What does Contrave do?
Generic Name: bupropion and naltrexone
Brand Names: Contrave
Contrave is a new treatment option for chronic weight management in addition to a reduced-calorie diet and physical activity. This drug is prescribed for obese (BMI of 30 and above) individuals as well as adults who are overweight and suffering from at least one weight-related condition, like hypertension, type-2 diabetes, or dyslipidaemia. Contrave combines two drugs – an antidepressant (bupropion) and an anti-addiction drug (naltrexone). It helps with controlling how much someone eats.
It is a combination of two FDA-approved compounds, naltrexone and bupropion, in an extended-release formulation. Naltrexone is prescribed to treat alcohol and opioid dependence whereas bupropion component is approved to treat depression and seasonal affective disorder as well as an aid to smoking cessation treatment. Contrave takes away hunger and the cravings for food: the bupropion helps lessen appetite whereas the naltrexone works by blocking certain receptors in the brain and curbing cravings, thus helps with controlling how much someone eats.
Safety information and side effects:
Contrave is contraindicated in pregnant women and those who are planning to get pregnant; also in people with eating disorders (bulimia or anorexia nervosa) and individuals suffering from seizures/ seizure disorders.
Contrave can affect heart rate and blood pressure so should not be taken by people with uncontrolled high blood pressure. It is also contraindicated in people undergoing an abrupt discontinuation of alcohol, benzodiazepines, barbiturates and antiepileptic drugs, or individuals using opioids, those who are treated for opioid dependence, or are experiencing acute opiate withdrawal. Bupropion ingredient poseses an increased risk of suicidal thoughts thus other medicines/products containing bupropion should not be used in combination with contrave.
Serious side effects include:
The risk of seizures is higher in people who take higher doses, have certain medical conditions; an in those who are taking other medicines. Do not take any other medicines while you are taking Contrave unless your healthcare provider has advised otherwise. If you have a seizure, stop taking contrave right away, and do not take it again.
Risk of opioid overdose. If you are undergoing treatment with opioid medicines, there is an increased risk of opioid overdose. Do not take large amounts of opioids to try to overcome the opioid-blocking effects of naltrexone. This can lead to serious injury, coma, or death.
Sudden opioid withdrawal. People who take contrave must be ‘opioid-free’ including street drugs, prescription pain killers (including tramadol), cough, cold, or diarrhoea medicines that contain opioids, or opioid-dependence treatments, buprenorphine, or methadone, for at least 7 to 10 days before starting contrave.
Severe allergic reactions. Stop taking contrave if you have any of the following signs and symptoms of allergic reactions: rash, itching, hives, fever, swollen lymph glands, painful sores in your mouth or around your eyes, swelling of your lips or tongue, chest pain, or trouble breathing.
Increases in blood pressure or heart rate. Increases in blood pressure or heart rate may occur in some people taking contrave.
Liver damage or hepatitis. Contrave can cause liver damage or hepatitis. Stop taking it if you have any of the following symptoms: stomach area pain lasting more than a few days, dark urine, yellowing of the whites of your eyes, or tiredness.
Manic episodes. Manic episodes can occur. Contrave can cause some people who were manic or depressed in the past to become manic or depressed again.
Visual problems. Contrave can cause visual problems (angle-closure glaucoma). Symptoms may include: eye pain, changes in vision, swelling or redness in or around the eye.
Increased risk of hypoglycaemia in people with type 2 diabetes mellitus who also take medicines to treat their diabetes (such as insulin or sulfonylureas).
More Common side effects include: nausea (most common), headaches, dizziness, dry mouth, insomnia, constipation, vomiting and diarrhoea.
How to use contrave
When you start taking contrave the dose is slowly increased over time to help you adjust to it:
Week 1: 1 x tablet in the morning
Week 2: 1 x tablet in the morning, 1 x tablet in the evening
Week 3: 2 x tablets in the morning, 1 x tablet in the evening
Week 4 –onwards: 2 x tablets in the morning, 2 x tablets in the evening.
Please note, the above are only guidelines – if you’re experiencing side effects such as nausea or vomiting, do not increase your dose. Also, dosage regimen depends on the severity of overweight; the more weight you need to lose the more likely you are to increase your dose up to a maximum of 4 tablets a day.
However, you should stop taking contrave if you have not lost a certain amount of weight after 16 weeks of treatment.
Swallow tablet whole, do not cut, chew, or crush contrave tablets.
Do not take more than 2 tablets in the morning and 2 tablets in the evening.
Do not take more than 2 tablets at the same time or more than 4 tablets in 1 day.
Do not take contrave with high-fat meals.