Contrave (Bupropion)

Prescription Required.

Product of Canada.

Shipped from Canada.

Contrave (Bupropion)

What is Contrave (Bupropion)?

Contrave is a combination medicine of naltrexone (a pure opioid antagonist) and bupropion (an antidepressant) that is used for appetite suppression to assist adult patients in losing weight. This medication is used in those who are overweight or obese and that have medical issues related to weight.

How is Contrave Used?

This medication is a daily medication that patients will use alongside changes to their exercise regimen and diet to assist them in losing weight and reducing the health risks associated with obesity. Patients will typically start with a once-daily dose of Contrave to be taken for the duration of a week, gradually increasing to a twice-daily dose of two tablets of the medication over the course of a month.

Storage

This medication should be stored at room temperature within a range of 68°F (20°C) to 77°F (25°C).

Keep this medication out of the reach of children at all times.

Uses

Contrave is prescribed to assist patients in achieving weight loss by causing suppression of the appetite and cravings. This medication is used alongside changes in the patient’s exercise levels as well as diet to promote weight loss.

How Does Contrave Work?

This medication is a combination of an antidepressant (bupropion) and a pure opioid antagonist (naltrexone). When combined together, the effects of these two medications combined result in appetite suppression and a reduction in cravings to assist patients on their weight loss journey by triggering changes within the patient’s reward center of the brain.

Dosage

This medication comes as an extended-release tablet with 8 mg of naltrexone and 90 mg of bupropion.

Patients should take this medication exactly as instructed by their physician to ensure maximum safety and efficacy.

In general, most patients will begin with a starting dose of one tablet in the morning time once per day for a week. During the second week of treatment, the dose is typically increased to one tablet in the morning and one tablet in the evening daily. As of the third week of treatment, this dose is commonly increased to two tablets in the morning and one tablet in the evening each day. Starting during the fourth week of treatment and onward, most patients will be at a consistent maximum dose of two tablets in the morning and two tablets in the evening each day for the duration of treatment.

This medication should not be crushed, chewed, or cut, and patients should never exceed four tablets in the span of 24 hours.

Additionally, this medication should not be consumed alongside a high-fat meal due to the increased risk of seizures occurring.

Overdose

If an overdose of this medication has occurred or is suspected, individuals should contact their physician or local Poison Control Center. If the person who has overdosed becomes unresponsive or experiences difficulty with breathing, emergency medical attention should be sought immediately.

Some of the symptoms of overdosing on Contrave include the following: hallucinations, a heart rate that becomes irregular or significantly fast or slow, losing consciousness, or seizures.

Side Effects

The most common side effects of taking Contrave are as follows:

  • blurry vision
  • constipation
  • diarrhea
  • difficulty focusing or paying attention
  • dry mouth
  • experiencing flu-like symptoms
    • cough
    • fatigue that comes on suddenly
    • fever
    • muscle aches
    • sore throat
  • fatigue
  • feeling dizzy
  • hair loss
  • headaches
  • itchiness
  • metallic taste in the mouth
  • nausea
  • reflux or heartburn
  • pain in the abdomen
  • skin rash
  • sleep difficulties
  • sweating
  • unusual dreams
  • vertigo
  • vomiting

Some of the following side effects may occur and should be discussed with your doctor, as they may increase in severity while taking this medication:

  • acting on impulses that may be dangerous or destructive
  • aggression
  • anxiety that worsens or is new
  • feeling agitated
  • feelings of paranoia
  • glaucoma
    • blurry vision
    • discomfort in the eyes
    • eye pain
    • eye redness
    • seeing colorful halos around lights
  • hallucinations (visual or auditory)
  • high blood pressure
    • dizziness
    • facial flushing
    • headaches
    • nosebleeds
  • hypoglycemia (low blood sugar)
    • cold sweats
    • headaches
    • rapid heart rate
    • skin that is cold and pale
    • weakness
  • lupus symptoms
    • fatigue
    • fever
    • joint pain
    • joint swelling
    • muscle aches
    • rash
  • manic episodes
    • requiring less sleep
    • fast speech
    • feeling excessively high
    • risky behaviors
  • migraines
  • new or worsening depression
    • decreased interest or enjoyment in activities
    • difficulty concentrating
    • sleep changes
    • suicidal ideation
    • weight changes
  • panic attacks
  • rapid heart rate
  • restlessness
  • symptoms of liver issues
    • dark-colored urine
    • jaundice (yellowing of the skin or eyes)
    • nausea
    • pain in the abdomen
    • vomiting
  • tinnitus
  • violent or angry behavior

Please seek emergency medical attention immediately if you experience any of the following symptoms:

  • allergic reaction symptoms
    • abdominal cramping
    • breathing difficulties
    • nausea
    • swelling of the throat or face
    • vomiting
  • opioid overdose (in those currently taking opioids)
    • breathing shallow and slow
    • confusion
    • difficulty breathing
    • dizziness
    • drowsiness
    • feeling faint
  • opioid withdrawal (in those who have taken opioids within 7-10 days of beginning Contrave)
    • anxiety
    • cold flashes
    • diarrhea
    • difficulty sleeping
    • hot flashes
    • muscle cramps
    • nausea
    • sweating
    • vomiting
  • seizures
  • symptoms of serotonin toxicity
    • confusion
    • feeling restless
    • hallucinations
    • muscle jerks
    • rapid heart rate
    • shivering or shaking
    • sweating
  • suicidal ideation or attempting suicide

Warnings & Precautions

Diabetic Patients

This medication helps a patient to lose weight, and weight loss may result in lower levels of blood glucose. Patients with diabetes may need to monitor their blood sugar levels more closely while using this medication to ensure they do not develop hypoglycemia. Patients that have diabetes or may be at risk of developing the condition should inform their prescribing physician before beginning treatment with this medication, as this may affect the dosage, safety, and efficacy of Contrave.

Drowsiness and Reduced Coordination

This medication is known to cause drowsiness in those taking it, and this may impair an individual’s ability to operate machinery, drive a vehicle, or perform certain tasks. Patients new to using this medication should exercise caution until they know how it is going to affect them.

Glaucoma

Patients with glaucoma should discuss this condition with their doctor before beginning treatment with this medication. Contrave is known to worsen the symptoms of this condition and impact the safety, efficacy, and required dosage to be used for treatment. Any individuals who are currently taking this medication that experience changes in their vision should report this to their prescribing physician as soon as possible.

Heart Disease

One of the ingredients in Contrave, bupropion, is associated with increases in a patient’s heart rate as well as blood pressure. It has not been determined if this medication may be safely used in those who have heart disease that is not stable or that have recently experienced a heart attack. Please inform your physician if you have experienced any of the following health conditions before beginning treatment with this medication: congestive heart failure, high blood pressure (hypertension), an irregular heartbeat, a recent stroke, or a heart attack that’s occurred within the past six months. Certain health-related conditions may require a patient to be monitored during their treatment with Contrave and may also impact the safety, efficacy, and dosage of the medication required.

Hepatic Function

Patients with impaired hepatic function or any type of liver disease are at an increased risk of having this medication build up within the body, resulting in a higher risk of experiencing side effects. Individuals with impaired liver function should be sure to discuss this aspect of their health with their physician before beginning treatment with this medication, as impaired hepatic function may affect the safety, efficacy, and dosage requirements of the medication, and it may also result in additional monitoring being required.

Lactose

Patients with galactose intolerance or lactose intolerance should not take Contrave due to this medication containing lactose.

Lupus

Individuals with systemic lupus erythematosus (SLE) or cutaneous lupus erythematosus (CLE) may experience changes in their conditions when taking the combination of bupropion and naltrexone. Any patients using Contrave that develop swelling, joint pain, fatigue, or a skin rash (especially if it occurs on the face) should inform their prescribing physician immediately.

Opiates and Narcotics

This medication limits the efficacy of narcotic pain relief medications due to its ability to block the action of opiates. This also means that it is capable of impacting the efficacy of other medications that also contain opiates, such as antidiarrheal medications, certain analgesics, and certain cold and cough medications. Patients should not try to take more of these medications to counter the inhibitive effects of Contrave due to the risk of experiencing serious side effects resulting from this combination. Individuals using this medication for treatment should speak to their physician or a trusted pharmacist to determine if opiate-free alternatives are available to bypass the potential risks of mixing these medications.

Individuals that are reliant on narcotics may experience severe withdrawal symptoms if this medication is ingested for any reason. This may result in symptoms such as diarrhea, confusion, anxiety, sweating, nausea, vomiting, shakiness, or visual hallucinations. Those who are currently taking medications that are considered narcotic should not take or be prescribed Contrave.

Psychological Effects

This medication is known to cause thought and behavioral disturbances in individuals with certain mental health conditions. It is also capable of triggering mania as well as inducing mania and psychosis in those using the medication who may have never experienced these symptoms in the past. Patients with any mental health conditions or a history of such should discuss these with their physician before beginning treatment with this medication. Those who are using Contrave and experience the following symptoms should report them to their physician as soon as possible: delusional thinking, unusual overexcitement (mania), or hallucinations.

Individuals using this medication may also experience the following symptoms after several weeks of treatment: the urge to hurt others or themselves; feeling emotional; not feeling like themselves; or experiencing anxiety, restlessness, aggression, or agitation. If these changes in thoughts and behaviors occur in someone taking this medication, their prescribing physician should be informed immediately.

Pregnancy and Breastfeeding

This medication should not be used in patients that are pregnant or planning to become pregnant, as Contrave is known to cause harm to a developing and unborn child, and patients should not try to lose significant amounts of weight during pregnancy. Patients currently using this medication that become pregnant should inform their prescribing physician immediately.

Additionally, both of the active ingredients in this medication have been confirmed to pass into breast milk. Due to the risk of potential side effects for a breastfed child, patients using this medication that are desiring to breastfeed are advised to consult with their physician before proceeding with potentially exposing their child to this medication via a contaminated milk supply.

Renal Function

Individuals with impaired renal function or kidney disease are more likely to have this medication build up within the body, resulting in an increased risk of side effects. Patients with impaired kidney function or other kidney-related conditions should be sure to discuss these aspects of their medical history with their physician before beginning treatment with this medication, as this may affect the required dosage, safety, and efficacy of the medication and may result in additional monitoring being required.

Seizures

One of the active ingredients in this medication, bupropion, is associated with an increased risk of seizures. Patients with a current seizure risk or history of experiencing seizures should be sure to inform their physician of this before beginning treatment with this medication. Any individual using this medication may further increase their risk of seizures occurring if any of the other following factors apply: brain tumors, spinal cord tumors, using over-the-counter appetite suppressants or stimulants, having serious liver function issues, having diabetes that is treated with insulin or certain other applicable medication, a history of seizures, a history of head trauma, epilepsy, using additional medications that increase their seizure risk, or having addiction difficulties pertaining to opiates, stimulants, or cocaine.

Senior and Pediatric Patients

Geriatric patients using this medication have an increased risk of experiencing side effects as the changes in liver and kidney function that typically occur in this age group may change the way the medication functions within the body.

The safety and efficacy of this medication in the pediatric age group have not been determined.

Serotonin Toxicity

This medication is known to result in serious adverse reactions occurring in patients that are already using any medications that affect serotonin. These include medications such as SSRIs, tricyclic antidepressants, and other medications that are typically prescribed for the treatment of depression and similar conditions. Symptoms of serotonin toxicity occurring in such circumstances may include the following: agitation, changes in the individual’s mental state, delirium, muscle rigidity, muscle spasms, and trouble moving. In severe cases of serotonin toxicity, patients may go into a coma or experience loss of life.

Drug Interactions

Speak to your doctor about any medications or herbal supplements you are currently taking before beginning treatment with this medication. Discuss any concerns you may have with your doctor or a trusted pharmacist.

The following medications and substances are known to potentially cause interactions when used while taking Contrave:

  • alcohol
  • amantadine
  • amoxapine
  • amphetamines
  • antipsychotics
  • apomorphine
  • atomoxetine
  • bromocriptine
  • caffeine
  • carbamazepine
  • carvedilol
  • chlorpromazine
  • citalopram
  • clopidogrel
  • codeine
  • desipramine
  • desvenlafaxine
  • dexmethylphenidate
  • dextroamphetamine
  • dextromethorphan
  • digoxin
  • doxorubicin
  • duloxetine
  • efavirenz
  • eliglustat
  • fentanyl
  • fesoterodine
  • flecainide
  • fluoxetine
  • glyburide
  • haloperidol
  • HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs)
  • hydrocodone
  • imipramine
  • ivacaftor
  • levodopa
  • linezolid
  • lisdexamfetamine
  • lithium
  • lopinavir
  • lumacaftor
  • methadone
  • methylene blue
  • methylphenidate
  • methylnaltrexone
  • metoclopramide
  • metoprolol
  • mexiletine
  • mifepristone
  • mirtazapine
  • moclobemide
  • monoamine oxidase inhibitors (MAOIs)
  • morphine
  • naloxegol
  • narcotic pain relievers
  • nevirapine
  • nortriptyline
  • oxycodone
  • ozanimod
  • paroxetine
  • phenelzine
  • phenobarbital
  • phenytoin
  • pimozide
  • pitolisant
  • pramipexole
  • prochlorperazine
  • propranolol
  • rifampin
  • risperidone
  • ritonavir
  • ropinirole
  • rotigotine
  • selective serotonin reuptake inhibitors (SSRIs)
  • selegiline
  • serotonin-norepinephrine reuptake inhibitors (SNRIs)
  • sertraline
  • tamoxifen
  • tamsulosin
  • tetrabenazine
  • theophylline
  • thioridazine
  • tolterodine
  • tramadol
  • tranylcypromine
  • tricyclic antidepressants
  • venlafaxine

Alternative Medications

For patients who are unable to take Contrave or experiencing significant adverse side effects, alternative medications may be used to treat some of the associated conditions for which this medication is commonly prescribed:

  • methamphetamine (Desoxyn)
  • orlistat (Alli)
  • phentermine (Adipex-P, Lomaira)
  • semaglutide (Ozempic, Rybelsus, Wegovy)
  • topiramate (Topamax)

Frequently Asked Questions

The most serious risk that patients should be aware of when using this medication is the risk of suicidal thoughts or actions, and those close to the individual should be aware of this risk as well to ensure the patient’s safety if changes in mood or behavior occur while using Contrave.

Contrave is a medication including two active ingredients that combine to help patients with medical issues contributing to obesity lose weight and keep it off. It is used alongside changes to the patient’s exercise regimen and diet.

If you have experienced any of the following, you should not take this medication: a history of seizures, uncontrolled high blood pressure, certain eating disorders, sedative use, alcohol consumption, or any current use of MAOIs.

This medication will typically be taken once per day in the mornings for one week before increasing the dose to one tablet twice per day for the second week, three tablets split daily into separate doses of two tablets in the morning and one in the evening during the third week, and two tablets twice per day as of the fourth week and for the remaining duration of treatment.

This medication may result in some patients experiencing seizures, having manic episodes, overdosing on opioids, developing hepatitis or liver damage, developing changes in visions, experiencing hypoglycemia more often (in patients who have type 2 diabetes), having severe symptoms of opioid withdrawal, or having serious allergic reactions.

The most common side effects of using this medication include the following: constipation, diarrhea, dizziness, dry mouth, headache, nausea, sleeping difficulties, and vomiting.

This medication should be stored at room temperature, ranging between 68°F (20°C) to 77°F (25°C).

Patients using this medication should not consume a significant amount of alcohol during treatment.

This medication is safe to be taken along with non-steroidal anti-inflammatory drugs (NSAIDs), including ibuprofen.

One alternative to Contrave is a medication known as Qsymia (phentermine/topiramate), which has been determined to be both safe and effective for use in children above the age of 12 and in adults. However, this medication is not safe for those who are pregnant or planning to become pregnant. Additionally, GLP-1 receptor agonists, such as Saxenda (liraglutide) and Wegovy (semaglutide), may be used as well.

Before beginning treatment with this medication, patients should be sure to inform their doctor of any alcohol or cannabis use and also discuss their medical history and any current medications they are taking. Additionally, patients should take this medication exactly as prescribed and instructed by their physician.

This medication is available as an extended-release tablet containing 90 mg of bupropion hydrochloride and 8 mg of naltrexone hydrochloride.

If a patient has forgotten a dose of their medication, it should be taken as soon as they remember. However, if the next scheduled dose is soon, it should simply be skipped. Patients should not take two doses of this medication at once and should not exceed a maximum of four tablets within the span of 24 hours.

The active ingredients in Contrave are bupropion hydrochloride and naltrexone hydrochloride. The inactive ingredients in this medication include the following: Opadry II Blue, FD&C Blue #2 aluminum lake, lactose monohydrate, colloidal silicon dioxide, edetate disodium, hypromellose, magnesium stearate, crospovidone, L-cysteine hydrochloride, lactose anhydrous, hydroxypropyl cellulose, and microcrystalline cellulose.

This medication should not be used by those who are breastfeeding or pregnant. Patients that become pregnant while taking this medication should report this to their physician immediately.

This medication is prescribed for appetite suppression to help patients lose weight.