II. Efficacy
- Results in 9 pounds weight loss more than Placebo in one year
III. Mechanism: Combination Agent
- Bupropion suppresses appetite
- Naltrexone decreases food cravings
IV. Dosing
- Contrave (90 mg Bupropion with 8 mg Naltrexone)
- Start: one tablet orally daily for 1 week
- Titrate gradually to 2 tablets twice daily over 4 weeks
V. Contraindications
- Seizure Disorder (due to Bupropion)
- Concurrent Opioid pain management (due to Naltrexone)
- Uncontrolled Hypertension
VI. Drug Interactions
- Opioids (due to Naltrexone)
VII. Adverse effects
- See Naltrexone and Bupropion
- Nausea is most common (up to 30% of patients)
- Up to 12% of patients stop due to adverse effects (only 50% of patients completed the first Contrave trial)
- Suicidality (FDA black box warning)
VIII. Disadvantages
- Expensive: $7 per day (or $210 per month) for an agent that is marginally better than Bupropion alone (see efficacy below)
IX. Efficacy
- Contrave (Bupropion and Naltrexone) results in 9 to 10.8 lb (up to 4.9 kg) weight loss more than Placebo in one year
- Bupropion alone results in 6 pounds weight loss more than Placebo in one year
- Contrast with Qsymia (Phentermine and Topiramate) which results in 20 pounds weight loss more than Placebo at 1 year
- Contrast with 250 calorie deficit per day results in 26 pounds weight loss per year
X. References
- (2014) Presc Lett 21(11): 62
Images: Related links to external sites (from Bing)
Related Studies
| contrave (on 3/3/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| CONTRAVE ER 8-90 MG TABLET | $4.99 each | |