Contrave is a brand-name medication combining naltrexone and bupropion, prescribed alongside exercise and a balanced diet to assist adults in weight loss and management. It is available as an extended-release tablet, meaning the medication is slowly released into the body over an extended period. This article provides detailed instructions on Contrave dosage, its strengths, and how to take it effectively, while also addressing crucial safety information.
Understanding Contrave
Contrave is prescribed for adults with obesity or those who are overweight with related conditions such as type 2 diabetes, high cholesterol, or high blood pressure. The drug contains two active ingredients: naltrexone, an opioid antagonist, and bupropion, an antidepressant. These components work synergistically to manage weight.
Available Forms and Strengths
Contrave is available as extended-release (ER) oral tablets. Each tablet contains 8 mg of naltrexone and 90 mg of bupropion. The extended-release formulation ensures a steady release of the medication, maintaining consistent levels in the body.
Dosage Guidelines
It is crucial to adhere to your healthcare provider's prescribed dosage. The information below outlines typical dosages, but your doctor will determine the best regimen for your specific needs.
Initial Dosage Adjustment
Typically, treatment begins with a low starting dosage, gradually adjusted over time to achieve the desired effect. Your doctor will aim to prescribe the smallest effective dosage. Dosage adjustments may be necessary based on individual factors such as age, kidney and liver function, and concurrent medications.
Read also: Comparing Contrave and Phentermine
Recommended Dosage Schedule
The dosage of Contrave is usually increased gradually over the first four weeks of treatment, as outlined below:
- Week 1: One tablet in the morning.
- Week 2: One tablet in the morning and one in the evening.
- Week 3: Two tablets in the morning and one in the evening.
- Week 4 and beyond: Two tablets in the morning and two in the evening.
Total daily doses should not exceed 32 mg of naltrexone and 360 mg of bupropion (two tablets twice daily).
Maintenance Dosage
After the initial four weeks, you will likely continue with the same dosage as prescribed by your doctor for the remainder of the treatment. Response to therapy should be evaluated after 12 weeks at the maintenance dosage.
Long-Term Use
Contrave is intended for long-term use. If you and your doctor determine that it is safe and effective, you will likely continue taking it long term. However, if Contrave does not demonstrate effectiveness within 12 weeks, your doctor may recommend discontinuing the medication.
Factors Affecting Dosage
Several factors can influence the dosage of Contrave prescribed:
Read also: Weight Loss with Contrave and Topiramate
- Age: Older adults may require dosage adjustments.
- Kidney and Liver Function: Impaired kidney or liver function may necessitate a lower dosage. In patients with moderate or severe renal impairment, the maximum recommended daily dose is two tablets (one tablet each morning and evening). Similarly, in patients with moderate hepatic impairment, the maximum recommended daily maintenance dose is two tablets (one tablet each morning and evening).
- Other Medications: Concurrent use of certain medications may require dosage adjustments. For instance, CYP2B6 inhibitors may necessitate a reduced Contrave dose.
It is essential to inform your doctor about your complete health history and all medications you are currently taking.
Administration Instructions
Contrave tablets should be swallowed whole and not crushed, chewed, or broken. The medication can be taken with or without food. However, it is advised to avoid taking Contrave with high-fat foods, as this can increase the risk of side effects.
Timing of Doses
Contrave is typically taken in the morning and evening. While there is no specific recommendation for the best time to take the evening dose, it is recommended to take doses approximately 12 hours apart to maintain a steady level of the drug in the body.
Missed Doses
If you miss a dose of Contrave, skip the missed dose and take the next dose at the regularly scheduled time. Do not take an extra dose to make up for the missed dose, as this could increase the risk of side effects.
Important Precautions and Warnings
Contrave carries a boxed warning regarding the risk of suicidal thoughts and behaviors. It is crucial to be aware of this risk and to monitor for any changes in mood, behaviors, or thoughts.
Read also: Comparing Contrave and Ozempic
Suicidal Thoughts and Behaviors
Contrave can increase the risk of suicidal thinking and behavior in children, adolescents, and young adults taking antidepressants for major depressive disorder or other psychiatric disorders. Although Contrave is only approved for use in adults, it is essential to be vigilant about any changes in mental state. Patients, families, and caregivers should be aware of this risk and immediately report any suicidal thoughts or behaviors to the prescriber.
Seizures
Bupropion, a component of Contrave, can cause seizures. The risk of seizure is dose-related and higher in individuals with certain medical conditions or those taking specific medications. Contrave should be avoided in patients who experience a seizure.
Opioid Interactions
The naltrexone component of Contrave is an opioid receptor antagonist. If opiate therapy is required, Contrave treatment should be stopped. Due to the blockade of opioid receptors, higher doses of opioids may be needed for pain relief, potentially leading to severe respiratory depression and circulatory collapse. When switching from opioids like buprenorphine or methadone, a washout period of up to two weeks may be necessary before starting Contrave.
Cardiovascular Risks
Contrave can increase resting heart rate and blood pressure. Caution is advised in patients with evidence of preexisting hypertension. Cases of elevated blood pressure requiring acute treatment have been reported. Blood pressure should be monitored regularly during Contrave treatment.
Allergic Reactions
Allergic reactions, including anaphylaxis, have been observed with naltrexone exposure. Patients should be monitored for signs and symptoms of severe allergic reactions.
Hepatotoxicity
Symptoms of acute hepatitis, such as pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin, should be promptly reported to a healthcare provider.
Psychiatric Disorders
Contrave may trigger depression, hypomanic episodes, or manic episodes. Exercise caution when prescribing Contrave to patients with a history of bipolar disorder or who have risk factors for bipolar disorder. Screen patients for a history of bipolar disorder, suicide, or depression before initiating treatment.
Hypoglycemia
Contrave may increase the risk of hypoglycemia in patients with type 2 diabetes, especially when used with antidiabetic medications like sulfonylureas. Blood sugar levels should be monitored regularly, and appropriate adjustments to diabetes medications may be necessary.
Drug Interactions
Contrave can interact with various medications, potentially affecting its efficacy and safety.
Monoamine Oxidase Inhibitors (MAOIs)
Contrave is contraindicated with MAOIs. At least 14 days should elapse between discontinuation of an MAOI intended to treat depression and initiation of therapy with Contrave.
CYP2B6 Inhibitors and Inducers
CYP2B6 inhibitors can increase bupropion concentrations, potentially leading to adverse effects. Reduce Contrave dose when taken with CYP2B6 inhibitors. CYP2B6 inducers may decrease bupropion concentrations, reducing Contrave's effectiveness.
Other Medications
Before starting Contrave, inform your doctor if you are taking any of the following medications:
- Drugs that increase the risk of seizures
- Opioid pain relievers
- Antidepressants
- Medications for diabetes
- Drugs that affect blood pressure
Overdose Information
Taking more Contrave than prescribed can lead to serious side effects.
Symptoms of Overdose
Symptoms of a Contrave overdose can include:
- Seizures
- Hallucinations
- Muscle jerking or twitching
- Loss of consciousness
- Fast heart rate
- Irregular heart rhythm
What to Do in Case of Overdose
If you suspect an overdose, seek immediate medical attention. Call your doctor right away or go to the nearest emergency room.
Additional Considerations
Alcohol Consumption
If you drink alcohol, minimize or avoid alcohol consumption during Contrave treatment. Discuss any concerns with your doctor.
Pregnancy and Breastfeeding
Using Contrave during pregnancy can harm the unborn baby. Use an effective form of birth control to prevent pregnancy during therapy. It is not known whether Contrave passes into breast milk, so caution is advised when breastfeeding.
Medical Tests
Inform healthcare providers that you are taking Contrave before undergoing any medical tests, as the medication may affect the results.
Frequently Asked Questions
What is the best time to take the evening dose of Contrave?
There isnât a specific recommended time to take the evening dose of Contrave. It is recommended to take the morning and evening doses approximately 12 hours apart.
How does the dosage of Contrave compare with that of Wellbutrin?
Contrave and Wellbutrin both contain bupropion but are not used to treat the same conditions. Contrave also contains naltrexone, while Wellbutrin does not. The dosages are not interchangeable.
How do I stop taking Contrave?
Consult your doctor before stopping Contrave. While studies have not shown side effects upon discontinuation, it is essential to seek medical advice before stopping any medication.
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