Contrave® (Bupropion/Naltrexone) Prolonged-Release Tablets
Contrave® is a prescription-only weight management medicine containing bupropion hydrochloride and naltrexone hydrochloride. It is indicated for adults who are overweight or living with obesity and is intended to be used alongside a calorie-controlled diet and increased physical activity.
What Is Contrave®?
Contrave® combines two established medicines in a single prolonged-release formulation.
Naltrexone is commonly used in the management of alcohol and opioid dependence, while bupropion is an antidepressant also prescribed to support smoking cessation.
Together, these agents act on central pathways involved in appetite regulation and reward, helping to reduce hunger and manage food cravings.
According to guidance from the National Institute for Health and Care Excellence (NICE),
pharmacological treatments for obesity may be considered in appropriate patients when lifestyle interventions alone are insufficient.
Regulatory oversight is provided in the UK by the Medicines and Healthcare products Regulatory Agency (MHRA).
How Contrave® Works
Contrave® targets areas of the brain responsible for appetite control and reward-driven eating behaviour.
Bupropion influences dopamine and noradrenaline activity, while naltrexone modulates opioid receptors involved in food-related reward signalling.
This dual mechanism supports reduced caloric intake when combined with lifestyle modification.
Dosage and Administration
Route: Oral administration.
Contrave® is supplied as blue prolonged-release tablets. Tablets must be swallowed whole and should not be crushed, split, or chewed, as this would interfere with the extended-release mechanism.
Recommended Titration Schedule
- Week 1: One tablet in the morning.
- Week 2: One tablet in the morning and one in the evening.
- Week 3: Two tablets in the morning and one in the evening.
- Week 4 onwards: Two tablets in the morning and two in the evening.
Tablets should be taken with food; however, high-fat meals should be avoided as they may increase the likelihood of adverse effects.
If a dose is missed, patients should continue with the next scheduled dose and must not double up.
Appearance
Contrave® tablets are blue, prolonged-release tablets bearing identifying markings. Appearance may vary slightly depending on the manufacturer or country of supply.
Common Side Effects
As with all prescription medicines, adverse effects may occur. Frequently reported side effects include:
- Nausea (particularly during early treatment)
- Constipation
- Headache
- Dizziness
- Dry mouth
- Insomnia
- Anxiety
- Vomiting
Many side effects improve as treatment continues. Persistent or severe symptoms should be discussed with a healthcare professional.
Serious Adverse Reactions
- Seizures: Contrave® may lower the seizure threshold, particularly in individuals with predisposing risk factors.
- Elevated blood pressure and heart rate: Monitoring is recommended during therapy.
- Hepatic injury: Rare cases of liver damage have been associated with naltrexone.
Urgent medical attention is required if symptoms such as severe abdominal pain, jaundice, dark urine, or seizure activity occur.
Drug Interactions
Patients must inform their clinician of all prescription medicines, over-the-counter products, vitamins, and herbal supplements.
- Opioid medicines: Naltrexone blocks opioid receptors and may precipitate withdrawal or reduce analgesic effectiveness.
- Other antidepressants: Concomitant use may increase the risk of adverse neurological or psychiatric effects.
Important Considerations
Not suitable for everyone: Contrave® is not recommended for individuals with uncontrolled hypertension, seizure disorders, or eating disorders such as anorexia nervosa or bulimia.
Pregnancy and breastfeeding: Use during pregnancy or lactation is not advised due to potential risks to the infant.
Contrave® vs Wegovy®
Wegovy® (semaglutide) is another prescription medicine used for weight management.
Unlike Contrave®, which acts on central appetite pathways through bupropion and naltrexone, Wegovy® is a GLP-1 receptor agonist that mimics a naturally occurring hormone involved in appetite regulation.
Suitability depends on individual medical history, tolerability, and weight management goals. A qualified healthcare professional can advise on the most appropriate treatment option.
Purchasing Contrave®
Contrave® is a prescription-only medicine. Patients should consult their doctor before initiating therapy and ensure that any online pharmacy complies with regulatory standards. Information regarding personal importation rules may be reviewed via the U.S. Food and Drug Administration (FDA).
Further Information
For comprehensive prescribing details, consult the official product monograph: Contrave® Product Monograph (PDF).
