Disclaimer: This article is for informational purposes only and does not constitute medical advice. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition.
Overview
Contrave is an extended-release tablet that combines two medicines: naltrexone hydrochloride (8 mg) and bupropion hydrochloride (90 mg). In Canada it is made by Bausch Health, Canada Inc. and is available by prescription only.
It is used for long-term weight management together with a reduced-calorie diet and more physical activity. It is taken by mouth, which sets it apart from injectable options such as semaglutide, liraglutide and tirzepatide.
Bupropion is also the active ingredient in Wellbutrin and Zyban, so Contrave must not be taken with those products.
Health Canada has approved Contrave, along with a reduced-calorie diet and increased physical activity, for chronic weight management in adults with a starting body mass index (BMI) of:
- 30 or more (obesity), or
- 27 or more (overweight) with at least one weight-related condition, such as controlled high blood pressure, type 2 diabetes or abnormal cholesterol.
Naltrexone hydrochloride and bupropion hydrochloride
Opioid antagonist and antidepressant combination for weight management
weight management
Prescription required
Available
How Contrave Works
The two ingredients act on areas of the brain involved in hunger and food cravings.
Bupropion is an antidepressant that also reduces appetite. Naltrexone blocks opioid receptors. Used together they are thought to reduce appetite and cravings, although the exact way Contrave leads to weight loss is not fully understood.
Dosage Instructions of Contrave
The dose is increased over four weeks to lower the chance of side effects.
- Week 1: one tablet in the morning
- Week 2: one tablet in the morning and one in the evening
- Week 3: two tablets in the morning and one in the evening
- Week 4 onward: two tablets in the morning and two in the evening
The full dose is four tablets a day (32 mg of naltrexone and 360 mg of bupropion). Do not take Contrave with a high-fat meal, because that raises the amount of both drugs absorbed.
Your doctor will check your progress after 12 weeks on the full dose. If you have not lost at least 5% of your starting weight by then, Contrave should be stopped, because it is unlikely to work with longer use.
If you miss a dose, skip it and take the next dose at the usual time. Do not double up. Taking doses too close together raises the risk of seizures.
Storage Instructions
Store Contrave as directed on the pharmacy label and package insert. Keep it out of the reach of children.
Side Effects of Contrave
The most common side effects in clinical trials, compared with placebo, were:
- Nausea: 33% of people, compared with 7% on placebo
- Constipation: 19%, compared with 7%
- Headache: 18%, compared with 10%
- Vomiting: 11%, compared with 3%
- Dizziness: 10%, compared with 3%
- Insomnia: 9%, compared with 6%
- Dry mouth: 8%, compared with 2%
Get medical help right away if you have a seizure, thoughts of harming yourself, severe mood changes, eye pain or sudden vision changes, or signs of liver problems such as yellowing skin, dark urine or pain in the upper abdomen.
Important Safety Information About Contrave
Contrave carries a boxed warning because bupropion is an antidepressant. Antidepressants are linked to an increased risk of suicidal thoughts and behaviour, so everyone taking Contrave should be watched for depression, agitation and changes in mood.
Do not take Contrave if you:
- have uncontrolled high blood pressure
- have a seizure disorder or a history of seizures
- take any other product that contains bupropion
- have or have had bulimia or anorexia nervosa
- use opioids regularly, take methadone or buprenorphine, or are in opioid withdrawal
- are suddenly stopping alcohol, benzodiazepines, other sedatives or anti-seizure medicine
- take a monoamine oxidase inhibitor (MAOI) or the antipsychotic thioridazine
- are pregnant
- have severe liver disease or end-stage kidney failure
Contrave can raise blood pressure and heart rate, so both should be measured before starting and checked during treatment. Bupropion can cause seizures, and the risk rises with the dose.
Drug Interactions
Contrave interacts with several common medicines. Tell your doctor and pharmacist about everything you take.
- MAOIs: must not be combined with Contrave. At least 14 days must pass between stopping an MAOI and starting Contrave.
- Opioid medicines: naltrexone blocks opioids, so opioid-containing medicines may not work properly.
- Some antidepressants, antipsychotics and beta-blockers such as metoprolol: bupropion can raise the levels of medicines processed by the CYP2D6 enzyme.
- SSRIs and SNRIs: taking them with bupropion increases the risk of serotonin toxicity.
- Clopidogrel and ticlopidine: the maximum dose of Contrave is lower, at one tablet in the morning and one in the evening.
Brands & DIN Number of Contrave
Brand Names
Contrave
DIN (Drug Identification Numbers)
02472945
Key Takeaways
- 1Contrave is a prescription tablet that combines naltrexone and bupropion for chronic weight management.
- 2It is approved for adults with a BMI of 30 or more, or 27 or more with a weight-related condition.
- 3The dose is built up over four weeks to four tablets a day.
- 4If you have not lost at least 5% of your weight after 12 weeks on the full dose, it should be stopped.
- 5Nausea, constipation and headache are the most common side effects.
- 6It must not be used with opioids, MAOIs or other bupropion products, or by people with seizures or uncontrolled high blood pressure.
- 7It is not a BC PharmaCare benefit.
Frequently Asked Questions
Avee Editorial
Avee Editorial Team