Contrave weight loss: How it works

Although Ozempic®, Wegovy®, Mounjaro®, and Zepbound® seem to capture all the headlines lately, they're not the only options when it comes to medication-assisted treatment for people who are overweight or have obesity. 

A prime example is the weight-loss pill Contrave®, which contains the active ingredients bupropion and naltrexone and can help control appetite and reduce cravings.

Contrave® weight loss may be an option if other medications aren't working effectively, you prefer a pill to an injection, or other drugs for weight loss aren’t covered by your insurance. Contrave® can help if you struggle with food cravings or emotional eating. 

Here's a look at how Contrave® works, along with how Found can help you determine whether it's a good fit for your weight care journey. 

What is Contrave?

Contrave® is a medication approved by the US Food and Drug Administration (FDA) for weight loss that combines two active ingredients shown to have significant effects on weight: naltrexone and bupropion.

Naltrexone, one of the active ingredients in Contrave®, is best known as an opioid agonist used to treat 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, and 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.)  

Unlike some weight-loss medications that are weekly injections, Contrave® is an extended-release oral medication. It’s approved for weight loss in adults with a body mass index (BMI) of 30 or greater and those with a BMI of 27 or greater (overweight) with at least one weight-related medical condition including high blood pressure, high cholesterol, or type 2 diabetes.

The typical starting dosage for those taking Contrave® is one pill, taken once a day, with a reduced-calorie diet and increased physical activity. Each tablet contains 8 mg naltrexone and 90 mg bupropion. The dosage increases gradually to the maximum dose of four pills daily: two in the morning and two in the evening, with or without a small, low-fat meal. (Note: Do not take the drug with a high-fat meal because it may increase the levels of Contrave® in your body, which can increase the risk of seizures.)

How does weight loss on Contrave happen?

Researchers believe that by helping reset the brain's reward behaviors, the active ingredients in Contrave® may reduce appetite and enhance a sense of fullness, which can result in weight loss. 

The combined action of its key ingredients also plays a role in reducing cravings.  An integrated analysis of four phase 3 clinical trials of the drugs published in the International Journal of Obesity found that food cravings are associated with lower success rates in weight-loss attempts—and that the intensity of food cravings varies greatly among individuals.

These findings suggest that people who take control of and reduce their food cravings are more likely to have success in their weight-loss efforts. 

Is Contrave right for you?

At Found, the ultimate decision regarding whether a patient is qualified for a medication rests with the provider. However, every patient is different, and many factors go into the decision. 

Found-affiliated clinicians specializing in weight management match your information to a medication and treatment plan with the help of MetabolicPrint^™︎. This proprietary health assessment identifies your unique metabolic traits so your Found provider can tailor your treatment plan to your unique needs.  

A breadth of variables—from lifestyle habits to family history to your experience with other medications—can influence your body’s ability to achieve and maintain a healthy weight. 

After considering all these factors, you and your clinician can talk about whether you may be more likely to successfully lose weight with Contrave® than with another medication. 

Are there side effects when taking Contrave for weight loss?

All medications—including over-the-counter cold medicines and pain relievers—have potential side effects. Contrave® is no exception. According to the manufacturer, common side effects of Contrave® include:

• Constipation
• Vomiting
• Dizziness
• Dry mouth
• Headache
• Insomnia
• Nausea
• Diarrhea

More serious Contrave® side effects include suicidal thoughts, high blood pressure, chest pain, high heart rate, liver problems, manic episodes, angle-closed glaucoma,  low blood sugar, and seizures. If you're experiencing any of these after starting Contrave,® talk with your health care provider immediately. 

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. 

It’s also important to tell your health care professional about any prescription drugs, over-the-counter medications, and supplements you are taking before you start Contrave®. Many medicines have known drug interactions with Contrave,® including antidepressants and monoamine oxidase inhibitors (MAOIs). Serious risks include suicidality and other psychiatric disorders (bupropion) or increased risk of overdose if taken with opioids or opiates (naltrexone).

People with certain health conditions, including eating disorders like anorexia or bulimia, severe kidney or liver problems, a history of seizures, or untreated high blood pressure, should not take Contrave®.

Please see the full prescribing information on the label for Contrave® for a more complete list of potential side effects and risks. 

How fast are people losing weight with Contrave?

While results vary by individual when it comes to weight loss, an analysis of six phase 3 clinical trials of Contrave® found that, at 16 weeks, more participants receiving the drug lost at least 5% or 10% of their starting body weight compared to those receiving the placebo. (The average weight at the start of the trials was about 228 pounds.)

Weight loss may continue long-term, according to a review of four 56-week phase 3 clinical trials published in the open-access journal eClinicalMedicine. That research review found that the combination of naltrexone and bupropion resulted in clinically significant weight loss (5%-10% of initial body weight) that was maintained by more than 40% of those on the drug combination for at least four years after starting the medication.

Another important consideration for Contrave® weight loss is the effect that lifestyle changes can make on the pace and sustainability of weight loss. In clinical studies, diet and exercise were part of the treatment with Contrave®. At Found, nutrition and movement are emphasized as an important part of any weight management plan.  This content does not provide medical advice and does not substitute for a consultation with a doctor or health care provider. 

Our verdict: Taking Contrave for weight loss

For those who are properly matched with Contrave®, it can be an effective treatment. That's why Contrave® is a medication in the larger toolkit that Found-affiliated providers utilize—along with health coaching, peer support, nutrition and movement guidance, and expert clinical care—to help members meet their weight-loss goals. 

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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.

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