What are the ingredients in Contrave®—and how do they work?

Contrave® is a brand-name medication that was FDA approved in 2014 as a treatment for obesity. It combines two active ingredients—naltrexone and bupropion—in one extended-release tablet. It’s prescribed for weight loss for people with a BMI (body mass index) of 30 or more, or a BMI of 27 with weight-related medical conditions such as high blood pressure, type 2 diabetes, or high cholesterol. 

In clinical trials, Contrave® helped people lose an average of 11 to 22 pounds over 56 weeks, or around 6.4% of body weight, a clinically significant amount. Contrave® also helped some study participants lower cholesterol and improve their fasting insulin levels, reducing the risk of developing weight-related medical problems like heart disease or type 2 diabetes. 

Because of the way the two drugs in Contrave® affect cravings, Contrave® can be a helpful weight care tool for people who struggle with food cravings.

What ingredients are in Contrave®? 

Each Contrave® tablet contains two active ingredients: 8 mg of naltrexone hydrochloride (HCL) and 90 mg of bupropion HCL. These extended-release tablets are designed to slowly release these medications into the bloodstream over the course of a day, helping to reduce food cravings and support weight loss.

Naltrexone, one of the active ingredients in Contrave®, is best known as an opioid agonist used to tread opioid and alcohol dependence. But the drug can also interrupt feedback loops affected by other substances including food, which for some is tied to feelings, emotions, or rewards. 

Bupropion, the other active ingredient in Contrave®, is an antidepressant. It increases norepinephrine and dopamine, two chemical messengers in the brain that affect mood. Bupropion works by blocking the brain’s absorption of these neurotransmitters. 

How does Contrave® work for weight loss? 

Researchers are still studying how Contrave® helps people lose weight. However, we know that both of its active ingredients help to reduce cravings. They believe that Contrave® works on the  pro-opiomelanocortin (POMC) cells in the brain’s hypothalamus, where appetite and hunger are regulated. It also interrupts the reward system and dampens pleasure from overeating. Research suggests that the drug combination also helps the body use more calories from food, increasing energy expenditure and prompting weight loss. 

Naltrexone and bupropion each enhance the actions of POMC cells, which reduce food cravings, in different ways. Combined with lifestyle changes, such as increased physical activity and a reduced-calorie diet, Contrave® can be an effective tool for weight management. 

Are there any side effects of Contrave®? 

Like all medications, Contrave® can have side effects. Its most common side effects are nausea, dizziness, constipation, trouble sleeping, headache, dry mouth, vomiting, and diarrhea. Contrave® can also cause more serious side effects including a risk of seizures, high blood pressure, chest pain, high heart rate, liver problems, manic episodes, angle-closed glaucoma, or low blood sugar. Even though bupropion is used to treat depression, Contrave® can increase the risk of suicidal thoughts and behavior, so a health care professional should monitor carefully for any mood changes you experience while taking Contrave.® 

Contrave® can cause allergic reactions; don’t take it if you’re allergic to any of its ingredients. Stop taking Contrave® and call your health care provider immediately if you experience any of the following symptoms of an allergic reaction: rash, itching, hives, fever, swollen lymph nodes, painful sores in your mouth or around your eyes, swelling of your lips or tongue, chest pains, or trouble breathing. 

Be sure to tell your health care provider about any prescription drugs, over-the-counter medications, and supplements you take, as they may have drug interactions with Contrave.® 

You should not take Contrave® if you are taking other antidepressants such as monoamine oxidase inhibitors (MAOIs) drugs containing  bupropion like Wellbutrin®. You also should not take Contrave® if you are breastfeeding, have an eating disorder such as anorexia or bulimia, or have untreated high blood pressure.

People taking Contrave® may experience side effects, and these medications are not advised for those with certain conditions or risk factors. Serious risks include suicidality and other psychiatric disorders (bupropion) or increased risk of overdose if taken with opioids or opiates (naltrexone). Find more details about possible side effects and risks in the drug label, medication guide, and prescribing information on our dedicated Contrave® page.

What dose of Contrave® should I take? 

Contrave® typically starts at a low daily dose and increases over four weeks. This approach helps minimize side effects. Your health care provider will tell you when and how to increase your dose of Contrave,® but the manufacturer’s recommended dosing schedule looks like this: 

• Week 1: Take 1 tablet each day (in the morning). 
• Week 2: Take 2 tablets each day (1 in the morning, 1 in the evening).
• Week 3: Take 3 tablets each day (2 in the morning, 1 in the evening).  
• Week 4: Take 4 tablets each day (2 in the morning, 2 in the evening). 

You can take the tablets with or without a small low-fat meal. (Note: Taking Contrave® with high-fat meals can increase the risk of seizures.) Always take the extended-release tablets whole because they are designed to release the active ingredients gradually as the pill dissolves.

After 12 weeks of taking the medication, it’s time to assess whether it’s helping you reach your weight goals. If you haven’t lost at least 5% of your body weight after 12 weeks, Contrave® is unlikely to work for you. Discuss with your provider how to discontinue the medication and pursue other options. 

If Contrave® works for you, you’ll likely continue taking it, along with lifestyle changes. Like other weight-loss medications, Contrave® is intended to be taken long-term. 

Because everybody is different and weight management is a chronic condition, getting individualized treatment and ongoing support can be critically important to long term success. 

At Found, it begins with a quiz designed by obesity medicine specialists to find your unique MetabolicPrint™. It continues with a personalized treatment plan (with prescription medication at a licensed clinician’s discretion) and access to one-on-one health coaching and a supportive peer community through the Found app.  

About Found

Found is among the largest medically-supported telehealth weight care clinics in the country, having served more than 250,000 members to date. To discover your MetabolicPrint™ and start your journey with Found, take our quiz.

Found is not affiliated with Currax, the owner of the registered trademark Contrave®. The content provided is for informational purposes only and should not be used as a basis for diagnosing or treating any health condition. Always follow your health care provider’s instructions to ensure safe and effective management of your health conditions.