Naltrexone and Bupropion

This information from Lexicomp^® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Contrave

Brand Names: Canada

Contrave

What is this drug used for?

• It is used to help with weight loss in certain people.

What do I need to tell my doctor BEFORE I take this drug?

• If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
• If you have ever had seizures.
• If you drink a lot of alcohol and you stop drinking all of a sudden.
• If you use certain other drugs like drugs for seizures or anxiety and you stop using them all of a sudden.
• If you have an eating problem, high blood pressure, liver problems, or kidney problems.
• If you have taken certain drugs for depression or Parkinson’s disease in the last 14 days. This includes isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline. Very high blood pressure may happen.
• If you are taking carbamazepine, efavirenz, linezolid, lopinavir, methylene blue, phenobarbital, phenytoin, ritonavir, or another drug that has the same drug in it.
• If you take drugs like methadone or buprenorphine to help you stop taking an opioid drug.
• If you are taking an opioid drug like morphine or oxycodone, have opioid use disorder, or are having withdrawal signs.
• If you are taking any of these drugs: Buprenorphine, butorphanol, nalbuphine, or pentazocine.
• If you have taken a pain drug within the past 7 to 14 days.
• If you are pregnant or may be pregnant. This drug may cause harm to an unborn baby. Do not take this drug if you are pregnant.
• If the patient is a child. Do not give this drug to a child.

This is not a list of all drugs or health problems that interact with this drug.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?

• Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
• Follow the diet and exercise plan that your doctor told you about.
• This drug may affect certain lab tests. Tell all of your health care providers and lab workers that you take this drug.
• This drug may cause high blood pressure.
• Check blood pressure and heart rate as the doctor has told you.
• If you have high blood sugar (diabetes) and take drugs to lower blood sugar, talk with your doctor. Weight loss may raise the chance of low blood sugar if you take drugs to lower blood sugar. Call your doctor right away if you have signs of low blood sugar like dizziness, headache, feeling sleepy, feeling weak, shaking, a fast heartbeat, confusion, hunger, or sweating.
• This drug may raise the chance of seizures. The risk may be higher in people who take higher doses, have certain health problems, or take certain other drugs. People who suddenly stop drinking a lot of alcohol or suddenly stop taking certain drugs (like drugs used for anxiety, sleep, or seizures) may also have a higher risk. Talk to your doctor to see if you have a greater chance of seizures.
• Talk with your doctor before you use alcohol, marijuana or other forms of cannabis, or prescription or OTC drugs that may slow your actions.
• Some people may have a higher chance of eye problems with this drug. Your doctor may want you to have an eye exam to see if you have a higher chance of these eye problems. Call your doctor right away if you have eye pain, change in eyesight, or swelling or redness in or around the eye.
• Talk with your doctor before taking opioid drugs like some cough and cold products, some diarrhea drugs, and some pain drugs. These drugs may not work as well. Do not take more of these drugs to try to get them to work better. Doing this may cause very bad injury, coma, or death. Talk with your doctor.
• People taking this drug may get more effects from opioid drugs when this drug is stopped. Even low doses of opioid drugs may cause very bad and sometimes deadly effects in these people. Talk with your doctor.
• If you have opioid use disorder and are given this drug, you may have signs of opioid withdrawal. Some of these signs are sweating, shaking, fever, chills, diarrhea, upset stomach, throwing up, stomach cramps, goosebumps, body aches, anxiety, feeling irritable, yawning, or fast heartbeat.
• This drug is not approved to treat mental or mood problems like depression or to help stop smoking. When another bupropion drug was used to stop smoking, mental or mood problems happened or got worse. Talk with the doctor.
• If you are 65 or older, use this drug with care. You could have more side effects.
• Tell your doctor if you are breast-feeding or plan to breast-feed. This drug passes into breast milk and may harm your baby.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
• Signs of liver problems like dark urine, tiredness, decreased appetite, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
• Signs of high blood pressure like very bad headache or dizziness, passing out, or change in eyesight.
• Hallucinations (seeing or hearing things that are not there).
• Restlessness.
• Seizures.
• Chest pain or pressure, a fast heartbeat, or an abnormal heartbeat.
• Swollen gland.
• Muscle or joint pain.
• Shortness of breath.
• Swelling.
• Fever.
• A severe skin reaction (Stevens-Johnson syndrome) may happen. It can cause severe health problems that may not go away, and sometimes death. Get medical help right away if you have signs like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in your mouth, throat, nose, or eyes.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Dizziness or headache.
• Constipation, diarrhea, throwing up, or upset stomach.
• Dry mouth.
• Trouble sleeping.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to your national health agency.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

How is this drug best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

• Swallow whole. Do not chew, break, or crush.
• Take by mouth only. Do not inject or snort this drug. Doing so can cause very bad side effects like seizures and death.
• Avoid taking this drug with high-fat meals.
• If you have trouble swallowing, talk with your doctor.
• Keep taking this drug as you have been told by your doctor or other health care provider, even if you feel well.
• Do not take this drug more often than you are told. This may raise the risk of seizures. Be sure you know how far apart to take your doses.

What do I do if I miss a dose?

• Skip the missed dose and go back to your normal time.
• Do not take 2 doses at the same time or extra doses.

How do I store and/or throw out this drug?

• Store at room temperature in a dry place. Do not store in a bathroom.
• Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
• Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

General drug facts

• If your symptoms or health problems do not get better or if they become worse, call your doctor.
• Do not share your drugs with others and do not take anyone else’s drugs.
• Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
• Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
• If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2024-05-21

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