Navigating Contrave side effects: A comprehensive guide

Contrave® is an FDA-approved medication commonly prescribed for weight management that combines two active ingredients: naltrexone and bupropion. While it can help in achieving weight loss goals, it's important to understand potential side effects and how to address them appropriately. This blog will delve into the side effects of Contrave, how long side effects last, and how to minimize them.

Overview of Contrave

Contrave is an FDA-approved prescription medication used for chronic weight management in adults with a BMI of 30+ or 27+ with one or more weight related conditions. It’s a combination medication of two active ingredients, naltrexone and bupropion. Each Contrave tablet contains 8 mg of naltrexone and 90 mg of bupropion. Naltrexone is a medication that blocks opiate receptors while bupropion is an antidepressant. Together, they work by acting on the brain to reduce food cravings and appetite. 

Contrave is most effective for weight loss when combined with a healthy eating pattern and increased physical activity. In this study, participants who completed the study and were taking the maximum dose of Contrave for weight loss (2 Contrave tablets twice daily) in combination with healthy lifestyle changes lost an average of 8.2% of their total body weight over 56 weeks versus those taking a placebo in combination with lifestyle changes who lost only 1.4% of their weight. 

Common side effects of Contrave

Prior to starting any medication, it’s important to know the potential side effects that can occur and discuss how to manage them with your healthcare clinician. Contrave is started at a low dose (1 tablet once a day) and gradually increased to minimize the risk of side effects and increase tolerance to the medication. The most common side effects of Contrave include: 

• Nausea 
• Constipation
• Headache 
• Vomiting 
• Fatigue
• Dizziness 
• Trouble sleeping (insomnia)
• Dry mouth
• Diarrhea

Rare side effects of Contrave

Contrave does have some more serious, but rare side effects:

• Mood changes: Contrave contains bupropion, an antidepressant, which in some cases can increase symptoms of anxiety and/or depression or worsen symptoms associated with bipolar disorder. If you begin to feel changes in mood, be sure to alert your prescribing clinician right away. 
• Increased heart rate and blood pressure, especially if you have a history of high blood pressure.
• Seizures may occur when taking this medication, and individuals at risk for seizures should not take Contrave. 
• Liver dysfunction and/or damage

It is important to work closely with a healthcare clinician while taking Contrav, so they can help monitor and manage any side effects you may experience. Our expert clinicians at Form Health carefully consider your medical history and lifestyle when recommending medications for weight loss as safety is a top priority. They closely monitor for side effects and tailor treatment plans to support your individual needs.

Onset and duration of side effects

If you experience side effects from Contrave and how long they last will vary from person to person due to biological factors that influence drug sensitivity. Typically, people experience Contrave side effects  within the first 4 weeks of starting the medication as patients slowly increase their dosage until they reach the maximum dose or the dose that is best tolerated. Common side effects are gastrointestinal in nature, such as nausea and constipation. Many patients find that these symptoms decrease after the first few days or weeks, as their bodies adjust to the medication. However, if you experience more severe or long-lasting side effects when starting Contrave, be sure to consult your prescribing provider. 

Managing Contrave side effects

Nutritional modifications

Contrave is most effective for weight loss when paired with a healthy eating pattern. What you eat while taking Contrave may also help with side effects such as nausea or constipation. If you are feeling nauseous, try to avoid spicy or fried foods and stick to bland foods like the BRAT diet (bananas, rice, applesauce, and toast). Additionally, separating meals into smaller, more frequent portions may help prevent nausea. Instead of having three large meals a day, aim to have five or six smaller ones. For weight loss, fiber and protein can be helpful to slow down digestion and help you feel more full. Working with a Registered Dietitian can help you build a personalized nutrition plan that fits your preferences and helps minimize side effects. 

Contrave can cause constipation, so it is important to make sure you are staying active and consume fiber-rich foods daily. These include fruits, vegetables, legumes, and whole grains. It is typically recommended to aim for 25-30 grams of fiber per day. As most people have relatively low fiber intake, it's recommended to gradually increase fiber intake over a few weeks and ensure you’re drinking plenty of water when having more fiber. The manufacturers of Contrave recommend that you avoid taking Contrave with high fat meals.

Hydration

When taking a weight loss medication like Contrave, you may find yourself eating and drinking less due to its appetite-suppressing effects. However, staying properly hydrated is important for overall health and may help with  side effects such as constipation and headaches. Contrave’s manufacturer recommends taking the medication with at least 8 ounces of water and drinking plenty of fluids throughout the day. To make hydration a habit, try carrying a reusable water bottle, setting reminders to drink water throughout the day, or try infusing your water with fresh fruits or herbs like mint for added flavor. 

Medication timing

Contrave comes in tablets and the dose is gradually increased over 4 weeks to help minimize side effects. For the first week you take 1 tablet in the morning, then the second week it increases to 1 tablet in the morning and 1 tablet in the evening, and you continue to increase by 1 tablet each week to a maximum dose of 2 tablets in the morning and 2 tablets in the evening.  Your prescriber may recommend a different schedule if you are having side effects from the medication, but you should not take more than 2 pills at the same time or more than 4 pills in one day. Staying consistent with your dosing time each day can improve effectiveness and help you remember to take it consistently.

Consulting your healthcare provider before and during Contrave treatment

Before starting Contrave, consult with a healthcare provider to ensure the medication is safe and appropriate for you. It’s important to review your medical history, current medications, and any pre-existing conditions like high blood pressure, seizure disorders, or mental health concerns with an expert medical provider before taking Contrave. There are certain conditions that make this medication an unsafe choice, and Contrave cannot be used in combination with certain medications, in particular opiate pain medications.

It is recommended to work closely with a healthcare provider who is experienced in prescribing Contrave and managing the side effects that may occur while taking this medication. Regular follow-ups with your healthcare provider can help monitor your progress, manage any side effects, and make necessary adjustments to your treatment plan. They can also offer individualized guidance on lifestyle changes, such as diet and exercise, to maximize the medication’s effectiveness. At Form Health, all of our doctors are board certified in Obesity Medicine, are experienced with prescribing Contrave and help their patients navigate any side effects that may occur.

Frequently asked questions about Contrave side effects

How long do side effects last?

The duration of Contrave side effects varies from person to person, influenced by individual biological factors that affect medication tolerance. To help the body adjust and minimize side effects, Contrave is typically introduced at a low dose and gradually increased over several weeks. Most side effects resolve within the first few days or weeks of treatment. However, it’s important to communicate openly with your healthcare provider about any side effects you experience. If they persist beyond the initial weeks, your provider may adjust your treatment plan, which could include lowering the dose or discontinuing Contrave if necessary.

What should I do if side effects are severe?

When taking any medication, it is important to speak to your prescribing provider right away if you are experiencing severe or potentially dangerous side effects. Severe side effects on Contrave may include an allergic reaction, seizures, uncontrolled high blood pressure, and increased anxiety or depression. 

Is it safe to combine Contrave with other medications?

Medications that should not be taken along with Contrave include MAOIs (a type of antidepressant) and opioids. There are some pain medications that are safe to take with Contrave such as aspirin, ibuprofen, or acetaminophen, so long as there are no other medical contraindications to taking these. Before taking any medication with Contrave, consult your healthcare provider to ensure it is safe and appropriate for you.

Managing Contrave side effects with Form Health

Taking Contrave for weight loss can come with side effects, but with the right support they can be effectively managed. At Form Health every patient works 1:1 with an expert Care Team that provides ongoing medical support and personalized treatment plans to help you navigate these challenges. Working with an American Board of Obesity Medicine doctor and Registered Dietitian, you will create a science-based plan that addresses behavioral health, nutrition, physical activity, and may include a prescription for FDA-approved medication, if appropriate. 

Send us a message or sign up for Form Health today to reach your health goals with the support of weight loss experts who will be with you each step of the way!

Contrave® is a registered trademark of Currax Pharmaceutical LLC.