Contrave for Weight Loss
Are you looking to add Contrave to your weight loss plan? Scroll down to learn if Contrave is the right medication for you.
What is Contrave?
Contrave is an FDA-approved prescription weight loss medication. It is a combination of two medications: Naltrexone and Bupropion.
How Does Contrave Work?
Contrave consists of two drugs: naltrexone and bupropion. Naltrexone targets brain reward systems to reduce food cravings, while bupropion, an antidepressant, suppresses appetite and boosts metabolism. Together, they aid weight loss by curbing calorie intake and enhancing energy expenditure. Despite containing an antidepressant, Contrave is not intended for depression treatment.
Who Qualifies for Contrave?
Contrave is approved for the treatment of obesity. If you have a BMI greater than or equal to 30 or a BMI greater than 27 with at least one other weight-related condition (diabetes, high blood pressure, high cholesterol), you may be eligible for this medication.
Effectiveness of Contrave for Weight Loss?
Contrave demonstrates high effectiveness in managing obesity. In the COR-1 trial published in 2010, researchers investigated its benefits for weight management in overweight and obese individuals. Participants received oral Contrave alongside a calorie-restricted diet and regular exercise for 52 weeks. Results indicated an average 5% reduction in body weight, with nearly half of participants experiencing at least a 5% weight loss. Notably, optimal outcomes are achieved when Contrave is coupled with a calorie-restricted diet and moderate exercise regimen (150 minutes/week)..
Contrave vs Other Prescription Weight Loss Medications
Contrave vs GLP-1 Medications
GLP-1 agonist medications, initially designed for treating type 2 diabetes, mimic the hormone GLP-1, regulating blood sugar and gut movement. While some are FDA-approved for obesity (Wegovy, Saxenda), others are used off-label for weight loss (Mounjaro, Ozempic, Rybelsus, Victoza, Trulicity). These medications can reduce body weight by 10-20%, particularly effective when combined with diet and exercise. For instance, in the SURMOUNT-1 Trial, Mounjaro users experienced a 15% average weight reduction over 72 weeks. Although highly effective, Contrave may be preferable for those averse to injectables and may benefit individuals with depression or smoking cessation goals.
Contrave vs Qsymia
Qsymia, a prescription weight loss medication, combines phentermine, an appetite suppressant affecting the central nervous system, with topiramate, an anti-seizure drug that reduces appetite and enhances feelings of fullness. The CONQUER Trial demonstrated Qsymia’s effectiveness in treating obesity over 52 weeks, resulting in weight loss of around 8-10 kg (18-22 lbs) and a 5% reduction for 68% of participants. While both Contrave and Qsymia manage obesity effectively, Qsymia shows a higher rate of at least 5% weight reduction. Contrave may be preferable for individuals with a history of heart disorders, and both medications require a combined approach with diet and exercise.
Contrave Side Effects
The most common side effects of Contrave vary. They are usually only mild to moderate in severity and go away with time. These side effects include:
- Nausea (35%)
- Constipation (19%)
- Headache (18%)
- Vomiting (11%)
- Dizziness (10%)
- Insomnia (9%)
- Dry Mouth (8%)
- Diarrhea (7%)
Contrave Dosage and Administration
Contrave is administered twice daily, with two tablets in the morning and evening. The dosage is 8 mg/90 mg and should not exceed 32 mg/360 mg per day. The titration period lasts approximately three weeks before reaching the recommended dosage.
Your provider may adjust the dose if you have a liver or kidney disease history. Do not crush, chew or split the tablets.
Contrave Contraindications and Warnings
Severe Allergic Reaction
You may experience a severe allergic reaction to Contrave when first taking it. Signs of a severe allergic reaction include swelling of your face, lips, tongue, or throat, problems breathing or swallowing, severe rash or itching, fainting or feeling dizzy, and very rapid heartbeat. Let your provider know immediately if you have experienced this when taking Contrave in the past.
History of Seizures
Contrave can increase the risk of seizures depending on the dose. This is particularly dangerous for those who have a history of seizure disorders. If you have had seizures in the past, notify your provider before starting Contrave.
Opioid Use
Contrave should not be given to anyone who uses opioids chronically for the risk of overdose. It can also precipitate withdrawal for those taking Suboxone (buprenorphine) or methadone.
Anorexia or Bulimia
People suffering from eating disorders like Bulimia and Anorexia may be at a higher risk for seizures when taking Contrave.
Uncontrolled High Blood Pressure
Contrave can increase blood pressure which is an issue for those with a history of uncontrolled high blood pressure. People taking Contrave should see their provider regularly to check their blood pressure and monitor for significant changes.
Liver Disease
Naltrexone can potentially cause clinically significant liver dysfunction and hepatitis (liver inflammation). Therefore, you should inform your provider if you are having symptoms of hepatitis while taking Contrave or have a history of liver dysfunction before starting Contrave.
Pregnancy
Contrave is not recommended for pregnant patients or patients thinking of becoming pregnant. The weight loss caused by Contrave may not benefit people who are pregnant and have the potential to harm the fetus.
Drug Interactions
You should not take Contrave if you are on any other medication that contains bupropion, such as Wellbutrin or Zyban. Review your medications with your provider before starting Contrave.
Contrave Cost
$410/month
Where Can I Get Contrave?
Compounded and commercial pharmacies.
Omni Health NP is a virtual obesity medicine practice that connects you with medical providers, like licensed physicians and nurse practitioners, to help you optimize your weight loss journey. We provide monthly video chats with actual medical providers to provide guidance about weight management and to get you started on prescription weight loss medications to supplement your weight loss plan.
References
- Greenway FL, Fujioka K, Plodkowski RA, Mudaliar S, Guttadauria M, Erickson J, Kim DD, Dunayevich E; COR-I Study Group. Effect of naltrexone plus bupropion on weight loss in overweight and obese adults (COR-I): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2010 Aug 21;376(9741):595-605. doi: 10.1016/S0140-6736(10)60888-4. Epub 2010 Jul 29. Erratum in: Lancet. 2010 Aug 21;376(9741):594. Erratum in: Lancet. 2010 Oct 23;376(9750):1392. PMID: 20673995.
- Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Connery L, Alves B, Kiyosue A, Zhang S, Liu B, Bunck MC, Stefanski A; SURMOUNT-1 Investigators. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med. 2022 Jul 21;387(3):205-216. doi: 10.1056/NEJMoa2206038. Epub 2022 Jun 4. PMID: 35658024.
- Sjöström L, Rissanen A, Andersen T, Boldrin M, Golay A, Koppeschaar HP, Krempf M. Randomised placebo-controlled trial of orlistat for weight loss and prevention of weight regain in obese patients. European Multicentre Orlistat Study Group. Lancet. 1998 Jul 18;352(9123):167-72. doi: 10.1016/s0140-6736(97)11509-4. PMID: 9683204.
- Gadde KM, Allison DB, Ryan DH, Peterson CA, Troupin B, Schwiers ML, Day WW. Effects of low-dose, controlled-release, phentermine plus topiramate combination on weight and associated comorbidities in overweight and obese adults (CONQUER): a randomised, placebo-controlled, phase 3 trial. Lancet. 2011 Apr 16;377(9774):1341-52. doi: 10.1016/S0140-6736(11)60205-5. Epub 2011 Apr 8. Erratum in: Lancet. 2011 Apr 30;377(9776):1494. PMID: 21481449.
