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Contrave
Contrave is a combination medication containing naltrexone and bupropion, used for weight management in adults who are obese or overweight with weight-related medical problems such as hypertension or type 2 diabetes. Naltrexone is an opioid antagonist, while bupropion is a dopamine/norepinephrine reuptake inhibitor. Together, they act on the central nervous system to help reduce appetite and cravings, assisting in long-term weight loss.
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Frequently Asked Questions
How long does it take for Contrave to start working?
Most patients begin to see weight loss results within the first 4 weeks, but it may take longer for some.
Can I drink alcohol while taking Contrave?
It is best to avoid alcohol, as it can increase the risk of serious side effects such as seizures and worsen psychiatric symptoms.
Can Contrave cause seizures?
Yes, Contrave contains bupropion, which lowers the seizure threshold, especially if taken in high doses or with alcohol.
Does Contrave suppress appetite?
Yes, Contrave works by reducing cravings and appetite, helping patients adhere to a reduced-calorie diet.
How much weight can I lose with Contrave?
Studies have shown that patients using Contrave along with diet and exercise can lose an average of 5% to 10% of their body weight.
Comprehensive Drug Guide
How Does Contrave Work?
- Naltrexone blocks opioid receptors, which may reduce cravings and the reward effects associated with food consumption.
- Bupropion acts on the brain's dopamine and norepinephrine pathways to reduce appetite and increase energy expenditure.
Common Dosages
- 8 mg naltrexone/90 mg bupropion extended-release tablets.
Typical Dosing
- The typical dosing regimen starts with one tablet in the morning for the first week, gradually increasing to two tablets twice daily (morning and evening) over the next few weeks, based on tolerability.
Typical Dosing
FDA Approved Indications
- Chronic weight management in adults with a body mass index (BMI) ≥30 (obese) or BMI ≥27 (overweight) with at least one weight-related condition such as high blood pressure, type 2 diabetes, or high cholesterol.
Who Shouldn't Take Contrave?
- Uncontrolled hypertension
- Seizure disorders
- Eating disorders such as bulimia or anorexia
- Recent use of opioids, monoamine oxidase inhibitors (MAOIs), or alcohol
Advice From The Pharmacist
- Take Contrave with food, but avoid taking it with high-fat meals, as this can increase the risk of seizures.
- Regularly monitor blood pressure, as Contrave may cause increases.
- Avoid drinking alcohol while on Contrave due to the risk of serious side effects.
Side Effects of Contrave
Common Side Effects
- Nausea
- Constipation
- Headache
- Dizziness
Uncommon/Severe Side Effects
- Seizures
- Suicidal thoughts or behaviors
- Increased blood pressure
Risks and Warnings of Contrave
- Seizure risk: Bupropion can lower the seizure threshold, so individuals with seizure disorders should avoid using Contrave.
- Blood pressure: Regular monitoring of blood pressure is required, as Contrave can elevate blood pressure and heart rate.
- Neuropsychiatric symptoms: Contrave may increase the risk of depression, anxiety, or suicidal thoughts, particularly in young adults.
Interactions with Contrave
Common Drug Interactions
- Opioids: Naltrexone blocks opioid receptors, so the use of opioids (for pain relief or recreationally) while taking Contrave is contraindicated.
- Monoamine oxidase inhibitors (MAOIs): Combining MAOIs with bupropion can increase the risk of hypertensive crisis.
- Antidepressants: The combination with other antidepressants can increase the risk of serotonin syndrome or seizures.
Alternatives to Contrave
- Qsymia (phentermine/topiramate): Another weight-loss drug that works by suppressing appetite.
- Saxenda (liraglutide): A GLP-1 receptor agonist used for weight management.
- Alli (orlistat): An over-the-counter weight loss aid that blocks fat absorption.
