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Overview: Contrave is taken to help people lose weight. It is a combination of two medicines that work in the brain to affect appetite. Contrave is a tablet that must be swallowed whole. The most common side effects are nausea, constipation, and headache. Discuss any changes in mood with your healthcare provider.

Uses

What is Contrave used for?

Contrave (naltrexone/bupropion) is commonly taken for weight loss and weight management in people who are overweight or obese. It should be used together with diet and exercise.

Contrave may also be taken for other conditions as determined by your healthcare provider.

How does Contrave work (mechanism of action)?

Contrave is a combination of two medicines. It is unknown exactly how these medicines work to achieve weight loss. Contrave may target areas of the brain such as the hypothalamus and dopamine. The hypothalamus is a gland in your brain that sends signals that can help to control your appetite. Dopamine is a chemical found in the brain that is responsible for pleasure and rewards. Contrave may work by increasing dopamine levels and acting at the hypothalamus to decrease appetite.

How is Contrave supplied (dosage forms)?

Brands and other names

  • Contrave

Dosage forms and strengths 

  • 8 mg/90 mg extended-release oral tablets 

How should I store Contrave?

Contrave should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Side Effects

What are the most common side effects of Contrave?

The most common side effects of Contrave are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Nausea and vomiting
  • Constipation
  • Headache
  • Dizziness
  • Trouble sleeping
  • Dry mouth
  • Diarrhea

There may be other side effects of Contrave that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Contrave?

While less common, the most serious side effects of Contrave are described below, along with what to do if they happen.

Severe Allergic Reactions. Contrave may cause allergic reactions, which can be serious. Stop taking Contrave and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Suicidal Thoughts or Actions. One of the medicines in Contrave is bupropion, which can be taken to treat depression. Contrave or other antidepressants may increase the risk of suicidal thoughts or actions in a small number of children, teenagers, or young adults in the first few months of taking the medicine or when the dose is changed. Depression or other serious mental health conditions are the most common causes of suicidal thoughts or actions. If you or your child is about to harm themselves, call 911 or call or text 988, the Suicide & Crisis Lifeline. Stop taking Contrave and call your healthcare provider right away if you have any of the following symptoms.

  • New or increased thoughts of suicide or death
  • Suicide attempt
  • New or increased feelings of anxiety, depression, or other unusual changes in your mood or behavior

Hallucinations or Psychotic-like Behaviors. Contrave may cause hallucinations or psychotic-like behaviors. Tell your healthcare provider right away if you have any of the following symptoms, or if you have been told by others you have these symptoms.

  • Hearing, seeing, smelling, tasting, or otherwise perceiving things that others do not
  • Delusional thoughts, such as false beliefs that you are being controlled
  • Disorganized thoughts, such as jumping between topics or having a hard time focusing
  • Sudden decline in self-care, such as personal hygiene or academic/work performance
  • Aggressive behavior

Seizures. Some people who have taken Contrave have reported having seizures. There are many different types of seizures and some of them are not easy to recognize. Stop taking Contrave and call your healthcare provider right away if you have any of the following signs that a seizure is happening or could happen.

  • Muscle twitching, jerking, spasms, tremors, or other uncontrolled movements
  • Stiffening of your arms and legs
  • Feeling anxious, nervous, confused, or a sense of dread
  • Feeling dizzy or lightheaded
  • Falling or losing consciousness

Increased Blood Pressure (Hypertension) and Heart Rate. Contrave may increase your blood pressure or make it worse if you have a history of high blood pressure. It can also raise your resting heart rate. Call your healthcare provider if your blood pressure or heart rate increases while taking this medicine.

If you measure your blood pressure and the top number (systolic) is 180 mm Hg or higher or the bottom number (diastolic) is 120 mm Hg or higher, get medical attention right away. Increases in blood pressure may not be noticeable but look out for any of the following symptoms of severely high blood pressure.

  • Sudden severe headache
  • Chest pain
  • Dizziness or confusion
  • Trouble breathing
  • Nausea/vomiting
  • Blurry or other changes to vision
  • Anxiety
  • Buzzing in the ears
  • Nosebleed
  • Feeling of skipped heartbeats

Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking Contrave. Call your healthcare provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Extremely Elevated Mood (Mania). People with bipolar disorder can have severe high and low moods. The first symptom of bipolar disorder may be depression. People with bipolar disorder who take an antidepressant, such as Contrave, may have a higher risk of having mania or a manic episode. Call your healthcare provider right away if you have any of the following symptoms of a manic episode.

  • Very increased energy
  • Significant trouble sleeping
  • Racing, fast-paced thoughts
  • Reckless behavior
  • Unusually grand ideas
  • Excessive happiness or irritability
  • Talking more or faster than usual

Glaucoma. Contrave may increase pressure inside the eye and cause or worsen narrow-angle glaucoma, which can lead to blindness. Tell your healthcare provider right away if you have any of the following symptoms of glaucoma.

  • Loss of vision
  • Eye pain or redness
  • Severe headache or vomiting
  • Seeing bright, colorful circles around lights (vision halos)

Severe Skin Reactions. Contrave can cause severe skin reactions, called Stevens-Johnson syndrome (SJS), that can lead to death if not treated. If you develop a rash, stop Contrave and call your healthcare provider right away. Get emergency help if you have any of the following symptoms of SJS.

  • Painful red or purple skin that looks burned and peels off
  • Flat red rash or blisters on your skin, mouth, nose, and genitals
  • Red, painful, watery eyes

Warnings & Precautions

Who should not take Contrave?

Allergies to Ingredients. People who are allergic to any of the following should not take Contrave.

  • Bupropion
  • Naltrexone
  • Contrave
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Contrave.

Uncontrolled High Blood Pressure. If you have high blood pressure (hypertension) that is not well controlled, you should not take Contrave. Ask your healthcare provider if you do not know if your blood pressure is under control.

Seizures or Suddenly Stopping Certain Medicines. You should not take Contrave if you currently have a seizure disorder or have had seizures in the past. You should not also not take Contrave if you were taking a medicine for seizures or a medicine known as a benzodiazepine or barbiturate and suddenly stop taking it. See the Interactions section for more details.

Anorexia Nervosa or Bulimia. You should not take Contrave if you have either anorexia or bulimia, which are eating disorders. 

Alcohol Use Disorder. If you drink a lot of alcohol and suddenly stop drinking alcohol, you should not take Contrave. Your chance of having a seizure may be increased if you suddenly stop drinking alcohol while taking this medicine.

Drug Interactions. Contrave should not be taken while you are using certain other medicines. Before taking Contrave, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Current Opioid Use and Dependence. People who are currently using prescription and/or illicit opioids, including buprenorphine, should not take Contrave. If you take Contrave while taking opioids, it could lead to withdrawal symptoms, which may require you to go to the hospital. Opioid use can cause physical dependence, which means your body relies on the medicine. If you have flu-like symptoms or anxiety when you stop opioids, you may have physical dependence. Physical dependence is not necessarily a sign that you have developed a substance use disorder.  Before taking Contrave, be sure to tell your healthcare provider about any use of prescription and/or illicit opioids. 

Opioid Withdrawal. You may have symptoms if you have been using prescription and/or illicit opioids and suddenly stop taking them. People who are in opioid withdrawal should not take Contrave. Tell your healthcare provider before you take Contrave if you have any of the following symptoms of opioid withdrawal. 

  • Anxiety 
  • Sleeplessness 
  • Yawning
  • Fever
  • Sweating 
  • Teary eyes 
  • Runny nose 
  • Goosebumps 
  • Shakiness
  • Hot or cold flushes 
  • Muscle aches or twitches
  • Restlessness
  • Nausea and vomiting 
  • Diarrhea
  • Stomach cramps

What should I know about Contrave before using it?

Do not take Contrave unless it has been prescribed to you by a healthcare provider. Take it as prescribed. Do not change your dose of Contrave without talking to your healthcare provider. Talk with your healthcare provider about your weight loss while taking this medicine.

Do not share Contrave with other people, even if they have the same condition as you. It may harm them.

Keep Contrave out of the reach of children.

Swallow Contrave tablets whole. Do not chew, cut, or crush Contrave.

People who are 65 and older can be at greater risk for some side effects from Contrave. Talk to your healthcare provider about your risks if you are in this age group.

It is possible that you may be more sensitive to the effects of prescription or illicit opioids if you stop taking Contrave. Resuming the doses of opioids you were using before starting Contrave can be very dangerous and can potentially lead to death. You can also have a bad reaction where you stop breathing if you take opioids to try to overcome the effects of this medicine. Should you feel the need to use opioids while on or after stopping Contrave, contact your healthcare provider. 

It is very important that you stop taking opioids before taking Contrave. Tell your healthcare provider the last time you took any prescription or illicit opioid. Your healthcare provider needs to know this information to determine if it is safe for you to take Contrave. 

What should I tell my healthcare provider before using Contrave?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Contrave is right for you.

In particular, make sure that you discuss any of the following.

Mental Health Conditions. Tell your healthcare provider about any history of mental health problems. One of the medicines in Contrave, bupropion, may increase your risk of suicidal thoughts and actions, especially when you first begin taking it. Make sure to tell your healthcare provider about any of the following.

  • Depression
  • Bipolar disorder
  • Previous suicide attempt or thoughts

Other Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

  • Liver problems
  • Kidney problems
  • Diabetes or low blood sugar
  • High blood pressure
  • History of head trauma or seizure
  • Stroke, heart attack, or heart problems
  • Arteriovenous malformation
  • Tumor or infection in your brain or spine
  • Low levels of sodium in your blood (hyponatremia)
  • Alcohol use disorder
  • Substance use disorder

Pregnancy. Weight loss during pregnancy may cause fetal harm. Tell your healthcare provider if you are or plan to become pregnant. Stop taking this medicine if you become pregnant.

Breastfeeding. Contrave passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should stop breastfeeding or stop Contrave.

How can I get more information about Contrave?

For more information about Contrave, you can visit the manufacturer’s website at www.contrave.com or call them at 877-298-8340.

Interactions

Does Contrave interact with foods or drinks?

It is best to avoid or limit the amount of alcohol you drink while taking Contrave. You may be at an increased risk of side effects from this medicine if you drink alcohol. If you normally drink a lot of alcohol, talk with your healthcare provider before taking Contrave.

Do not take Contrave with high fat meals because it can increase your risk of seizures.

Does Contrave interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking Contrave.

  • A monoamine oxidase inhibitor (MAOI) within the past two weeks, which is a medicine usually used for depression or Parkinson’s disease
  • An opioid, such as oxycodone, morphine, methadone, codeine, or fentanyl, which is a medicine used for certain types of pain
  • A partial agonist opioid analgesic, such as buprenorphine (Butrans, Sublocade), which is a medicine used to treat certain types of pain or opioid use disorder
  • A benzodiazepine, such as clonazepam (Klonopin), diazepam (Valium and others), or lorazepam (Ativan and others), which is a medicine used for anxiety, muscle spasms, or seizures
  • A barbiturate, such as phenobarbital, butalbital, or primidone, which is a medicine that may be used to treat insomnia, migraines, or seizures
  • Any medicine for seizures, such as carbamazepine or phenytoin
  • A medicine for diabetes
  • A stimulant, such as methylphenidate, lisdexamfetamine, or amphetamine, which is a medicine commonly used to treat attention deficit hyperactivity disorder (ADHD)
  • A tricyclic antidepressant, such as amitriptyline, nortriptyline, or protriptyline, even if it is not used for depression
  • Bupropion (Wellbutrin SR, Wellbutrin SR, Aplenzin), which is a medicine used to treat depression
  • Digoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failure
  • Levodopa, which is a medicine for Parkinson’s disease
  • Amantadine (Gocovri), which is a medicine that may be used to treat Parkinson’s disease
  • Theophylline (Theo-24, Elixophyllin), which is a medicine for asthma or certain other breathing problems

Many other medicines may alter the blood levels of Contrave, and vice versa. Tell your healthcare provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with Contrave. Always check with your healthcare provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally take too much Contrave?

If you or someone else has taken too much Contrave, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Contrave?

If you miss a dose of Contrave, take it when your next dose is scheduled. Do not double or increase your normal dose.