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How to use it
Contrave® should be taken as instructed by a qualified health care provider. Take Contrave® with or without food and a full glass of water. Do not crush, chew, or cut the tablet. Do not take Contrave® with high-fat meals.
Store this medication at room temperature, away from direct light, excess heat, and moisture. (That means don’t keep it in the bathroom.)
Dosing
Dosing recommendations are based on the number of tablets; each contains 8 mg of naltrexone and 90 mg of bupropion. The manufacturer recommends patients begin with 1 pill in the morning during the first week and gradually work their way up to 2 pills twice a day by week 4. Always take Contrave® as prescribed by your provider.
Your health care provider may customize dosing based on various factors, including your weight and how well you tolerate the medication. If you miss a dose of Contrave®, wait until your next regular time to take it. DO NOT take more than 1 dose of Contrave® at a time. Do not take more than 4 tablets in 1 day.
Side effects
While some people experience no side effects while taking Contrave®. Some of the most common side effects are:
- Nausea
- Constipation
- Headache
- Vomiting
- Dizziness
- Insomnia
- Dry mouth
- Diarrhea
Additional side effects include:
- Anxiety
- Hot Flush
- Fatigue
- Tremor
- Upper abdomen pain
- Viral gastroenteritis
- Influenza (Flu)
- Tinnitus (Ringing in the ears)
- Urinary tract infection
- Excessive sweating
- Irritability
- Increased blood pressure
- Changes in taste and smell
- Rashes
- Muscle strains
- Palpitations; racing heart
Additional side effects include:
Fast heart rate, heart attack, dizziness, motion sickness, lower abdominal pain, gas, lip swelling, rectal bleeding, hernia, inflamed gallbladder, pneumonia, staph infection, kidney infection, increased blood creatinine, increased hepatic enzymes, decreased hematocrit, feeling jittery, feeling abnormal, feeling weak or a loss of energy, thirst, feeling hot, disturbance in attention, feeling sleepy, intention tremor, balance problems, impaired memory, amnesia, abnormal dreams, nervousness, feeling spacey, tension, agitation, mood swings, abnormal and frequent urination, dehydration, erectile dysfunction, bulging or herniated discs, jaw pain, feeling faint, vaginal dryness, hair loss, and irregular menstrual cycles (periods).
Symptoms may subside after your body adjusts to the medication.
Because this drug may make you dizzy, drowsy, and/or impair judgment, please do not drive, operate heavy machinery, or perform any hazardous task until you know how Contrave® affects you.
Black Box Warning
The “black box” on Contrave® warns that this drug may cause suicidal thinking and behavior. The medicine may also cause high blood pressure, fast, irregular heartbeats, seizures, acute angle-closure glaucoma, and death.
Precautions
Tell your health care provider about your medical history. You should not take Contrave if you:
- Have uncontrolled high blood pressure
- Have anorexia or bulimia
- Have or have had seizures
- Use other medicines that contain bupropion such as Wellbutrin®, Wellbutrin® SR, Wellbutrin® XL, Aplenzin®, or Zyban®
- Are undergoing an abrupt discontinuation of alcohol, benzodiazepines, barbiturates, and antiepileptic drugs
- Drink a lot of alcohol and abruptly stop drinking
- Have kidney disease
- Have liver disease (it may cause liver dysfunction or hepatitis)
- Are depressed or have suicidal feelings
- Have current or recent (within the past 7-14 days) use of opioids or opiate drugs
You should not take Contrave under these circumstances either:
- If you’re pregnant, breastfeeding, or planning to become pregnant
- If you’ve taken an MAOI (monoamine oxidase inhibitor), such as Nardil®, Parnate®, or Marplan® in the past 14 days
- If you’re taking any opioids or opiate drugs
- If you’re dependent on opioids or using methadone or buprenorphine
- If you are in opioid withdrawal
- Are allergic to any of the ingredients in Contrave
If you take opioids or opiates right after stopping Contrave, you may be more sensitive to them and require lower doses—which poses a risk of overdose. Please talk to your provider before initiating any opioids or opiates after stopping Contrave.
Tell your health care provider right away if you experience:
- Anxiety
- Buzzing or ringing in ears
- Chest discomfort
- Confusion or trouble concentrating
- Depression
- Dry mouth
- Fainting
- Hallucinations
- Headaches
- Hyperventilation
- Impulsivity
- Irregular heartbeats
- Irritability
- Lightheadedness
- Mood or mental changes
- Restlessness
- Seizures
- Shaking
- Skin hives, rashes, or itching
- Suicidal thoughts
- Sweating
- Trouble sleeping
- Unusual tiredness
- Vision changes or eye pain
Stop using this medication and get medical help immediately if you have any symptoms of a serious allergic reaction, including swelling of your face, lips, tongue, or throat; problems breathing or swallowing; severe rash or itching; fainting or feeling dizzy; or very rapid heartbeat.
Interactions
Some medications and other substances can interact with Contrave®, including:
- Alcohol
- MAOIs (like isocarboxazid, linezolid, phenelzine, selegiline, or tranylcypromine)
- Drugs that increase dopamine levels in your system (like levodopa and amantadine)
- Drugs that affect the central nervous system (like antihistamines or medicine for allergies or colds, sedatives, tranquilizers, or sleeping medication)
- Drugs for depression or anxiety
- Antipsychotics
- Theophylline
- Systemic corticosteroids
- Prescription pain medicine or narcotics
- Medicine for attention deficit and hyperactivity disorder (ADHD)
- Medicine for seizures or barbiturates
- Muscle relaxants
- Anesthetics, including some dental anesthetics
- Dextromethorphan
- Diarrhea medication (such as diphenoxylate)
- Disulfiram
- Opioid pain or cough relievers (such as codeine and hydrocodone)
- Thioridazine
Avoid drinking alcohol while taking Contrave®.
If you take diabetes medications, please discuss with your prescribing clinician before taking Contrave® since your diabetes medications may need to be adjusted as you lose weight.
