What is CONTRAVE for?

  • CONTRAVE is indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adults with a BMI >30 or a BMI>27 with comorbidities (high blood pressure, diabetes, high cholesterol).
  • Unlike other weight loss medications, you do not have to stop taking it after a short time. You may continue as long as you think it’s helpful.

How does CONTRAVE work?

  • Naltrexone is a pure opioid antagonist, and bupropion is a relatively weak inhibitor of the neuronal reuptake of dopamine and norepinephrine. The exact neurochemical effects of naltrexone/bupropion leading to weight loss are not fully understood. Effects may result from action on areas of the brain involved in the regulation of food intake: the hypothalamus (appetite regulatory center) and the mesolimbic dopamine circuit (reward system).
  • Naltrexone is also indicated to treat alcohol and opioid addiction. It’s important to tell us and any other providers that you are taking CONTRAVE since it can reduce the effectiveness of opioids.
  • Bupropion is also indicated to treat depression, seasonal affective disorder, ADHD, and smoking cessation.
  • CONTRAVE is proven to help people lose weight and keep it off.

What about Emotional Hunger?

CONTRAVE is especially suited for people with emotional hunger because the mechanism of action controls cravings and curbs hunger.

  • In studies of people taking CONTRAVE, there was a 11% weight loss at one year.
  • In studies of people taking CONTRAVE with emotional hunger, there was:
    • a 5% weight loss (on average) by 16 weeks
    • a 15% weight loss (on average) by one year
  • At your 16 week follow up visit, we will accurately evaluate if this medication works for you.

How do I take the tablets?

CONTRAVE  8mg/90mg is typically prescribed as follows:

  • Week one:       take 1 tab by mouth every morning
  • Week two:      take 1 tab by mouth twice a day (about 8 hours apart)
  • Week three:    take 2 tabs in the morning and 1 tab in the evening 
  • Week four on: take 2 tabs by mouth twice a day

If evening eating is more problematic for you, you may want to begin with evening dosing. Your nurse practitioner may advise dosing differently based on your specific needs.

What are possible Side Effects?

  • It’s common to experience nausea, constipation, headache, vomiting, dizziness, insomnia, dry mouth, or diarrhea.
  • Gastrointestinal symptoms could occur upon starting the medication and when increasing the dose each week. The symptoms usually resolve by 2-4 weeks.
  • If you experience nausea upon starting the medication:
    • Take it with food (not a high fat meal)
    • Contact us if you don’t feel better after a few days and we can prescribe a temporary medication for nausea.
  • Because CONTRAVE includes an antidepressant there is a warning about increased suicidal thoughts. Studies showed that antidepressant use increased suicide risk only in people under age 24. It did not occur with people over age 24, and there was a reduction in risk for people aged 65 and older. Please contact us (your prescriber) if you experience thoughts of suicide.
  • Please read the “Up to Date” patient education handout for a more complete list of possible side effects. (Will be given to you at your visit)

We Encourage You to:

  • Come to our weekly Zoom support group Mondays 5:30pm to 6:00pm to be with others on a similar weight loss journey. You can share ideas, challenges, and successes. Our nurse, Dr. Ellen Makar, RN will be there with you all to answer medication questions you may have.
  • Eat nutritious food throughout the day to avoid hypoglycemia (low blood sugar), lightheadedness, or weakness. If you are diabetic and take insulin, check your blood sugars more often so you can prevent hypoglycemia.
  • Move your body at least once a week or more as you are able. Muscle growth with resistance training will increase your resting calorie burn, and cardiovascular exercise will improve your heart health, win win!
  • Avoid high calorie beverages like juice, soda, and alcohol.

We are in this with you!                                 

We wish you the best success on this journey,                                                       

Dr. Courtney Holmes, DNP, APRN, Diana Greenia, APRN, Dr. Ellen Makar, DNP, RN

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