Key takeaways
Contrave, a combination of naltrexone and bupropion, is a weight-loss prescription drug for adults with a BMI of 30 kg/m2 or more or 27 kg/m2 with other weight-related conditions. It is intended to be used in conjunction with a reduced-calorie diet and increased physical activity.
The recommended dosage of Contrave starts with one tablet in the morning and increases in a stepwise manner to a maximum daily dosage of two tablets in the morning and two tablets in the evening.
The dosage for those with kidney or liver impairment may be reduced to a maximum of two tablets daily (one tablet in the morning and one tablet in the evening).
Contrave treatment is not recommended for those under age 18.
Contrave extended-release tablets are a brand-name prescription medication approved by the U.S. Food and Drug Administration (FDA) for weight management in adults who are overweight or obese. Contrave contains two medicines (naltrexone, an opioid antagonist, and bupropion, an antidepressant medicine) intended to be used along with a reduced-calorie diet and increased physical activity to help lose weight.
Contrave is used in adults with an initial body mass index (BMI) of ≥30 or in adults with an initial BMI of ≥27 plus at least one weight-related health condition such as Type 2 diabetes mellitus, high blood pressure, or high cholesterol. Contrave works to reduce food intake by targeting two areas of the brain to help control cravings and curb hunger. Contrave is available in an extended-release tablet that contains 8 mg of naltrexone and 90 mg of bupropion and is taken in a stepwise dosing schedule by mouth once and then twice daily with food. There is not a generic version of Contrave available at this time.
Contrave forms and strengths
Contrave is available in one strength and one dosage form:
Extended-release tablets: 8 mg of naltrexone hydrochloride and 90 mg of bupropion hydrochloride
Contrave dosage for adults
Contrave is a prescription weight-loss medicine that should be combined with a reduced-calorie diet and increased physical activity. It is indicated for adults with a body mass index (BMI) of ≥30 or adults with an initial BMI of ≥27 with at least one weight-related medical problem such as Type 2 diabetes, high blood pressure, or high cholesterol. Contrave is dosed in the following stepwise manner:
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Contrave dosage chart |
|||
|---|---|---|---|
| Indication | Timeframe | Morning dose | Evening dose |
| Weight loss | Week 1 | 1 tablet | None |
| Week 2 | 1 tablet | 1 tablet | |
| Week 3 | 2 tablets | 1 tablet | |
| Week 4 - maintenance | 2 tablets | 2 tablets |
Contrave dosage for children
Contrave has not been studied in and is not approved for use in children and adolescents under the age of 18.
Contrave dosage restrictions
The recommended Contrave dosage for adults 18 years and older is escalated from a starting dose of one tablet in the morning for the first week of treatment up to two tablets in the morning and two tablets for the evening dose of Contrave by the fourth week. People with certain medical conditions, such as kidney disease or liver disease, may be at greater risk of side effects and be prescribed lower doses based on medical advice from their healthcare provider.
Hepatic (liver) impairment
Mild to moderate impairment: no more than two tablets daily (one tablet each morning and evening)
Severe impairment: Contrave not recommended
Renal (kidney) impairment
Moderate to severe impairment: No more than two tablets daily (one tablet each morning and evening)
End-stage renal disease: Contrave not recommended
How to take Contrave
Contrave is taken by mouth as a fixed-dose extended-release tablet once or twice per day. It is intended to be combined with a reduced-calorie diet and increased physical activity for weight management in adults meeting specified body mass index (BMI) and risk factors.
Take Contrave exactly as your healthcare provider tells you. Your healthcare provider will change your dose if needed.
Do not change your Contrave dose without consulting your healthcare provider.
Swallow Contrave tablets whole. Do not break, chew, or crush the tablets.
Do not take more than two tablets in the morning and two tablets in the evening.
Do not take more than two tablets at the same time or more than four tablets daily.
Take Contrave with food, but do not take it with high-fat foods which may increase the risk of seizures.
If you miss a dose of Contrave, wait until your next regular time to take it.
It is important to read all of the additional information in the Medication Guide
before starting Contrave treatment.
Contrave dosage FAQs
How long does it take Contrave to work?
In clinical trials, most participants had significant weight loss four weeks after starting treatment with Contrave. If no clinically-meaningful response is observed after three months of treatment (i.e., weight loss of greater than 5%) Contrave therapy may be discontinued.
How long does Contrave stay in your system?
A drug’s half-life is the length of time it takes the body to clear half of a drug dose. It typically takes approximately four half-lives for a drug to be fully eliminated from the body. Because Contrave is a combination medicine, the length of time it can remain in the body is based on the longer half-life of the bupropion component of Contrave (about 21 hours). This means Contrave can stay in one’s system for around four days before being completely eliminated.
What happens if I miss a dose of Contrave?
If you miss a dose of Contrave, wait until your next regular time to take it. Do not take two doses to make up for a missed dose. Take your next dose at the normal time and go back to your regular schedule.
How long can you take Contrave?
Contrave is typically used for long-term weight management. If you do not lose 5% of your initial body weight after 12 weeks, Contrave is unlikely to be helpful, and your doctor will probably have you stop taking the drug. If significant weight loss is achieved after 12 weeks, therapy may be continued for up to one year or more.
How do I stop taking Contrave?
You should consult your healthcare professional before discontinuing your Contrave treatment, however stopping Contrave did not cause withdrawal symptoms in clinical studies. In these clinical trials, neither patients who stopped Contrave suddenly or those who tapered off of it experienced any increase in adverse events.
After 12 weeks of treatment with Contrave, if you have not achieved meaningful weight loss of at least 5% from your baseline body weight, it should be discontinued and other weight-loss options should be considered.
What is the maximum dosage for Contrave?
The maximum daily dose of Contrave is two tablets in the morning and two tablets in the evening. Do not take more than two tablets at the same time or more than four tablets in one day.
Can you overdose on Contrave?
Serious side effects reported with overdoses of bupropion, one of the two active ingredients of Contrave, include seizures, hallucinations, loss of consciousness, and increased heart rate and other cardiac problems. If you take too much Contrave, you may need immediate medical attention and you should contact your healthcare provider or a poison control center.
What interacts with Contrave?
To avoid drug interactions, Contrave should not be taken with the following:
Other forms of bupropion such as Wellbutrin, Zyban, and Aplenzin
Monoamine oxidase inhibitors (MAOIs) such as tranylcypromine, selegiline, or rasagiline, within 14 days before or after taking Contrave
Other medications in the weight-loss drug class such as phentermine
Opioid medications (e.g., oxycodone) or opiate agonists (e.g., methadone)
What happens when you mix Contrave and alcohol?
Because Contrave can lower a person's alcohol tolerance, you should minimize or avoid drinking alcohol while taking Contrave. If you drink a lot of alcohol, talk with your healthcare provider before suddenly stopping. If you suddenly stop drinking alcohol, you may increase your chance of having a seizure.
Is it safe to take Contrave during pregnancy?
It is not recommended to use Contrave if you are pregnant or intend to become pregnant. Weight loss during pregnancy is not recommended and may harm your unborn baby. If you become pregnant while taking Contrave, tell your healthcare provider immediately as you will likely be told to discontinue Contrave.
Sources
Naltrexone/Bupropion ER (Contrave): Newly approved treatment option for chronic weight management in obese adults
, Pharmacy and Therapeutics (2016)Bupropion/naltrexone (Rx)
, Medscape (2024)Contrave (naltrexone HCl and bupropion HCl) medication guide
,
Contrave.comContrave (naltrexone HCl and bupropion HCl)
, FDA label
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