Understanding the Contrave Side Effects

Contrave is an FDA-approved prescription weight loss medication for treating overweight and obesity. It is especially helpful for people who describe themselves as emotional eaters who struggle with food cravings.
Since 42% of U.S. adults live with obesity and nearly two-thirds of U.S. adults are overweight, losing weight is a popular topic.1,2 Government agencies, insurance companies, researchers, and individuals living with this condition are working to better understand the causes of obesity and how best to treat it.
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In recent years, several highly effective prescription weight loss medications have become available, arming healthcare providers with nonsurgical options to treat obesity, a condition that tends to increase with increasing age.
Contrave is intended to be used along with a reduced-calorie diet and an exercise plan. Implementing a comprehensive weight management plan will give you the best chance to achieve optimal before and after results. Contrave can improve your body composition and positively impact your sexual health.
Like most medications, Contrave has known side effects. The medication is not appropriate or safe for all people. Understanding Contrave side effects can help you work with your doctor to determine whether Contrave is the proper weight-loss medication for you.
Mild Side Effects of Contrave
Before seeking FDA approval, medications undergo clinical trials to assess their safety and efficacy. One of the essential outcomes of these clinical trials is an understanding of how commonly side effects occur in the group taking the study medication when compared to the control group. As medication usage becomes more widespread, additional side effects may be reported.
Milder or more common side effects reported by people taking Contrave include the following:
- Abdominal pain
- Altered taste
- Anxiety
- Constipation
- Diarrhea
- Dizziness
- Dry mouth
- Excessive sweating
- Fatigue
- Headache
- Heart palpitations
- Hot flush
- Increase in blood pressure
- Increase in heart rate
- Influenza
- Insomnia
- Irritability
- Muscle strain
- Nausea
- Rash
- Ringing in ears
- Stomach virus
- Tremor
- Trouble sleeping
- Urinary tract infection
- Vomiting
This is not a complete list of potential side effects. For more information, see the Contrave Medication Guide or ask your pharmacist.
Serious Side Effects of Contrave
Serious side effects can also occur when taking Contrave, including the following:
- Suicidal thoughts or actions
- Depression, anxiety, agitation, or restlessness
- Panic attacks
- Mania
- Mood changes
- Allergic reactions: rash, itching, hives, fever, swollen lymph glands, painful mouth sores, swelling of the lip or tongue, chest pain, trouble breathing
- Increased blood pressure or heart rate
- Liver damage or hepatitis
- Visual problems (angle-closure glaucoma)
- Hypoglycemia
- Seizures
Contrave has a boxed warning for suicidal thoughts and behaviors.
How Can I Minimize the Risk of Side Effects?
The best way to minimize the risk of side effects is to take Contrave precisely as prescribed and call your doctor or pharmacist if you notice any side effects, start a new medication, or are diagnosed with another medical condition.
When taking Contrave, follow the dosage instructions carefully. According to the manufacturer, Contrave is dosed:
Morning Dose | Evening dose | Total daily dose | |
Week 1 | one tablet | none | 8 mg naltrexone/90 mg bupropion |
Week 2 | one tablet | one tablet | 16 mg naltrexone/180 mg bupropion |
Week 3 | two tablets | one tablet | 24 mg naltrexone/270 mg bupropion |
Week 4 and after | two tablets | two tablets | 32 mg naltrexone/360 mg bupropion |
To minimize the risk of side effects when taking Contrave:
- Take Contrave with a low-fat meal: Bupropion can cause seizures, and the risk increases as the dose increases. Fatty foods can increase the absorption and concentration of Contrave in the body. More Contrave is released into the bloodstream too quickly, increasing the seizure risk.
- Follow the prescribed dosage: The risk of side effects when taking Contrave increases with higher medication doses.
- Stay hydrated: Drinking plenty of water and staying hydrated can reduce stomach aches and constipation.
- Avoid alcohol: Alcohol consumption while taking Contrave increases the risk of seizures and other side effects.

Do Contrave Side Effects Go Away?
Milder side effects associated with Contrave generally improve within a few days to weeks. More serious side effects may be permanent. Contact your doctor or pharmacist for guidance if you have concerns about side effects.
Contrave Interactions
Tell your doctor or pharmacist about all medications you take, including prescription and over-the-counter medicines, as well as vitamins and herbal products.
Some classes of medications Contrave is known to interact with include:
- Monoamine oxidase inhibitors
- Some antidepressants
- Some antipsychotics
- Beta-blockers
- Some antiarrhythmics
- Opioids
- Dopaminergic drugs
- Drugs that lower the seizure threshold, such as antipsychotics, antidepressants, theophylline, and corticosteroids
Who Should Not Take Contrave?
Before starting any new medication, it is essential to provide your doctor with a complete medical history. People with some medical conditions are more likely to experience serious side effects when taking Contrave.
According to the manufacturer, people with the following conditions should not take Contrave. This list is not complete. See the Contrave medication guide for more complete information.
Do not take Contrave if you:
- Have uncontrolled hypertension (high blood pressure)
- Have or had seizures
- Take other medications that contain bupropion
- Have been diagnosed with an eating disorder such as anorexia or bulimia
- Are dependent on opioids, or are taking medications to stop taking opioids
- Drink excessive alcohol, take sedatives, benzodiazepine, or anti-seizure medications
- Take medications classified as monoamine oxidase inhibitors
- Are allergic to any of the ingredients in Contrave
Discuss with your doctor the risks and benefits of taking Contrave if you have any of the following:
- History of depression
- Past suicidal attempts
- History of seizures
- History of a head injury
- Brain tumor or brain infection
- Low blood sugar or low blood sodium
- Liver problems
- High blood pressure
- Heart disease, heart attacks, or strokes
- Kidney problems
- Diabetes or taking medications for diabetes
- Have a history of an eating disorder
- Drink alcohol
- Abuse prescription medications or street drugs
- Are over age 65
- Are pregnant or planning to become pregnant
- Are breastfeeding or planning to breastfeed
When To See a Doctor
Contrave has common side effects that are usually mild gastrointestinal side effects that improve over time, but there is also the potential for Contrave to cause serious side effects. This is one reason the medication dosage is slowly increased. If you notice any concerning side effects, seek immediate medical attention.
If you have milder side effects that are not improving or are not losing weight with Contrave, contact your doctor to discuss your options.
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. The Organization for Economic Co-operation and Development. Obesity Update 2017. https://www.oecd.org/health/health-systems/Obesity-Update-2017.pdf
2. Stierman B, Afful, J., Carroll, M. D., Chen, T.-C., Davy, O., Fink, S., Fryar, C. D. H., Gu, Q., Hales, C. M., Hughes, J. P., Ostchega, Y., Storandt, R. J., & Akinbami, L. J. National Health and Nutrition Examination Survey 2017–March 2020 Prepandemic Data Files—Development of Files and Prevalence Estimates for Selected Health Outcomes. Vol. 158. 2021. https://www.cdc.gov/nchs/data/nhsr/nhsr158-508.pdf
Leann Poston, M.D.
Author
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