temporarily stop your Contrave treatment. Seven to ten days after stopping the opioid, you can resume the medicine.

Examples of other drugs that can interact with Contrave include:

Alcohol
Amantadine (available under the brand names Gocovri, Osmolex ER, and Symmetrel) (known under the brand names Gocovri, Osmolex ER, and Symmetrel)
Antipsychotics, such as Risperdal (risperidone) and Haldol (haloperidol), among others
Beta-blockers like Lopressor (metoprolol), Plavix (clopidogrel)
Digoxin (available under the brand names Lanoxin, Cardoxin, Digitek, Digoxin, and Lanoxicas) (known under the brand names Lanoxin, Cardoxin, Digitek, Digoxin, and Lanoxicas)
HIV drugs like Sustiva (efavirenz) and Kaletra (lopinavir and ritonavir)
Ingrid (levodopa)
Selective serotonin reuptake inhibitor antidepressants, such as Lexapro (escitalopram) and Prozac (fluoxetine), among others
Theophylline is sold under the trade names Elixophyllin, Norphyl, and Theo-24.
Tricyclic antidepressants, such as Elavil (amitriptyline) and Aventyl (nortriptyline), among others
Antiarrhythmics of type 1C include Tambocor (flecainide) and Rythmol (propafenone).

Note: This is not an exhaustive list of medication interactions. Consult your healthcare professional for medical advice regarding medication interactions with Contrave.

What Medications Are Similar?

Besides Contrave, other medicines used for weight loss include:

Xenical (orlistat): An oral medication available by prescription
Alli (orlistat): A lower dose of orlistat available OTC
Qsymia (phentermine and topiramate): An oral prescription drug
Saxenda (liraglutide): A daily injectable prescription drug
Wegovy (semaglutide): A weekly injectable prescription drug
Oral appetite suppressants such as phentermine and diethylpropion: Available by prescription and suggested for short-term usage of up to 12 weeks

Note: Many dietary supplements advertise weight loss. However, the FDA does not regulate these supplements. Many of these products are dangerous with certain medical conditions and other drugs. Always ask your healthcare physician before using any weight loss supplement.

This list contains a list of medicines also prescribed for weight loss. It is not a list of medications suggested to take with Contrave. Ask your pharmacist or a healthcare practitioner if you have questions.

FREQUENTLY ASKED QUESTIONS

What is Contrave Used for?

The FDA authorized Contrave for long-term weight management in individuals who are obese or overweight with at least one other weight-related disorder such as high cholesterol, high blood pressure, or type 2 diabetes. Contrave is taken combined with diet and exercise.

How Does Contrave Work?

Contrave comprises two ingredients: naltrexone and bupropion. The medications function in the brain to lower hunger and manage cravings.

What Medicines Should Not be Taken with Contrave?

Many drugs can interact with Contrave, including MAOIs, opioid pain treatments, some antidepressants, antipsychotics, and beta-blockers, among others. Before taking Contrave, review your prescription list with your healthcare professional to ensure Contrave is safe for you.

How Long Does It Take for Contrave to Work for Weight Loss?

People start to lose weight with Contrave in as fast as four weeks. Your healthcare practitioner will evaluate results at roughly 12–16 weeks of treatment with Contrave. If you have not dropped 5 percent or more of body weight, your physician may advise you to discontinue taking Contrave.

What Are the Side Effects of Contrave?

As mentioned above, the most common side effects of Contrave are stomach pain, nausea, vomiting, and constipation or diarrhea. Other typical adverse effects may include headache, sleeplessness, dizziness, dry mouth, anxiety, palpitations, and elevated heart rate and high blood pressure. Other side effects may arise. Ask your healthcare professional for a complete list of adverse effects.

How Do I Safely Discontinue Using Contrave?

Your healthcare professional will advise you on how long to take Contrave for weight loss.

How Can I Stay Healthy While Taking Contrave?

Some people report thoughts of suicide when taking bupropion, a component in Contrave. Make sure that you and your family, friends, and caregivers observe any behavior changes while using this drug. If any changes occur, get medical assistance straight once.

In addition to taking your medication, aim to incorporate a reduced calorie diet and exercise adjustments into your weight-management plan. Talk to your healthcare physician about what diet and exercise could be appropriate for you.

Avoid ingesting alcohol and high-fat meals while taking Contrave for weight loss, as these can raise the risk of seizures.

Again, Contrave is not one of the readily available over the counter medicines for weight loss. Before taking Contrave to improve your body weight, discuss your medical history with your healthcare professional. Tell your provider about all the medications you use. When using Contrave to lose weight, follow your provider's instructions for use. Do not take any other weight-loss drugs or supplements unless your provider tells you to.

References:

https://www.webmd.com/drugs/drugreview-166975-contrave-oral
https://www.consumerreports.org/drugs/is-contrave-worth-trying-to-lose-weight/
https://www.medicalnewstoday.com/articles/drugs-contrave
https://www.goodrx.com/contrave/heres-how-to-save-on-weight-loss-medication-contrave
https://www.nps.org.au/medicine-finder/contrave
https://www.singlecare.com/blog/contrave-vs-phentermine/
https://reviews.everydayhealth.com/drugs/contrave
https://www.goodrx.com/contrave/what-is
https://www.drugs.com/comments/bupropion-naltrexone/contrave.html
https://www.webmd.com/diet/obesity/news/20150518/weight-loss-contrave-safety