Contrave for Weight Loss: Uses, Side Effects, and Precautions

A comprehensive guide to Contrave (bupropion/ naltrexone) for weight loss

Contrave is one of many weight loss drugs exploding onto the market. Unlike other medications prescribed for weight management, Contrave (bupropion and naltrexone) is FDA-approved for the treatment of obesity and excess weight in adults. But with all the weight management options out there, is Contrave right for you?

This article will detail what Contrave is used for, how it works, what you should consider before taking it, and how it stacks up to other prescription weight-loss drugs.

What is Contrave?

Contrave is a oral weight loss medication. The U.S. Food and Drug Administration (FDA) approved it in 2014 to help adults with obesity or adults who are overweight and who also have a weight-related health condition lose weight. Contrave contains two active medications: bupropion and naltrexone. Here's how each one works to help you lose weight:

Bupropion is an antidepressant. When prescribed by itself, it is used to treat depression and seasonal affective disorder (SAD). It's also prescribed off-label as a smoking cessation medication, since it helps reduce cravings and compulsive behaviors. In weight loss, this translates into fewer food cravings and less snacking. In other words, it supresses your appetite.

Naltrexone (also available under the brand name ReVia) is a type of opioid antagonist. When prescribed by itself, it is used to help individuals who have quit drinking or using street drugs to continue to avoid using substances. It works by blocking opioid receptors in the brain, so that your brain doesn't feel rewarded by the use of those substances. However, those opioid receptors also play a role in how pleasurable food tastes and how rewarding eating feels. This means that naltrexone can make food feel less rewarding.

When combined, these two drugs work together to help you eat less without feeling as hungry.

How does Contrave cause weight loss?

Bupropion and naltrexone, the two medications that make up Contrave, cause weight loss in different ways. Here's how each one works to to help you lose weight:

Appetite control (Bupropion): Bupropion affects the brain's neurotransmitters, particularly dopamine and norepinephrine. These two neurotransmitters are involved in mood and the sensation of pleasure. By influencing these neurotransmitters, bupropion can help reduce food cravings and control your appetite. This effect can be helpful for people who struggle with emotional eating or managing portion sizes.

Craving reduction (Naltrexone): Naltrexone works by binding to opiate receptors in the brain and blocking the pleasurable effects associated with substances like opioids and alcohol. When used in Contrave, naltrexone helps reduce cravings for high-calorie, unhealthy foods. This is because it blocks the reward response that typically drives people to overindulge in such foods. This effect can make it easier for individuals to stick to a healthier diet plan.

Is Contrave safe?

Contrave was approved by the FDA in 2014 and is generally considered safe when prescribed and monitored properly. Like with any medication, it isn't right for everyone, and it has been shown to cause some side effects.

Common side effects of Contrave include:

Nausea
Vomiting
Headache
Dizziness
Fatigue
Diarrhea
Constipation
Dry mouth
Excessive sweating
Changes in taste

Serious side effects include:

Allergic reactions like skin rash, hives, swelling, or shortness of breath
Seizures
Chest pain
Cardiovascular problems like a rapid heart rate or elevated blood pressure
Fever symptoms
Yellowing of the skin or eyes
Muscle or joint pain
Dark-colored urine

It's important to note that taking high doses of Contrave can raise your risk of seizures. If you have a seizure or any serious side effects, contact your doctor. They may lower your dose or stop the medicine. Don’t take Contrave right after a high-fat meal, as it can cause too much of the drug to enter your body at once and trigger seizures.

Contrave contains bupropion, an antidepressant. Antidepressants may cause suicidal thoughts in some patients. If you or someone you know is experiencing any mental health symptoms while taking Contrave, seek medical advice from a healthcare professional immediately.

Does Contrave cause any drug interactions?

Yes, Contrave can interact with certain medications, including opioids, certain antidepressants and antipsychotics, monoamine oxidase inhibitor (MAOI)s, and blood thinners.

Before starting treatment with any prescription medication, you should tell your doctor about any medical conditions you have, any supplements or prescription drugs you are taking, and any allergies you may have. This information will help reduce the risk of any drug interactions or adverse reactions.

Healthcare providers may avoid prescribing Contrave for people with:

A history of seizures
Eating disorders (such as anorexia or bulimia nervosa)
Mood disorders (like bipolar disorder or major depressive disorder)
Hypertension (high blood pressure)
Type 1 or type 2 diabetes
Hypoglycemia (low blood sugar)
Alcohol or substance abuse
Liver problems or hepatitis
Kidney problems
Heart disease
Glaucoma
Use of other Bupropion-containing products

Contrave may not be prescribed to pregnant women, women who are trying to conceive, or women who are breastfeeding.

Who should take Contrave for weight loss?

Contrave is specifically indicated for use in adults with obesity (with a body mass index— BMI—of 30 kg/m2 or greater) or overweight adults (a BMI of 27 kg/m2 or greater) who also have weight-related health conditions such as hypertension (high blood pressure), high cholesterol, or obstructive sleep apnea.

Contrave is not prescribed to children and should not be used by individuals who are currently taking opioid medications or using street drugs.

How do you take Contrave?

Contrave comes in the form of an oral tablet. Each tablet contains 8 mg of naltrexone and 90 mg of bupropion.

The standard starting dose of Contrave is usually one tablet in the morning, increasing gradually to the full recommended dose of two tablets in the morning and two tablets in the evening. This increase in dosage usually takes about 4 weeks before the maintenance dose is reached.

After about 16 weeks on the medicine, your doctor will check your progress. If you’ve lost less than 4–5% of your starting weight after 3 months at the maintenance dose, they may recommend stopping it because it’s unlikely to be effective for you.

Are there alternatives to Contrave?

Contrave is specifically indicated as a chronic weight management aid. However, it can cause serious side effects in some patients and may not be suitable for everyone. If you are looking for an alternative to Contrave, discuss these options with your healthcare provider:

Semaglutide: Semaglutide is a medication that can help you lose weight loss when prescribed with a healthy diet and regular exercise. Semaglutide works by managing blood sugar levels, curbing appetite, and slowing stomach emptying (which makes you feel fuller longer). Wegovy, a brand-name medication containing semaglutide, is specifically approved for the treatment of obesity in patients.
Tirzepatide: Like semaglutide, tirzepatide is a GLP-1 receptor agonist used to treat type 2 diabetes and obesity. It regulates blood sugar levels, reduces appetite, and slows stomach emptying. Zepbound, a brand name containing tirzepatide, is specifically approved to treat obesity in patients without type 2 diabetes.
Liraglutide: Liraglutide is a GLP-1 receptor agonist approved by the FDA to treat obesity in adults and children over 12. It works by reducing blood sugar levels and appetite while slowing stomach emptying.
Metformin: Metformin is a prescription diabetes drug that has been shown to cause weight loss in some patients. It works by regulating blood sugar levels and improving insulin sensitivity. Increased insulin usage lowers the amount of sugar circulating in the blood.
Topiramate: Topiramate is an anticonvulsant medication that has been shown to cause weight loss in some patients. While its mechanism of action is not fully understood, it is thought to work through appetite suppression (reduced calorie intake), preventing the body from storing excess fat and lowering some fat and cholesterol levels. It might also affect the brain's reward system, potentially preventing binge eating.

How Sesame can help

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Maintaining a healthy weight can lead to significant health benefits, including a lower risk of heart disease, improved mobility, better sleep, and enhanced overall well-being. Get started on your weight loss journey today. Note that all prescriptions are at the discretion of your healthcare provider.