Contrave: A Clinically Proven Weight Management Medication
Contrave
| Product dosage: 98mg | |||
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Synonyms | |||
Contrave is a prescription medication approved for chronic weight management in adults with obesity or overweight with at least one weight-related comorbidity. It combines two FDA-approved drugs, naltrexone HCl and bupropion HCl, in an extended-release formulation, working on areas of the brain involved in appetite control and reward eating behavior. This dual-action approach helps reduce food cravings and caloric intake, supporting sustainable weight loss when used alongside a reduced-calorie diet and increased physical activity. It is intended for long-term use under medical supervision as part of a comprehensive weight management plan.
Features
- Contains naltrexone HCl (8 mg) and bupropion HCl (90 mg) in an extended-release tablet
- FDA-approved for chronic weight management
- Dual mechanism targets hypothalamic melanocortin system and mesolimbic dopamine pathway
- Gradual dose titration over four weeks to minimize side effects
- Recommended as an adjunct to reduced-calorie diet and increased physical activity
Benefits
- Supports clinically significant weight loss (≥5% of baseline body weight)
- Helps reduce food cravings and emotional eating behaviors
- Improves cardiometabolic parameters including waist circumference and HDL cholesterol
- Provides a non-surgical option for long-term weight management
- May improve quality of life measures related to weight concerns
- Can be used concurrently with lifestyle modifications for enhanced efficacy
Common use
Contrave is indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index (BMI) of:
- 30 kg/m² or greater (obesity)
- 27 kg/m² or greater (overweight) in the presence of at least one weight-related comorbidity such as hypertension, type 2 diabetes, or dyslipidemia
Treatment should be discontinued if patients fail to achieve at least 5% weight loss after 16 weeks of therapy at the maintenance dose.
Dosage and direction
Week 1: One tablet (8 mg naltrexone/90 mg bupropion) once daily in the morning Week 2: One tablet twice daily (morning and evening) Week 3: Two tablets in the morning and one tablet in the evening Week 4 and maintenance: Two tablets twice daily (morning and evening)
Tablets should be swallowed whole and not crushed, divided, or chewed. Doses should be taken with food to reduce nausea. Maximum daily dose is 32 mg naltrexone/360 mg bupropion. Dose escalation should occur only if previous dose level is tolerated.
Precautions
- Monitor blood pressure and heart rate regularly; elevations may occur
- Assess psychiatric status and suicide risk, particularly in patients with history of depression
- Use caution in patients with hepatic or renal impairment
- May lower seizure threshold; avoid in patients with seizure disorders
- Not recommended during pregnancy or breastfeeding
- May cause angle-closure glaucoma; monitor for eye pain and vision changes
- Can cause hypoglycemia in patients with type 2 diabetes on antidiabetic medications
Contraindications
- Uncontrolled hypertension
- Seizure disorder or history of seizures
- Use of monoamine oxidase inhibitors (MAOIs) within 14 days
- Chronic opioid use or acute opioid withdrawal
- Eating disorders (anorexia nervosa or bulimia nervosa)
- Pregnancy or attempting to become pregnant
- Severe hepatic impairment
- Known hypersensitivity to naltrexone, bupropion, or any product components
Possible side effects
Common (≥5%):
- Nausea (32.5%)
- Constipation (19.2%)
- Headache (17.6%)
- Vomiting (10.7%)
- Dizziness (9.9%)
- Insomnia (9.2%)
- Dry mouth (8.1%)
- Diarrhea (7.3%)
Serious:
- Increased blood pressure and heart rate
- Suicidal thoughts and behaviors
- Seizures
- Angle-closure glaucoma
- Liver damage
- Allergic reactions
- Hypoglycemia
Drug interaction
- MAO inhibitors: Contraindicated due to risk of hypertensive crisis
- Opioids: Reduced efficacy of opioids; may precipitate withdrawal
- Antidepressants: Increased risk of serotonin syndrome
- Antipsychotics: May lower seizure threshold
- Drugs metabolized by CYP2D6: Bupropion inhibits CYP2D6 metabolism
- Alcohol: Increases risk of neuropsychiatric events
- Diabetes medications: May require adjustment due to enhanced hypoglycemic effects
- Blood thinners: May affect warfarin metabolism
Missed dose
If a dose is missed, patients should skip the missed dose and take the next dose at the regular time. Do not double the dose to make up for a missed dose. If multiple doses are missed, re-initiate therapy according to the titration schedule under medical supervision.
Overdose
Overdose may manifest as seizures, ECG changes, hallucinations, loss of consciousness, tachycardia, or nausea/vomiting. There is no specific antidote. Management includes symptomatic and supportive care, with particular attention to cardiac monitoring and seizure control. Activated charcoal may be considered if ingestion was recent. Due to the extended-release formulation, monitoring should continue for at least 24 hours.
Storage
Store at room temperature (20-25°C or 68-77°F) with excursions permitted between 15-30°C (59-86°F). Keep in original container, tightly closed, and protect from light and moisture. Keep out of reach of children and pets. Dispose of unused medication properly according to local regulations.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Contrave is available by prescription only and should be used under appropriate medical supervision. Individual results may vary. Patients should consult their healthcare provider for personalized medical advice, including potential risks and benefits based on their complete medical history. Never initiate or discontinue medication without consulting a qualified healthcare professional.
Reviews
Clinical trials demonstrate that approximately 42% of patients achieved ≥5% weight loss with Contrave compared to 17% with placebo at 56 weeks. The COR-I trial showed mean weight loss of 6.1% versus 1.3% for placebo. The COR-BMOD trial combining Contrave with intensive behavior modification showed 9.3% mean weight loss versus 5.1% with behavior modification alone. Real-world evidence suggests similar efficacy with appropriate patient selection and adherence to lifestyle modifications. Most common reasons for discontinuation include gastrointestinal side effects and increased blood pressure.