What is Contrave (naltrexone/bupropion)?

Contrave® is an FDA-approved prescription medication used for chronic weight management in adults with overweight and obesity. It is a combination medication meant to target areas of the brain tied to cravings and appetite. This medication can be a great tool to assist weight loss, but is not meant for all patients trying to lose weight. Keep reading to learn more about what Contrave is and if it might be right for you.

What’s in Contrave?

Contrave contains two active ingredients- bupropion and naltrexone, combined into one extended-release tablet. Contrave is most effective when the patient commits to a reduced-calorie diet and increased physical activity.

It is not known if Contrave® can be safely used with other prescription, over-the-counter, or herbal weight loss products. Contrave is not approved for the treatment of depression, other mental illnesses, or for quitting smoking, and it is not known if Contrave changes your risk of heart problems or stroke. It is important to discuss your health history and the safety of taking this medication further with your healthcare provider.

How does Contrave (naltrexone/bupropion) work?

The exact mechanism of how Contrave works to promote weight loss is not fully understood. What is known is that Contrave works in at least two areas of the brain – the hypothalamus and the mesolimbic rewards center.

The hypothalamus is the area of the brain responsible for several important automatic functions, including the regulation of our hunger. The action of Contrave in the hypothalamus helps to reduce our hunger level. Within the mesolimbic rewards center of the brain, Contrave acts to regulate neurotransmitters responsible for cravings, thereby reducing the pleasure we experience when eating certain foods and ultimately those cravings for food even when we’re not eating.

Why do people use Contrave (naltrexone/bupropion)?

Numerous studies have confirmed that most people who have lost weight with calorie-restricting diets alone regain some, if not all, of the weight they lost (NLM). As a result, other treatments for weight loss and weight loss maintenance are needed. Contrave is one such treatment option. 

In clinical trials studying the effects of naltrexone plus bupropion on weight loss, participants taking Contrave® while following reduced-calorie diet and increased physical activity lost more weight after one year compared with those who only changed their diet and level of physical activity - 5.4% versus 1.3% in the initial study and 8.1% versus 4.9% in a follow-up study. Participants in both trials also lost more inches off of their waist.

Research on the effects of naltrexone/bupropion in patients with type 2 diabetes showed a significantly greater reduction in hemoglobin A1c levels when taking Contrave with lifestyle changes versus by making lifestyle changes alone. 

Additionally, while Contrave is not indicated for the treatment of depression, it does contain bupropion, an antidepressant. Therefore, doctors and their patients may choose Contrave to help with weight loss and for its beneficial effects on mood. 

When asked about using Contrave in her patients, board-certified obesity medicine specialist Dr.Lauren Lemieux of Form Health said, “​​It can take time to find the right medication for each patient, but once you do, it is life-changing. My patients who have done well with Contrave describe no longer thinking about food as much as they did or having cravings like before. They feel empowered to lose weight and keep it off.” 

Dr. Emily Smith, a board-certified endocrinologist and obesity medicine specialist at Form Health, has similar thoughts on Contrave’s ability to help with cravings and thoughts about food. She states, “Food cravings, particularly those triggered by strong emotions, can make it challenging to adhere to lifestyle changes. Contrave, a combination of bupropion and naltrexone, is a valuable resource that helps one exert more control over dietary choices. My patients frequently report a more natural relationship with food with the assistance of this medication.”

Potential side effects of Contrave (naltrexone/bupropion)

It’s always important to know about potential side effects when you are starting on a new medication. The most common side effects of Contrave include:

• Nausea 
• Vomiting
• Headache 
• Dizziness
• Insomnia (trouble sleeping)
• Dry mouth
• Changes in bowel habits (diarrhea or constipation)
• Hot flashes

Starting with a lower dose and slowly increasing over time helps to improve tolerance of the medication, and side effects do tend to decrease with time. Some patients can experience an increase in heart rate and blood pressure while taking Contrave, so these should be monitored closely, especially if you have a history of high blood pressure. Very rarely, patients taking Contrave experience suicidal ideation. 

Monitoring for changes in your mood while taking Contrave is extremely important. Patients taking Contrave should notify their healthcare provider right away should they experience any side effects from the medication. 

The board-certified and obesity-trained medical providers at Form Health work closely with a patient and their primary care provider to get a complete understanding of a patient’s health history to be sure they are safely prescribing Contrave. They subsequently monitor the patient closely with monthly appointments to ensure the patient is tolerating the medication and experiencing the anticipated weight loss benefit. 

Providers are also available to answer any patient questions or concerns about side effects via telephone or messaging in the convenient Form Healthapp. 

The obesity medicine specialists at Form understand the complexity of overweight and obesity and the need for treatments like Contrave to assist patients with chronic weight management. 

All patients of Form Health undergo a comprehensive medical evaluation, including laboratory testing, to determine the best treatment plan for their individual needs. 

The Form Health approach to medical weight loss with Contrave

Every patient at Form Health also receives extensive counseling and support from a Registered Dietitian who provides a nutrition plan, accountability, and support for long-term behavior change that promotes weight loss. When Contrave is part of the treatment plan, patients are monitored closely to ensure they are tolerating the medication and getting the desired weight loss effect.  

With the use of Contrave paired with lifestyle changes, we hope to achieve at least a 5% reduction in weight, which has been shown to improve overall health. Clinical trials on the effectiveness of Contrave show that patients using Contrave in combination with lifestyle changes lost 2-4x more weight than those who made lifestyle changes alone.

If you’re interested in seeking medical care for weight management and working with experts who can help you consider medications such as Contrave as a tool to help you reach your weight loss goal, give Form Health a try! 

Our insurance-covered medical weight loss program uses tools like nutrition, physical activity, mindset shifts, and FDA-approved medication, if appropriate, as part of a comprehensive weight loss program to help you lose weight and improve your health. 

Get started with Form today by taking our quiz to see if medical weight loss is right for you.

Contrave® is a registered trademarks of Currax Pharmaceuticals, LLC