Contrave: A Clinically Proven Weight Management Medication
Contrave
| Product dosage: 98mg | |||
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Synonyms | |||
Contrave is a prescription medication approved by the FDA for chronic weight management in adults. It combines two active ingredients, naltrexone HCl and bupropion HCl, in an extended-release formulation designed to work on areas of the brain involved in appetite control and reward. This dual-action approach helps reduce hunger and cravings, supporting sustainable weight loss when used alongside a reduced-calorie diet and increased physical activity. It is indicated for use in adults with an initial body mass index (BMI) of 30 kg/m² or greater, or 27 kg/m² or greater in the presence of at least one weight-related comorbidity such as hypertension, type 2 diabetes, or dyslipidemia.
Features
- Contains naltrexone hydrochloride (8 mg) and bupropion hydrochloride (90 mg) in an extended-release tablet
- FDA-approved for chronic weight management
- Dual mechanism of action targeting hypothalamic appetite centers and mesolimbic reward circuitry
- Designed for once-daily initiation with gradual titration to a maintenance dose of two tablets twice daily
- Available in blister packs to aid compliance with the prescribed dosing schedule
Benefits
- Supports significant weight loss when combined with lifestyle modifications
- Helps reduce caloric intake by decreasing appetite and cravings
- May improve certain metabolic parameters in individuals with weight-related comorbidities
- Provides a non-surgical pharmacological option for long-term weight management
- Can contribute to improved quality of life and body composition changes over time
Common use
Contrave is commonly prescribed for adults struggling with obesity or overweight with associated health conditions. It is typically used when diet and exercise alone have not resulted in adequate weight loss. The medication is intended as part of a comprehensive weight management program that includes behavioral modifications, nutritional counseling, and increased physical activity. Treatment response should be evaluated after 16 weeks; if a patient has not lost at least 5% of baseline body weight, discontinuation should be considered as the medication is unlikely to be effective for that individual.
Dosage and direction
The recommended dosing schedule involves a gradual titration to minimize side effects:
- Week 1: One tablet taken orally 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 onward: Two tablets in the morning and two tablets in the evening (maintenance dose)
Tablets should be swallowed whole and not crushed, chewed, or divided. The maximum daily dose is 32 mg naltrexone/360 mg bupropion. Administration with food may reduce the incidence of nausea. Dose escalation should not proceed if the patient has not tolerated the previous dose level.
Precautions
Patients should be monitored for increased blood pressure and heart rate; regular monitoring is recommended, especially during initial dose titration. Contrave contains bupropion, which is associated with a dose-related risk of seizure; the risk is increased in patients with certain predisposing factors. Patients should be advised about the potential for neuropsychiatric symptoms including changes in behavior, hostility, agitation, and suicidal thoughts. Caution is advised when prescribing to patients with a history of bipolar disorder, depression, or suicidal attempts. Abrupt discontinuation should be avoided due to potential withdrawal symptoms.
Contraindications
Contrave is contraindicated in:
- Patients with uncontrolled hypertension
- Patients with a seizure disorder or history of seizures
- Patients undergoing abrupt discontinuation of alcohol, benzodiazepines, barbiturates, or antiepileptic drugs
- Patients with eating disorders (anorexia nervosa or bulimia nervosa)
- Patients taking monoamine oxidase inhibitors (MAOIs) or who have taken MAOIs within the past 14 days
- Patients with known hypersensitivity to naltrexone, bupropion, or any component of the formulation
Possible side effects
Common adverse reactions (≥5%) include:
- Nausea (32.5%)
- Constipation (19.2%)
- Headache (17.6%)
- Vomiting (10.7%)
- Dizziness (9.9%)
- Insomnia (9.2%)
- Dry mouth (9.1%)
- Diarrhea (7.6%)
Serious side effects may include:
- Increased blood pressure and heart rate
- Seizures
- Angle-closure glaucoma
- Liver toxicity
- Hypersensitivity reactions
- Neuropsychiatric events
Drug interaction
Significant drug interactions include:
- MAO inhibitors: Contraindicated due to risk of hypertensive crisis
- Other bupropion-containing products: Increased seizure risk
- Drugs that lower seizure threshold: Antipsychotics, antidepressants, systemic corticosteroids
- CYP2B6 inhibitors (e.g., ticlopidine, clopidogrel): May increase bupropion exposure
- Drugs metabolized by CYP2D6 (e.g., antidepressants, antipsychotics, beta-blockers): Bupropion may inhibit their metabolism
- Dopaminergic drugs: Increased risk of adverse effects
Missed dose
If a dose is missed, patients should take it as soon as they remember unless it is close to the time of the next scheduled dose. In that case, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not take extra tablets to make up for a missed dose.
Overdose
Overdose may manifest as seizures, ECG changes, hallucinations, loss of consciousness, tachycardia, or nausea/vomiting. There is no specific antidote. Management involves symptomatic and supportive care, including ECG monitoring. Due to the extended-release formulation, gastrointestinal decontamination may be considered if presentation is early after ingestion.
Storage
Store at room temperature (20-25°C/68-77°F) with excursions permitted between 15-30°C (59-86°F). Keep in the original blister package to protect from moisture. Keep out of reach of children and pets.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Contrave is available by prescription only and should be used under the supervision of a healthcare provider. Individual results may vary. Patients should discuss their medical history and potential risks with their prescribing physician before beginning treatment.
Reviews
Clinical trials demonstrated that approximately 42% of patients taking Contrave achieved at least 5% weight loss compared to 17% with placebo at 56 weeks. In another study, 25% of patients achieved at least 10% weight loss compared to 7% with placebo. Many patients report reduced food cravings and improved satiety. However, gastrointestinal side effects, particularly during dose titration, are commonly reported. Healthcare providers generally recommend Contrave for appropriate candidates who have struggled with traditional weight loss methods and understand the commitment to lifestyle changes required for success.