Obesity is a serious chronic disease, and it’s critical that healthcare professionals have access to rigorous, data-driven evidence when considering treatment options. Contrave is a prescription weight-loss medication approved by the Food and Drug Administration (FDA) for adults with a body mass index (BMI) of 30 or greater (obese) or a BMI of 27 or greater (overweight) who also have at least one weight-related medical problem, such as high blood pressure, high cholesterol, or type 2 diabetes mellitus. It combines two active drugs, naltrexone and bupropion, and is intended to be used in conjunction with a reduced-calorie diet and increased physical activity.
What is Contrave?
Contrave is a brand-name prescription drug containing naltrexone and bupropion. Naltrexone is an anti-addiction medication approved to treat alcohol and opioid dependence. Bupropion is an antidepressant approved to treat depression and seasonal affective disorder and is an aid in smoking cessation treatment. It is an oral extended-release (ER) tablet, meaning it slowly releases its active ingredients over a longer period. Each tablet contains 8 mg of naltrexone and 90 mg of bupropion.
While experts have yet to fully understand the exact neurochemical effects of Contrave leading to weight loss, they believe Contrave works on the part of the brain that deals with hunger and the reward system. When you feel hungry, it is your brain notifying you that your body needs food. When you eat and feel filled, the brain sends a similar but opposite signal saying you’re filled. In such cases, an individual tends to overeat without knowing when to stop. As a result, they eat more, and the body converts the unneeded foods to fat. The goal of this medication is that the brain will be able to effectively perform its function and quickly notify your body when to stop eating. It’ll also help to control the way you crave food.
How Contrave Works for Weight Loss
Contrave is believed to work on the areas of the brain that control hunger and cravings, helping individuals feel full appropriately. The medication comprises naltrexone and bupropion, which individually are not approved as weight-loss products. Naltrexone is known as an opioid agonist used to treat opioid and alcohol dependence. However, the drug can also interrupt feedback loops affected by other substances including food, which for some is tied to feelings, emotions, and rewards. Bupropion increases norepinephrine and dopamine, two chemical messengers in the brain that affect mood, potentially reducing appetite and enhancing a sense of fullness.
Cardiovascular Safety
Currax Pharmaceuticals LLC announced the publication of its Cardiovascular Health Outcomes Analysis (HOA) for CONTRAVE®/MYSIMBA® in Obesity Pillars, the official journal of the Obesity Medicine Association. The study’s publication provides important real-world evidence that further substantiates the cardiovascular safety profile of CONTRAVE/MYSIMBA building on findings from prior clinical trials, a systemic literature review, two published FDA Adverse Event Reporting System (FAERS) database studies, and over ten years of post-marketing safety surveillance.
Read also: Weight Loss Guide Andalusia, AL
Dosage and Administration
When starting Contrave, your doctor will have you take a low dosage of the drug. They’ll increase your dosage over time to reach the recommended daily dosage. After about 4 weeks, you’ll take two tablets in the morning and two tablets in the evening. This will be your dosage for the remainder of the treatment period.
When starting Contrave, your dosage schedule will look like this:
- Week 1: One tablet in the morning
- Week 2: One tablet in the morning and one tablet in the evening
- Week 3: Two tablets in the morning and one tablet in the evening
- Week 4 and beyond: Two tablets in the morning and two tablets in the evening
Contrave should be taken orally in the morning and the evening and should not be taken with high-fat meals. You should drink plenty of water when taking Contrave. However, some individuals with certain medical complications might be instructed to follow a different Contrave dosage schedule.
Effectiveness for Weight Loss and Weight Management
Clinical trials have found Contrave to be effective for weight management when combined with a balanced diet and exercise.
Three clinical trials looked at people who had overweight or obesity. The people in these trials all followed a reduced-calorie diet and increased their physical activity, but some also took Contrave. After a little over a year, people who took the drug lost more weight compared with those who didn’t. In the studies, people taking CONTRAVE lost 2-4x more weight compared to those who used diet and exercise alone.
Read also: Beef jerky: A high-protein option for shedding pounds?
An analysis of six phase 3 clinical trials of Contrave® found that, at 16 weeks, more participants receiving the drug lost at least 5% or 10% of their starting body weight compared to those receiving the placebo. (The average weight at the start of the trials was about 228 pounds.)
Weight loss may continue long-term, according to a review of four 56-week phase 3 clinical trials published in the open-access journal eClinicalMedicine. That research review found that the combination of naltrexone and bupropion resulted in clinically significant weight loss (5%-10% of initial body weight) that was maintained by more than 40% of those on the drug combination for at least four years after starting the medication.
Side Effects of Contrave
Contrave can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Contrave. These lists do not include all possible side effects.
Mild side effects of Contrave can include:
- Nausea or vomiting
- Headache
- Dizziness
- Insomnia
- Dry mouth
- Diarrhea or constipation
- Hot flashes
Serious side effects from Contrave aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.
Read also: Inspiring Health Transformation
Serious side effects and their symptoms can include:
- Increased blood pressure or heart rate. Symptoms can include:
- Feeling lightheaded
- Rapid heart rate
- Headache
- Seizures. Symptoms can include:
- Loss of consciousness
- Muscle spasms
- Drooling or frothing at the mouth
- Allergic reaction
- Liver damage or hepatitis. Symptoms of liver problems include abdominal pain lasting more than a few days, dark urine, yellowing of the whites of the eyes, and tiredness.
- Suicidal thoughts and behaviors
- Angle-closure glaucoma. Symptoms can include:
- Severe headache
- Eye pain
- Blurred vision
Contrave has a boxed warning from the FDA for the risk of suicidal thoughts and behaviors. A boxed warning is the most serious warning from the FDA.
Contraindications and Precautions
You should not use Contrave if you have uncontrolled high blood pressure, seizures, an eating disorder, opioid addiction, if you take narcotic medicine or use other drugs that contain bupropion such as Wellbutrin, Aplenzin, or Zyban, have bulimia or anorexia nervosa, are taking monoamine oxidase inhibitors (MAOIs), or if you have suddenly stopped using alcohol, seizure medication, or a sedative. At least 14 days should elapse between discontinuation of an MAOI intended to treat depression and initiation of therapy with Contrave. Persons who are pregnant or breastfeeding should not take this supplement.
Contrave is also not for people suffering from mental health issues including depression, bipolar disorder, and suicidal thoughts and behaviors. It is also not approved to help people quit smoking.
People who take CONTRAVE must not use any type of opioid including street drugs, prescription pain medicines, cough, cold, or diarrhea medicines that contain opioids, or opioid dependence treatments, for at least 7 to 10 days before starting CONTRAVE. Using opioids in the 7 to 10 days before you start taking CONTRAVE may cause you to suddenly have symptoms of opioid withdrawal when you take it. Sudden opioid withdrawal can be severe, and you may need to go to the hospital.
Cost and Availability
Contrave sells for $99 per 120 tablets, a one-month supply. You’ll also pay a $45 physician consultation fee on all new orders. The consultation fee applies whether or not you are prescribed the medication. Contrave does not accept insurance at this time.
As with all medications, the cost of Contrave can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.
Currax Pharmaceuticals LLC, the manufacturer of Contrave, offers ways to save on its drug. Contrave may be less expensive if purchased through the manufacturer’s CurAccess program and offers a coupon card to help lower the cost of its drug.
Real Patient Experiences
Many patients have shared their experiences with Contrave, both positive and negative. Some have reported significant weight loss and improved control over their eating habits. However, others have experienced unpleasant side effects, such as nausea, vomiting, and mood changes. It’s important to remember that individual results may vary, and it’s crucial to discuss any concerns or side effects with your doctor.
One customer has this to say on Drugs.com “So I have been taking these for one and a half months, four pills a day. The Good: I have to force myself to eat, or I can go all day without eating. I have lost 20 lbs. Contrave has helped curb my alcohol addiction, which is helping with the weight loss. I have no trouble sleeping. The Bad: I’ve had to throw up a couple of times. I’ve had a few tummy aches, little constipation; I have had a few headaches, but nothing too bad. Once I went up to 4 pills a day, I’ve noticed that I am a little jittery, more depressed, anxious, and for the last few days, my chest has been hurting, and I got a couple of sharp pains in my heart. So I’m dropping down to 3 pills a day. I don’t want to stop taking the pills because they do work. If I don’t feel any better, I will drop to 2 pills a day. I feel like I’m dehydrated all day! But this has made me have to drink a lot more water, which is also helping with the weight-loss. Another Contrave review from a patient claims that he “started Contrave 4 weeks ago and have lost 10kg (~22 lbs)”. He does admit to some mild side effects like a fuzzy head and needing to pay attention to eating habits.
Currax is also running a campaign featuring real patients taking CONTRAVE who share their personal health journeys in their own words.
Contrave vs. Other Weight Loss Medications
Contrave is not the only medication available for weight loss. Other options include Ozempic, Wegovy, Mounjaro, and Zepbound.
Contrave is a combination medication of naltrexone and bupropion. Naltrexone is an opioid antagonist medication while bupropion is an antidepressant medication. Together, these medications act on the reward center in the brain to reduce food cravings. They also work in the appetite control center in the brain to reduce appetite.
Ozempic, a brand name for semaglutide, is a GLP-1 receptor agonist which mimics gut hormones that our body naturally produces after meals. Like Contrave, Ozempic acts in the appetite control center of the brain to reduce appetite and in the reward center of the brain to reduce cravings.
Ozempic also works in the gut to slow stomach emptying to produce earlier and longer-lasting feelings of satiety or fullness. Additionally, Ozempic acts at the pancreas and other sites in the body to enhance insulin sensitivity and improve blood sugar regulation.
Choosing an obesity management medication is an individualized decision made by a patient and their healthcare provider based on factors such as:
- A patient’s weight loss and health history
- A patient’s personal preferences
- Cost
- Other factors