Contrave® side effects: everything you need to know

If you’re considering taking Contrave® for weight loss or any medication really, it’s natural and smart to wonder about any known side effects and potential risks. 

So today, we’re tracking down answers to some of the top questions Found members (and others) have about common Contrave® side effects and serious risks when taking it. 

First, what is Contrave®?

FDA-approved for weight loss for a decade now, Contrave® is an oral prescription medication..

Its two active ingredients, naltrexone and bupropion, have been approved by the US Food and Drug Administration (FDA) even longer for other uses: naltrexone to treat alcohol and opioid dependence, and bupropion to treat depression and seasonal affective disorder and as an aid in smoking cessation. 

Researchers believe that Contrave® affects dopamine signaling in the brain and body to boost energy expenditures and help curb cravings and appetite. 

The FDA approved Contrave® in 2014 as a treatment for chronic weight management in adults with obesity (defined as having a body mass index, or BMI, of 30 or greater) and adults with a BMI of 27 and at least one weight-related condition, such as high blood pressure, high cholesterol, or type 2 diabetes. 

Contrave® is prescribed for weight loss, along with a reduced-calorie diet and increased physical activity. It is available as extended-release tablets taken orally, generally once or twice a day. The manufacturer’s recommended dosing schedule starts with one tablet a day and gradually increases over four weeks to four tablets daily, two in the morning and two in the evening.

What are the most common side effects of taking Contrave® for weight loss? 

According to the FDA-approved prescribing information and drug label, some of the most commonly reported Contrave® side effects (occurring in 5% or more of patients taking the drug) are: 

• Nausea
• Constipation
• Headache
• Vomiting
• Dizziness
• Insomnia (trouble sleeping)
• Dry mouth
• Diarrhea

Other side effects—mild, more serious, and even life-threatening—and severe allergic reactions can also occur. Talk to your health care provider if you notice side effects, especially if they are severe, persistent, or worsening.

Other medications have known drug interactions with Contrave®. People with certain medical conditions (including those with eating disorders like anorexia or bulimia; those with severe kidney problems, liver problems, heart problems, or a history of seizures; those with uncorrected hypertension or high blood pressure; and those with allergies to naltrexone or bupropion) should not take Contrave®.

That’s why it’s so important, before taking Contrave®, to tell your health care provider and pharmacist about any medications you take and your health conditions. 

At Found, the clinician-developed MetabolicPrint™ process helps ensure each patient gets a treatment plan personalized for their unique biology and medical history. Patient safety is paramount, so the final decision about whether to prescribe a medication is always up to a licensed health care provider. Subscribers receive ongoing support from health coaches and the Found community.

How long do Contrave® side effects usually last? 

Individual results and tolerances vary. However, clinical studies and patient experience suggest that Contrave®’s side effects tend to surface shortly after people start or increase their dosage. These side effects typically resolve within a few days or weeks as patients adjust to the medication. 

What are some tips for minimizing, avoiding, or managing Contrave® side effects?

• Never cut, crush, or chew Contrave®. Swallow tablets whole with water. They’re intended to release slowly into your system as the outer layers of the tablets dissolve. 
• Take your dose as prescribed, and take morning and evening doses at about the same time each day.
• When possible, take Contrave® with a small low-fat meal. It can be taken on an empty stomach, too, but in clinical studies the drug was taken with meals. Some find that taking Contrave® with a small low-fat meal can help lessen common side effects.
• Do NOT take Contrave® with a high-fat meal. This can cause an overdose-like reaction and seizures.

What if I have nausea with Contrave®?

You can try:

• Eating several small meals throughout the day (rather than three large ones).
• Limiting rich, fatty, fried, spicy, or heavily seasoned foods.
• Sipping cold water or sucking on ice chips throughout the day.
• Avoiding strong smells or odors.

What if I have constipation with Contrave®?

You can try: 

• Drinking plenty of water.
• Drinking a hot caffeinated beverage, like coffee or tea.
• Gradually introduce more fiber-rich foods to your diet (such as bananas, unpeeled apples, prunes, oatmeal, whole grains, and nuts). 
• Taking walks and staying physically active which will help stimulate the bowels.
• Eating probiotic foods (like yogurt or kefir with live cultures) or taking a probiotic supplement—talk to your provider first, because probiotics can be harmful to some. 

What if I have insomnia or trouble sleeping when taking Contrave®? 

You can try: 

• Taking your evening dose well before bedtime.
• Keeping a regular bedtime routine and schedule.

Are there serious side effects, symptoms, and risks to monitor with Contrave®? 

Yes, there are some biggies. Serious, even life-threatening, risks include:

• Suicidal ideation and behavior. Contrave® has a “black box” warning from the FDA about suicidal thoughts and behaviors, especially if used when taking other antidepressant medications (including Wellbutrin® or other monoamine oxidase inhibitors or MAOIs) and in young people. Contrave® has not been studied or approved for children or adolescents. Anyone taking Contrave® should be monitored closely for worsening depression, changes in mood and behavior, and the emergence of suicidal thoughts or behavior, especially during the first few months of treatment and at times of dose changes.
• Neuropsychiatric symptoms in those trying to stop smoking while on Contrave®. Mood changes, depression, mania, psychosis, hallucinations, paranoia, delusions, homicidal ideation, aggression, hostility, agitation, anxiety, and panic, as well as suicidal ideation, suicide attempt, and completed suicide, have been reported. 
• Risk of seizures, which may be minimized by following the dosing schedule and avoiding taking Contrave® with high-fat meals.
• Increased blood pressure and heart rate. Patients, especially those with heart disease or cerebrovascular disease, should monitor their blood pressure and heart rate while taking Contrave®.
• Liver problems. Hepatitis and clinically significant liver dysfunction have occurred with naltrexone exposure. Reduced doses are recommended for those with reduced liver function (as well as those with reduced kidney function), and those with severe impairment should not take Contrave®. 
• Eye pain and eye problems, specifically angle-closure glaucoma, which can cause blindness if untreated.
• Hypoglycemia (low blood sugar) can occur when losing weight and using Contrave® with antidiabetic medications. Patients with type 2 diabetes should monitor their blood glucose carefully while taking Contrave®. 

Working with a health care provider specializing in weight care who takes the time to understand your medical history—including any prescription and over-the-counter medications you are taking—before you’re prescribed a medication is essential to a successful weight care journey. Equally important is a provider who offers ongoing support after you begin taking it. At Found, the journey begins with this quiz. 

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 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 healthcare provider’s instructions to ensure safe and effective management of your health conditions.