Contrave (naltrexone/bupropion)

What is Contrave?

Contrave is a brand-name prescription drug. It’s FDA-approved to help adults lose weight when combined with a balanced diet and exercise.

This drug has certain limitations of use as well as minimum body mass index (BMI) requirements. (BMI is an estimate of a person’s body fat based on height and weight.) To learn more, see the “Contrave for weight loss and weight management” section below.

Drug details

Contrave contains two active drugs: naltrexone and bupropion. Naltrexone is in a class of drugs called opioid antagonists, and bupropion is in a class called antidepressants.

Contrave is an oral extended-release (ER) tablet. (An extended-release form of a drug slowly releases its active ingredients over a longer period of time.) It comes in one strength: 8 milligrams (mg)/90 mg. This means each tablet contains 8 mg of naltrexone and 90 mg of bupropion.

When you start taking Contrave, your doctor will have you gradually increase both the number of tablets you take and how often you take them. Once you’re used to the drug, you’ll take two tablets in the morning and two in the evening.

Effectiveness

For information about the effectiveness of Contrave, see the “Contrave for weight loss and weight management” section below.

Contrave side effects

Contrave can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Contrave. These lists do not include all possible side effects.

For more information about the possible side effects of Contrave, talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may be concerning or bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Contrave, you can do so through MedWatch.

Mild side effects

Mild side effects* of Contrave can include:

• nausea or vomiting
• headache
• dizziness
• insomnia
• dry mouth
• diarrhea or constipation
• hot flashes†

* This is a partial list of mild side effects from Contrave. To learn about other mild side effects, talk with your doctor or pharmacist, or view Contrave’s medication guide.
† For more information about this side effect, see the “Side effect details” section below.

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Contrave aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

• Increased blood pressure or heart rate. Symptoms* can include:
  • feeling lightheaded
  • rapid heart rate
  • headache
• Seizures. Symptoms can include:
  • loss of consciousness
  • muscle spasms
  • drooling or frothing at the mouth
• Allergic reaction.†
• Liver damage or hepatitis.†
• Suicidal thoughts and behaviors.†‡
• Angle-closure glaucoma. Symptoms can include:
  • severe headache
  • eye pain
  • blurred vision

* Many people with high blood pressure don’t experience any symptoms.
† For more information about this side effect, see the “Side effect details” section below.
‡ Contrave has a boxed warning for this side effect. A boxed warning is the most serious warning from the FDA.

Side effect details

Here’s some detail on certain side effects this drug may cause.

Suicidal thoughts and behaviors

Contrave may increase the risk of suicidal thoughts and behaviors. This drug has a boxed warning from the FDA for this side effect. A boxed warning is the most serious warning from the FDA.

In people who have depression or other mental health conditions, antidepressants such as bupropion can increase the risk of suicidal thoughts and behaviors. Bupropion is one of the active ingredients in Contrave.

Contrave can increase this risk in children, adolescents, and young adults (up to age 24 years). Because of the seriousness of this side effect, Contrave is not approved for use in children.

While taking Contrave, you should pay close attention to any unusual changes in your mood, behaviors, thoughts, or feelings. Also ask loved ones, caregivers you may have, and healthcare professionals you may see to watch for such changes.

If you have any symptoms of worsening depression or suicidal thoughts, contact your doctor right away.

Liver damage or hepatitis

Contrave contains the generic drug naltrexone. In clinical trials, naltrexone has been reported to cause hepatitis and other liver problems.

Symptoms of liver problems include abdominal pain lasting more than a few days, dark urine, yellowing of the whites of the eyes, and tiredness. If you experience any of these symptoms, contact your doctor right away.

If you already have liver problems, your doctor will prescribe you a lower dose of Contrave. If you have serious liver problems, your doctor may have you stop taking Contrave.

Hot flashes

In clinical trials, some people taking Contrave reported having hot flashes. A hot flash, also called a hot flush, is a sudden feeling of heat. This feeling can occur either all over the body or in the upper part only. Additionally, it can cause flushing (temporary warmth, redness, or deepening of skin color) on the chest, arms, and back.

You can help ease the symptoms of a hot flash by:

• dressing in layers that you can remove when you feel hot
• avoiding alcohol
• quitting smoking
• taking cool showers
• using a portable fan as needed

For additional tips that may help with hot flashes, see this article.

If you have hot flashes from taking Contrave that are bothersome, tell your doctor. They may have additional suggestions for treating this side effect.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Contrave.

Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

• swelling under your skin, typically in your eyelids, lips, hands, or feet
• swelling of your tongue, mouth, or throat
• trouble breathing

Call your doctor right away if you have an allergic reaction to Contrave, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Contrave for weight loss and weight management

The Food and Drug Administration (FDA) approves prescription drugs such as Contrave to treat certain conditions. Contrave is an FDA-approved weight loss pill meant to be used with balanced diet and exercise for weight management. This drug works as an appetite suppressant, and it reduces cravings.

If you’re taking Contrave for weight loss, it should be in combination with a reduced-calorie diet and exercise. Contrave is only FDA-approved for weight loss in individuals who either:

• have a body mass index (BMI)* of 30 kilograms per square meter (kg/m²) or greater, which indicates obesity, or
• have a BMI of 27 kg/m² or greater, which is considered overweight, and have at least one weight-related condition, such as high blood pressure, type 2 diabetes, or high cholesterol

* BMI is an estimate of a person’s body fat based on height and weight.

In addition, Contrave has the following limitations of use:

• It’s unknown whether Contrave may reduce the risk of serious health conditions related to heart disease.
• It’s unknown whether Contrave is safe or effective to use with other weight-loss products.

Effectiveness for weight loss and weight management

Clinical trials have found Contrave to be effective for weight management when combined with a balanced diet and exercise.

Three clinical trials looked at people who had overweight or obesity. The people in these trials all followed a reduced-calorie diet and increased their physical activity, but some also took Contrave. After a little over a year, people who took the drug lost more weight compared with those who didn’t.

Results may vary for individuals taking Contrave. If you have any questions about weight management and Contrave, talk with your doctor.

Contrave and children

Contrave is not FDA-approved for use in children. The safety and effectiveness of Contrave have not been studied in people younger than 18 years old. It is not recommended that children take Contrave.

Contrave generic

Contrave is available only as a brand-name medication. It’s not currently available in generic form.

Contrave contains two active drugs: naltrexone and bupropion.

A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.

Contrave cost

As with all medications, the cost of Contrave can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Keep in mind that you may be able to get a 90-day supply of Contrave. If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of trips to the pharmacy and help lower the cost. If you’re interested in this option, check with your doctor or your insurance company.

Before approving coverage for Contrave, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure whether you’ll need to get prior authorization for Contrave, contact your insurance company.

The sections below provide additional information about Contrave’s cost. For more details on Contrave and cost, see this article.

Financial and insurance assistance

If you need financial support to pay for Contrave, or if you need help understanding your insurance coverage, help may be available.

Currax Pharmaceuticals LLC, the manufacturer of Contrave, offers ways to save on its drug. Contrave may be less expensive if purchased through the manufacturer’s CurAccess program. It may also cost less with a coupon, as described just below.

To learn more about Contrave’s CurAccess program, see the manufacturer’s site.

Coupon for Contrave

The manufacturer of Contrave offers a coupon card to help lower the cost of its drug. For more information and to find out if you’re eligible to use this coupon card, visit the manufacturer’s site. Or call 800-905-5576.

Mail-order pharmacies

Contrave may be available through a mail-order pharmacy. Using this service may help lower the drug’s cost and allow you to get your medication without leaving home.

If recommended by your doctor, you may be able to receive a 90-day supply of Contrave, so there’s less concern about running out of the medication. If you’re interested in this option, check with your doctor and your insurance company. Some Medicare plans may help cover the cost of mail-order medications.

If you don’t have insurance, you can ask your doctor or pharmacist about online pharmacy options.

Generic version

Contrave isn’t available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

Contrave use with diet and exercise

Contrave is approved by the Food and Drug Administration (FDA) for weight management when taken with a balanced diet and exercise.

In clinical trials, the drug was used in combination with a reduced number of daily calories and increased exercise. This treatment combination was more effective in helping people lose and manage weight compared with diet and exercise alone.

To learn more about obesity and weight management, see our hub dedicated to this subject. And if you’re interested in finding out whether Contrave might work with your weight management regimen, talk with your doctor.

Contrave dosage

The Contrave dosage your doctor prescribes will depend on several factors. These include:

• the type and severity of the condition you’re taking Contrave to treat
• other medical conditions you may have
• other medications you may be taking

Typically, your doctor will start you on a low dosage of Contrave. Then they’ll adjust it over time to reach the recommended daily dosage.

The following information describes dosages that are commonly used or recommended. But be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Contrave comes as extended-release tablets. This means that the drug is released more slowly into your body for a longer lasting effect. Contrave comes in only one strength: 8 milligrams (mg)/90 mg, which is 8 mg of naltrexone and 90 mg of bupropion.

Dosage for weight loss and weight management

When you start Contrave, your doctor will have you take a low dosage of the drug. They’ll increase your dosage over time to reach the recommended daily dosage. After about 4 weeks, you’ll take two tablets in the morning and two tablets in the evening. This will be your dosage for the remainder of the treatment period.

When starting Contrave, your dosage schedule will look like this:

What if I miss a dose?

If you miss a dose of Contrave, skip the missed dose and take your next dose at the regularly scheduled time. Do not take an additional dose to make up for the missed dose.

To help make sure that you don’t miss a dose of Contrave, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

Will I need to take this drug long term?

Contrave is meant to be taken as a long-term treatment. If you and your doctor determine that Contrave is safe and effective for you, you’ll likely take it long term.

Common questions about Contrave

Here are answers to some frequently asked questions about Contrave.

Why might Contrave not work for me?

Contrave may not be right for you if your body mass index (BMI) is below a certain level. (BMI is an estimate of a person’s body fat based on height and weight.)

Contrave is approved for use in people who have obesity (BMI greater than or equal to 30) or overweight (BMI greater than or equal to 27). Those in the latter category also must have at least one weight-related condition, such as high blood pressure, type 2 diabetes, or high cholesterol. If you don’t meet these criteria, Contrave may not work for you.

Contrave is also meant to be used in combination with a balanced diet and exercise. If you don’t think you would be able to make any necessary changes to your diet or the amount of physical activity you get, Contrave may not be right for you.

Once you’ve been taking the recommended dosage (two tablets in the morning and two tablets in the evening) for 12 weeks, your doctor will evaluate how you’re responding to the drug. If you haven’t lost at least 5% of your body weight, your doctor will have you stop taking the medication.

Is Contrave prescribed for depression or to help you stop smoking?

No, it isn’t. One of Contrave’s active ingredients, bupropion, is used in other medications to treat depression and help people quit smoking. But Contrave isn’t approved for these uses.

If you want to know more about taking bupropion for depression or to help you stop smoking, talk with your doctor.

Do I need to follow a certain diet, such as the ketogenic diet, while I’m taking Contrave?

There is no specific type of diet you need to follow while taking Contrave.

But you should avoid taking Contrave with a high fat meal. Too much fat can expose your body to more of the active ingredients in Contrave, bupropion and naltrexone. If your body is exposed to too much bupropion, you may have an increased risk of seizures.

During treatment, it’s important that you eat fewer calories than you might have usually before starting Contrave. You should also aim to have a balanced diet.

In addition to helping with weight management, a balanced diet helps your overall health and may reduce the risk of certain diseases. For more information about eating a balanced diet, see this article. You might also consider talking with your doctor or a dietitian about ways to help make your diet balanced.

What should I know about stopping Contrave?

When you want to end treatment, your doctor will simply have you stop taking Contrave. In clinical trials, people who stopped the medication at the end of the study didn’t report any side effects.

But don’t stop taking Contrave on your own. If you feel Contrave isn’t working for you and you wish to stop taking it, talk with your doctor first.

Will Contrave make me feel ‘high’?

During clinical trials of Contrave, there were no reports of people feeling “high” or developing a physical dependence on the drug. But there haven’t been many studies on Contrave’s potential for misuse, tolerance, or physical dependence. (Misuse is taking a drug in a way other than how a doctor prescribes it. With dependence, your body needs the drug to feel as you typically would.)

Naltrexone, one of Contrave’s active ingredients, doesn’t cause any physical or psychological dependence.

Bupropion is the other active ingredient in Contrave. In some clinical trials, larger doses of bupropion have been reported to cause mild feelings of euphoria. But smaller doses of this drug, such as the amount present in Contrave, aren’t likely to cause feelings of being high.

If you have any concerns about how Contrave might make you feel, talk with your doctor or pharmacist.

How Contrave works

Contrave is used to help adults lose weight in combination with a balanced diet and exercise. It contains the active ingredients bupropion and naltrexone. This drug comes as an extended-release tablet. (An extended-release form of a drug slowly releases its active ingredients over a longer period of time.)

Bupropion belongs to a class of drugs called aminoketone antidepressants. It’s the only drug in this class. Aminoketone antidepressants work by affecting the activity of norepinephrine and dopamine. These two neurotransmitters (chemicals that help send messages in your brain) play a role in regulating mood.

While it isn’t completely understood how bupropion works, it likely helps prevent norepinephrine and dopamine from being reabsorbed into nerve cells in the brain. This can help regulate the levels of these chemicals in your brain, and it allows your nerve cells to better communicate.

Naltrexone is an opioid antagonist. This means it blocks certain receptors (docking stations) on your brain cells. When naltrexone blocks these receptors, it helps prevent dopamine from being released. The exact way that naltrexone works for weight loss isn’t completely understood. It likely affects areas of the brain that tell you how much food to eat and how you feel after eating.

With these two active ingredients, Contrave can target two areas of the brain that are tied to cravings and an urge to eat. Both naltrexone and bupropion can help control feelings of pleasure you get when eating. This can help manage cravings. Naltrexone and bupropion also work together to help decrease your appetite.

How long does it take to work?

In clinical trials, most people had significant weight loss 4 weeks after starting treatment with Contrave. Results may differ depending on the person.

Contrave vs. Saxenda

You may wonder how Contrave compares with similar drugs, such as the brand-name prescription drug Saxenda. The following table gives an overview of these two drugs.

* An ER form of a drug slowly releases its active ingredients over a longer period of time.
† Contrave is prescribed only in certain situations. For more information, see the “Contrave for weight loss and weight management” section above.
‡ Saxenda is prescribed only in certain situations. For more information, see this article.

The side effects of these drugs vary, though some are similar. For example, both Contrave and Saxenda may increase the risk of suicidal thoughts and behaviors. But only Contrave carries a boxed warning for this side effect. (Boxed warnings are the most serious warning from the Food and Drug Administration [FDA].) Saxenda carries a boxed warning for a different side effect: increased risk of thyroid cancer.

For more information about Contrave’s boxed warning, see the “Contrave side effects” section above. You can learn more about Saxenda’s boxed warning in this article.

Serious side effects specific to Contrave include seizures and liver damage. Serious side effects specific to Saxenda include inflammation of the pancreas and gallbladder problems.

For details about the side effects of these drugs, see the prescribing information for Contrave and Saxenda.

To learn more about how Contrave and Saxenda compare, talk with your doctor or pharmacist.

Contrave vs. phentermine

You may wonder how Contrave compares with similar drugs, such as the generic prescription drug phentermine. The following table gives an overview of these two drugs.

* An ER form of a drug slowly releases its active ingredients over a longer period of time.
† An orally disintegrating tablet is a tablet that you take by dissolving it on your tongue.
‡ Contrave is prescribed only in certain situations. For more information, see the “Contrave for weight loss and weight management” section above.
§ Phentermine is prescribed only in certain situations. For more information, talk with your doctor or pharmacist.

The side effects of these drugs vary, though some are similar. Serious side effects specific to Contrave include seizures and liver damage. Serious side effects specific to phentermine include heart valve issues and pulmonary hypertension (high blood pressure in the blood vessels of the lungs).

Also, Contrave has a boxed warning for increased risk of suicidal thoughts and behaviors. (Boxed warnings are the most serious warning from the Food and Drug Administration [FDA].) Phentermine has no boxed warning. For more information about Contrave’s boxed warning, see the “Contrave side effects” section above.

For details about the side effects of these drugs, see the prescribing information for Contrave and phentermine.

To learn more about how Contrave and phentermine compare, talk with your doctor or pharmacist. They can also give you details about the brand-name versions of phentermine, Adipex-P and Lomaira.

How to take Contrave

You should take Contrave according to the instructions your doctor or another healthcare professional gives you.

Contrave comes as oral tablets that you swallow. When starting Contrave treatment, your doctor will have you follow a schedule to slowly increase your dosage. For details of this dosing schedule, see the “Contrave dosage” section above.

By your fourth week, your dosage will likely be two Contrave tablets taken twice per day. This will be the dosage you follow until your doctor has you stop taking Contrave.

When to take

You should take Contrave twice per day, once in the morning and once in the evening.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

Taking Contrave with food

You can take Contrave with or without food. But you should avoid taking Contrave with a high fat meal. Too much fat can expose your body to more of the active ingredients in Contrave, bupropion and naltrexone. This can increase your risk of side effects.

Can Contrave be crushed, split, or chewed?

No, you should not cut, crush, or chew Contrave tablets. They should be swallowed whole. If you have problems swallowing pills, see this article for some tips.

If you still have issues taking your Contrave tablets, talk with your doctor or pharmacist.

Contrave and alcohol

No interactions between Contrave and alcohol were reported in clinical trials.

But Contrave contains bupropion, which, when combined with alcohol, may lead to changes in how you think, feel, or behave. Examples include agitation, depression, sleeping problems, and suicidal thoughts and behaviors. Additionally, bupropion can cause reduced alcohol tolerance, meaning you may be more sensitive to the effects of alcohol. As a result, minimizing or avoiding alcohol while taking Contrave is recommended.

If you have any questions about drinking alcohol while taking Contrave, talk with your doctor.

Contrave interactions

Contrave can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Contrave and other medications

Below is a list of medications that can interact with Contrave. This list does not contain all drugs that may interact with Contrave.

Before taking Contrave, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

In most cases, Contrave should not be taken with the following drugs:

• MAOIs. When Contrave is taken with other medications that increase levels of norepinephrine and dopamine, such as monoamine oxidase inhibitors (MAOIs), it can increase the risk of high blood pressure. If you’re taking an MAOI, your doctor will have you stop taking it and wait at least 14 days before you start taking Contrave. Examples of MAOIs include:
  • selegiline (Emsam, Zelapar)
  • phenelzine (Nardil)
  • isocarboxazid (Marplan)
• Opioids. Contrave can make opioid pain relievers less effective. This may lead to sudden opioid withdrawal. It may also cause a person to take more than the recommended dosage of an opioid, which can result in a fatal overdose or life threatening opioid intoxication. If you take opioid pain relievers every day and you plan on taking Contrave, your doctor will have you stop taking the opioids. Then you’ll need to wait for at least 7 to 10 days before you start taking Contrave. Examples of opioids include:
  • oxycodone (Oxycontin, Roxicodone)
  • hydrocodone (Hysingla ER)
  • fentanyl (Actiq)
• CYP2B6 inducers. When taken with Contrave, this type of drug can cause decreased levels of bupropion in the body. This may make Contrave less effective. Examples of CYP2B6 inducers include:
  • ritonavir (Norvir)
  • lopinavir
  • efavirenz

Drugs that can interact with Contrave include:

• Drugs affected by the CYP2D6 enzyme, which helps the body break down many different medications. Contrave can increase or decrease the levels of these drugs in the body. Examples include:
  • metoprolol (Lopressor)
  • certain antidepressants, such as:
    • escitalopram (Lexapro)
    • fluoxetine (Prozac)
    • amitriptyline
  • certain antipsychotics, such as:
    • haloperidol
    • risperidone (Risperdal)
    • thioridazine
  • drugs prescribed to treat abnormal heart rhythm, such as:
    • propafenone (Rythmol SR)
    • flecainide
  • desipramine (Norpramin)
  • venlafaxine (Effexor XR)
• Digoxin (Lanoxin). Contrave can decrease the amount of this drug that is available in the body. If you take both Contrave and digoxin, your doctor will monitor your digoxin levels closely to ensure you’re receiving enough of the drug.
• CYP2B6 inhibitors. When taken with Contrave, CYP2B6 inhibitors can lead to increased levels of bupropion in the body. This may cause an increased risk of side effects. Examples include:
  • ticlopidine
  • clopidogrel (Plavix)
• Drugs that can increase your risk of a seizure. Contrave may also increase risk of seizures. When taken with the following drugs, the risk of seizures may increase even more:
  • antipsychotics, such as:
    • aripiprazole (Abilify)
    • haloperidol
    • clozapine (Clozaril)
  • antidepressants, such as:
    • escitalopram (Lexapro)
    • fluoxetine (Prozac)
    • duloxetine (Cymbalta)
  • theophylline
  • corticosteroids, such as prednisone (Rayos)
• Dopaminergic drugs. Taking Contrave with these drugs can lead to central nervous system (CNS) toxicity. This occurs when your CNS works slower than usual, which can result in decreased alertness, restlessness or agitation, tremors (shaking), trouble walking, or dizziness. When taken with Contrave, the following drugs can cause CNS toxicity:
  • levodopa (Inbrija)
  • amantadine (Gocovri)

Contrave and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Contrave. But you should still check with your doctor or pharmacist before using any of these products while taking Contrave.

Contrave and foods

If you decide to take Contrave with meals, note that you should avoid eating high fat meals with this drug. Taking Contrave with high fat meals increases the level of the drug in your body. This may lead to increased side effects.

Contrave and lab tests

Bupropion, an active ingredient in Contrave, may cause false-positive results with urine tests for amphetamines. These false-positive results can occur even after stopping Contrave treatment. More specific tests can be given to avoid a false positive.

Contrave and pregnancy

It is not recommended to take Contrave while you are pregnant. Contrave hasn’t been reported to cause problems with fetal development, pregnancy loss, or other pregnancy-related effects. But trying to lose weight while pregnant is not recommended. This is because weight loss during pregnancy may cause harm to the fetus.

If you become pregnant while taking Contrave, your doctor will likely recommend that you discontinue this drug.

Contrave and birth control

It is not recommended to take Contrave while you are pregnant. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re taking Contrave.

For more information about taking Contrave during pregnancy, see the “Contrave and pregnancy” section above.

Contrave and breastfeeding

Contrave’s active ingredients, bupropion and naltrexone, can pass into breast milk and may harm a child who is breastfed. As a result, it’s not recommended that you breastfeed while taking Contrave.

If you’re breastfeeding or plan to breastfeed, talk with your doctor. They can recommend other treatment options for your condition.

Contrave precautions

This drug comes with several precautions.

FDA warning: Risk of suicidal thoughts and behaviors

Contrave has a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

In people who have depression or other mental health conditions, antidepressants such as bupropion can increase the risk of suicidal thoughts and behaviors. Bupropion is one of the active ingredients in Contrave.

This risk is higher in children, teenagers, and young adults (up to age 24 years), especially during the first few months of treatment or when the dose is adjusted.

While taking Contrave, you should pay close attention to any unusual changes in your mood, behaviors, thoughts, or feelings. Also ask loved ones, caregivers you may have, and healthcare professionals you may see to watch for such changes.

For more information on this boxed warning, see “Side effect details” in the “Contrave side effects” section above.

Other precautions

Before taking Contrave, talk with your doctor about your health history. Contrave may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

• Use for quitting smoking. Contrave isn’t approved to help you stop smoking. But bupropion is, and this is one of Contrave’s active ingredients. People taking bupropion to help them stop smoking can experience serious mental health issues. This includes depression, psychosis, hallucinations, aggression, anxiety, and suicidal thoughts. If you have any of these symptoms or other changes in behavior, stop taking Contrave and contact a healthcare professional immediately.
• Activation of mania. Contrave contains the active ingredient bupropion, which is often prescribed to treat depression. Antidepressants can sometimes cause people to experience a manic, mixed, or hypomanic episode. This risk increases in people with bipolar disorder. If you have bipolar disorder, talk with your doctor before starting treatment with Contrave.
• Seizures. Bupropion, an active ingredient in Contrave, can cause seizures. The higher the dose of bupropion, the higher the risk of seizures. Risk of seizures increases even more for people who already have this risk, such as those with seizure disorders. If you have a seizure disorder, tell your doctor before starting Contrave. Also talk with your doctor if you have or have had anorexia or bulimia, or are abruptly stopping alcohol or certain medications.
• Low blood sugar. In people with type 2 diabetes, weight loss can increase the risk of low blood sugar when taking insulin or drugs that help with insulin production. Examples include glyburide (Diabeta), glipizide (Glucotrol XL), and glimepiride (Amaryl). If you have type 2 diabetes and are taking Contrave, you need to measure your blood glucose levels before and during treatment. Your doctor may adjust the dose of your diabetes medication to help prevent low blood sugar.
• Unmanaged or untreated high blood pressure. Contrave can increase blood pressure and heart rate. It’s not known how this increase in blood pressure may affect people with a history of heart disease or stroke. As a result, doctors typically will not prescribe Contrave to people who have untreated high blood pressure. If you have untreated high blood pressure or a history of heart disease or stroke, tell your doctor. They’ll work with you to determine whether Contrave is the right treatment option for you.
• Allergic reaction. If you’ve ever had an allergic reaction to Contrave or any of its ingredients, the manufacturer of Contrave recommends against taking this drug. Ask your doctor what other medications are better options for you.
• Pregnancy. It is not recommended to take Contrave while pregnant. For more information, see the “Contrave and pregnancy” section above.
• Breastfeeding. It is not recommended to take Contrave while breastfeeding. For more information, see the “Contrave and breastfeeding” section above.

Note: For more information about the potential negative effects of Contrave, see the “Contrave side effects” section above.

Contrave overdose

Taking more than the recommended dosage of Contrave can lead to serious side effects. Do not take more Contrave than your doctor recommends.

Overdose symptoms

Symptoms of an overdose can include:

• seizures
• hallucinations
• loss of consciousness
• muscle twitching or jerking
• abnormal heart rhythm

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.