Contrave: Comprehensive Weight Management with Dual-Action Therapy
| Product dosage: 98mg | |||
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Synonyms | |||
Contrave represents a significant advancement in the pharmacological management of chronic weight issues, combining two established medications to target both appetite control and reward pathways in the brain. This prescription medication is specifically designed for adults with obesity (BMI ≥30) or overweight (BMI ≥27) with at least one weight-related comorbidity, serving as an adjunct to reduced-calorie diet and increased physical activity. Its unique mechanism addresses multiple physiological factors contributing to weight regulation, offering a scientifically-backed approach to sustainable weight loss. Clinical trials demonstrate consistent efficacy, with a substantial proportion of patients achieving clinically meaningful weight reduction when used as part of a comprehensive weight management program.
Features
- Contains two active ingredients: naltrexone HCl (8 mg) and bupropion HCl (90 mg) per extended-release tablet
- Dual mechanism targeting hypothalamic melanocortin system and mesolimbic dopamine pathway
- Gradual dose escalation over four weeks to optimize tolerability
- Extended-release formulation for twice-daily dosing
- FDA-approved for chronic weight management
- Manufactured under strict pharmaceutical quality standards
Benefits
- Promotes sustained weight loss through complementary neurological pathways
- Reduces food cravings by modulating reward system responses to eating
- Increases feelings of fullness and satiety during meals
- Supports long-term weight maintenance when combined with lifestyle modifications
- Improves cardiometabolic parameters in patients with obesity-related conditions
- Provides a non-surgical option for patients who have struggled with conventional weight loss methods
Common use
Contrave is indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index (BMI) of 30 kg/m² or greater (obesity), or 27 kg/m² or greater (overweight) in the presence of at least one weight-related comorbid condition such as hypertension, type 2 diabetes mellitus, or dyslipidemia. The medication is typically prescribed after assessment of appropriate patient selection criteria, including evaluation of contraindications and potential drug interactions. Treatment response should be evaluated by week 16, with discontinuation considered if patients haven’t lost at least 5% of baseline body weight.
Dosage and direction
The recommended dosage involves a gradual titration schedule to minimize initial side effects:
- Week 1: One tablet each morning
- Week 2: One tablet each morning and one tablet each evening
- Week 3: Two tablets each morning and one tablet each evening
- Week 4 and maintenance: Two tablets each morning and two tablets each evening
Tablets should be swallowed whole and not crushed, divided, or chewed. Administration with food may reduce the incidence of nausea. The maximum recommended daily dose is 32 mg naltrexone/360 mg bupropion (two tablets twice daily). Dose escalation should follow the recommended schedule unless tolerability issues emerge, requiring slower titration or dose reduction.
Precautions
Patients should be monitored for increased blood pressure and heart rate, with baseline and regular assessments recommended. Contrave contains bupropion, which is associated with seizure risk (approximately 0.1%); caution is advised in patients with predisposing conditions. Psychiatric symptoms including anxiety, insomnia, and suicidal ideation require monitoring, particularly in patients with pre-existing psychiatric conditions. Hepatic impairment necessitates careful consideration, as naltrexone metabolism may be affected. Patients should be advised about the potential for allergic reactions and instructed to discontinue use if signs of hypersensitivity develop.
Contraindications
Contrave is contraindicated in patients with:
- Uncontrolled hypertension
- Seizure disorders or history of seizures
- Eating disorders (current or history of anorexia nervosa or bulimia nervosa)
- Use of monoamine oxidase inhibitors (MAOIs) within 14 days
- Chronic opioid or acute opioid withdrawal; patients requiring opioid treatment
- Known hypersensitivity to naltrexone, bupropion, or any component of the formulation
- Pregnancy and breastfeeding
- Severe hepatic impairment
- Concomitant use with other bupropion-containing products
Possible side effects
Common adverse reactions (≥5% and more frequent than placebo) include:
- Nausea (32.5%)
- Constipation (19.2%)
- Headache (17.6%)
- Vomiting (10.7%)
- Dizziness (9.9%)
- Insomnia (9.2%)
- Dry mouth (8.1%)
- Diarrhea (7.3%)
Serious but less common side effects may include:
- Increased blood pressure and heart rate
- Seizures
- Angle-closure glaucoma
- Liver damage
- Hypomania or mania
- Suicidal thoughts and behaviors
- Severe allergic reactions
Drug interaction
Significant interactions occur with:
- MAO inhibitors: Risk of hypertensive crisis
- Opioids: Reduced efficacy and potential withdrawal symptoms
- Drugs that lower seizure threshold: Increased seizure risk
- CYP2B6 inhibitors (e.g., ticlopidine, clopidogrel): Increased bupropion exposure
- Drugs metabolized by CYP2D6 (e.g., antidepressants, antipsychotics, beta-blockers): Altered concentrations
- Alcohol: Increased risk of neuropsychiatric events
- Dopaminergic drugs: Potential synergistic effects
Missed dose
If a dose is missed, patients should take the next dose at the regular time. Doubling of doses is not recommended. If multiple doses are missed, re-titration may be necessary to minimize gastrointestinal side effects. Patients should maintain the prescribed twice-daily schedule and avoid taking extra tablets to make up for missed doses.
Overdose
Overdose may manifest with bupropion-related symptoms including seizures, hallucinations, tachycardia, and cardiac arrhythmias, or naltrexone-related symptoms including nausea, abdominal pain, and lethargy. Management requires immediate medical attention with supportive care including ECG monitoring, airway protection, and control of seizures with benzodiazepines. Activated charcoal may be considered if presentation is early. There is no specific antidote; treatment remains symptomatic and supportive.
Storage
Store at room temperature (20-25°C/68-77°F) with excursions permitted between 15-30°C (59-86°F). Keep in original container with tight closure to protect from moisture. Keep out of reach of children and pets. Do not use if tablets appear damaged or discolored. Properly dispose of unused medication through take-back programs or according to FDA guidelines.
Disclaimer
This information does not replace professional medical advice. Contrave is available by prescription only and should be used under appropriate medical supervision. Individual results may vary. Patients should discuss their complete medical history with their healthcare provider before starting treatment. Safety and effectiveness in pediatric patients have not been established.
Reviews
Clinical trials demonstrate that approximately 42-48% of patients achieved ≥5% weight loss at 56 weeks, with 21-25% achieving ≥10% weight loss. Real-world evidence supports maintained efficacy with appropriate patient selection and adherence to lifestyle modifications. Many patients report reduced preoccupation with food and improved eating behaviors. Healthcare providers note the importance of comprehensive patient education regarding expectations, side effect management, and the necessity of concurrent dietary and exercise interventions for optimal outcomes.