Contrave for Weight Loss: Does It Work?
Contrave is one of many weight-loss medications. Contrave, an FDA-approved weight loss medication, assists emotional eaters who struggle with food cravings.
Obesity is a chronic disease that has not received the attention it deserves in terms of treatment options until the last decade or so. Obesity is linked to more than 200 chronic diseases. Using an effective weight-loss medication to shed excess pounds and improve body composition can lower your risk of chronic disease and improve other aspects of your health, such as age management, sexual health, and overall general health.
Table of Contents
What Is Contrave for Weight Loss?
Contrave combines two active ingredients: naltrexone HCl and bupropion HCl. Naltrexone is commonly used to treat substance use disorders, while bupropion is an antidepressant. When used together, these medications work synergistically in two key brain areas to help regulate hunger signals, leading to reduced appetite and fewer food cravings.
Contrave may be prescribed for adults with obesity, defined as a body mass index (BMI) over 30 kg/m2, or adults with a BMI of over 27 mg/m2 with an obesity-related medical condition such as diabetes, abnormal blood lipids, or high blood pressure.
Maximizing the Benefits of Contrave
Contrave comes in a single dosage form containing 8 mg of naltrexone and 90 mg of bupropion. Each extended-release tablet is taken by mouth at about the same time each day. Your doctor will probably gradually increase the number of tablets taken each day until you take two tablets in the morning and two in the evening. A slow increase in dosage should minimize side effects.
Contrave is intended to be used as part of a comprehensive weight-loss program. Consuming a nutritious, reduced-calorie diet and making exercise a regular part of your daily schedule is essential to get the best results from Contrave.
During clinical trials, Contrave users lost an average of 12 to 18 pounds. In both clinical trials, participants consumed a reduced-calorie diet and participated in an exercise program. To maximize your Contrave benefits, consume a diet rich in whole foods. In the second trial, they also received behavioral counseling.
Contrave user reviews vary. Some people report weight loss, and others do not. Some people had to discontinue the medication due to side effects, and others had no side effects at all. This underlines the importance of providing your healthcare provider with a complete medical history and reporting any side effects you may experience.
Comparing Contrave with Other Weight Loss Medications
Several weight-loss medications are now available by prescription from a licensed healthcare provider.
| Medication | Mechanism of Action | Most Common Side Effects | Average Weight Loss in Clinical Trials | Average Cost for 30 days (GoodRX) |
|---|---|---|---|---|
| Orlistat | Decreases fat absorption in the intestines | Excessive gas, oily stool, and a need to urgently have bowel movements | 6.5 to 7.5 pounds1,2 or about 3% of body weight | $645 |
| Bupropion/Naltrexone | Acts in the brain to reduce hunger and cravings | Stomach problems, headache, dizziness, trouble sleeping, increased heart rate and blood pressure | 10 pounds1 or 4% of body weight | $620 |
| Liraglutide | Delays stomach emptying, reduces hunger, increases insulin secretion | Nausea, diarrhea, constipation, vomiting, headache | 11.7 pounds1 or 6% of body weight | $1,332 |
| Tirzepatide | Delays stomach emptying, reduces hunger, increases insulin secretion | Nausea, diarrhea, vomiting, constipation, stomach pain | 30 pounds3 | $1,000 |
| Semaglutide | Delays stomach emptying, reduces hunger, increases insulin secretion | Nausea, diarrhea, vomiting, constipation, stomach pain | 35 pounds or 11 to 16% of body weight4,5,6 | $1,332 |
| Phentermine | Stimulant medication that suppresses appetite | Headache, overstimulation, insomnia, high blood pressure, rapid heart rate, tremor | 6% of body weight | $15 |
| Phentermine-topiramine | Stimulant medication and anti-seizure medication that suppresses appetite | Abnormal sensations, dizziness, altered taste, insomnia, constipation, dry mouth | 14.5 to 19 pounds or 5% to 10% of body weight1,7 | $162 |
What Should I Consider Before Taking Contrave?
Before taking Contrave, it is essential to carefully consider the medication’s risks and benefits. Contrave has a box warning. These warnings are required by the Food and Drug Administration (FDA) to warn doctors and patients about particularly serious or dangerous side effects.
In people with depression or other mental health conditions, bupropion (and other antidepressants) can increase the risk of suicidal thoughts and behaviors. This risk is higher in people under the age of 24, especially when the dose is adjusted during the first few months of treatment.
Contrave may interact with several medications. Do not take Contrave if you are pregnant, planning to become pregnant, or are nursing.
Side effects
Like all medications, Contrave has side effects. Not everyone will experience these side effects. Common side effects associated with Contrave include the following:
- Anxiety
- Constipation
- Diarrhea
- Dizziness
- Dry mouth
- Headache
- Insomnia
- Irritability
- Nausea
- Restlessness
- Seizures
- Trouble sleeping
- Vomiting
Contrave side effects generally subside after taking the medication for 3 to 4 weeks. For a complete list of side effects, view Contrave’s medication guide.
In addition, more serious side effects associated with Contrave include:
- Increased risk of seizure when consuming and then withdrawing from alcohol use (avoid alcohol use when taking Contrave)
- Increased seizure risk
- Risk of an opioid overdose and severe sudden withdrawal symptoms if opioids are not stopped 7 to 14 days before using Contrave
- Severe headache
- Severe allergic reactions
- Increases in blood pressure and heart rate
- Liver damage or hepatitis
- Manic episodes
- Suicidal thoughts
- Depression
- Anxiety
- Visual problems, eye pain, or swelling
- Kidney disease, especially in older adults
- Liver disease
While understanding the benefits and side effects of each of these medications is important when choosing a weight-loss medication, it is even more important to discuss your health and concerns about your weight with your doctor. They can help you evaluate your lifestyle, health goals, and current medical history to determine which of these medications is safest and most effective for you.
Disclaimer
While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.
References
1. Singh AK, Singh R. Pharmacotherapy in obesity: a systematic review and meta-analysis of randomized controlled trials of antiobesity drugs. Expert Review of Clinical Pharmacology. 2020 2020;13(1):53-64. doi:10.1080/17512433.2020.1698291
2. Srivastava G, Apovian CM. Current pharmacotherapy for obesity. Nature Reviews Endocrinology. 2018 2018;14(1):12-24. doi:10.1038/nrendo.2017.122
3. Jastreboff, A. M., Aronne, L. J., Ahmad, N. N., Wharton, S., Connery, L., Alves, B., Kiyosue, A., Zhang, S., Liu, B., Bunck, M. C., & Stefanski, A. (2022). Tirzepatide once weekly for the treatment of obesity. The New England Journal of Medicine, 387(3), 205–216. https://doi.org/10.1056/nejmoa2206038
4. Rubino D, Abrahamsson N, Davies M, et al. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial. JAMA. 2021;325(14):1414-1425. doi:10.1001/jama.2021.3224
5. Wadden TA, Bailey TS, Billings LK, et al. Effect of Subcutaneous Semaglutide vs Placebo as an Adjunct to Intensive Behavioral Therapy on Body Weight in Adults With Overweight or Obesity: The STEP 3 Randomized Clinical Trial. JAMA. 2021;325(14):1403-1413. doi:10.1001/jama.2021.1831
6. Wilding JPH, Batterham RL, Calanna S, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. New England Journal of Medicine. 2021 2021;384(11):989-1002. doi:10.1056/NEJMoa2032183
7. Apovian CM, Aronne LJ, Bessesen DH, et al. Pharmacological management of obesity: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. Feb 2015;100(2):342-62. doi:10.1210/jc.2014-3415
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