Contrave for Weight Loss: Does It Work?

By Jennifer Nadel, MD
Medically reviewed checkmarkMedically reviewed
January 4, 2023

Key takeaways

  • Contrave is an FDA-approved weight loss medication for adults with a BMI over 30 or who are overweight and have serious medical conditions, including diabetes or high blood pressure.

  • It is uniquely designed to control cravings and reduce hunger to achieve weight loss goals when combined with diet modifications and increased physical activity.

  • Contrave is not approved for children or people with a history of seizures and should not be prescribed for people with certain other health conditions, such as anorexia nervosa and diabetes.

Contrave is an FDA-approved combination of two medications—bupropion and naltrexone. These medications work together to help reduce appetite, promote fullness after meals, and increase energy levels. 

During clinical trials, patients who took Contrave along with following a reduced-calorie diet and exercising lost 2–4 times more weight than those who did not. However, results may vary for individuals, and there are certain people who should not take Contrave. 

Read on to learn if Contrave may be a good medication for you and how it may help you achieve your weight loss goals. Also, learn who should avoid taking Contrave. 

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What Is Contrave?

Contrave is a prescription medication made by combining two medications, naltrexone and bupropion. Naltrexone is an opioid agonist that may curb hunger and food cravings. Bupropion is an antidepressant that can decrease appetite. 

Both of these medications have been prescribed and used safely for over 30 years (though not in combination, and the weight loss indication is newer). When taken individually, the medications are not approved for weight loss. However, in combination, Contrave has been shown to promote weight loss.

Contrave comes as an oral extended-release (ER) tablet. That means the medication ingredients slowly release into your bloodstream over time. Each tablet contains 8 milligrams (mg) of naltrexone and 90 mg of bupropion.

When starting Contrave, your doctor will have you start at a lower dose and gradually increase it over time, depending on how you tolerate it. The timeline typically looks like this:

Morning doseEvening dose
Week 11 tablenone
Week 21 tablet1 tablet
Week 32 tablets1 tablet
Week 4 – Onward2 tablets2 tablets

Uses

Contrave is a prescription weight-loss medication that helps adults with obesity, meaning a body mass index (BMI) of 30 kg/m² or greater, or adults with a BMI of 27 kg/m² or greater with at least one weight-related medical problem such as high cholesterol, high blood pressure, or type 2 diabetes. 

It is designed to be taken alongside a reduced-calorie diet and an increase in physical activity to provide adults with an elevated level of support while they strive for a healthier lifestyle. Research backs the effectiveness of Contrave, showing that patients saw a significant improvement in their BMI when using it over diet and exercise alone. 

Is Contrave Used for Weight Loss?

Contrave helps promote weight loss by targeting areas of the brain that are involved in controlling hunger and cravings, thus making it easier to reach diet goals. Consequently, it helps those with a high BMI reach the ideal range when taken along with diet and exercise. As with any medical treatment, weight loss pills should only be taken on the advice of a doctor or other medical professional who knows your health needs best.

Side Effects Of Contrave

Get emergency medical treatment if you experience an allergic reaction to Contrave. Symptoms of an allergy include:

  • Hives
  • Rash or itching
  • Chest pain
  • Difficulty breathing
  • Swelling of your face, lips, tongue, or throat
  • Fever
  • Swollen glands
  • Mouth sores
  • Muscle or joint pain

Common side effects

Common side effects of taking Contrave include:

  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Headache
  • Dizziness
  • Dry mouth
  • Insomnia

Serious side effects

Stop taking Contrave, call your doctor, or go to the emergency department right away if you experience:

  • Severe headache
  • Blurred vision, tunnel vision, halos around light, eye pain or swelling
  • A seizure
  • Changes in mood or behavior
  • Thoughts of suicide or hurting yourself
  • A manic episode
  • Upper stomach pain
  • Fatigue
  • Yellow skin or eyes

This is not a complete list of side effects. Talk with your medical provider about medical advice about side effects and a complete list. 

Pros and Cons of Taking Contrave For Weight Loss

As with most medications, Contrave has several potential benefits and risks.

Benefits

Contrave is great for weight loss in adults who have difficulty losing weight with diet and exercise alone. It’s indicated to help those who have a body mass index of 30 or greater achieve desired health goals by helping decrease their appetite, leading to overall weight loss. 

Contrave has been found to be an effective tool for those struggling with their weight when used correctly in conjunction with diet and increased physical activity, with a high long-term success rate. 

Cons

Taking Contrave to aid in weight loss is a decision you should make after careful consideration. This medication has several risks and side effects, so individuals need to understand the potential downsides before taking the leap. Those who decide to take Contrave for weight loss should still eat a healthy, reduced-calorie diet and increase their physical activity.

It is also important to note that Contrave does not guarantee success with weight loss. Any type of diet or lifestyle change comes with its own set of challenges as well as rewards. Be sure to consult your healthcare professionals to determine if Contrave is appropriate for you.

Cost of Contrave

How much you pay for Contrave depends on whether your insurance covers it or if you plan on paying cash. Other factors that determine the cost include your location and the pharmacy you use. 

With insurance 

If you plan on using your insurance, your insurance company may first require prior authorization for the medication. This means your doctor and the insurance company need to communicate about the possibility of you taking Contrave before your insurance will agree to cover the prescription. If you are not sure if your plan requires preauthorization, contact your insurance company before your healthcare provider prescribes it for you.

If your insurance does cover Contrave, you may pay as little as $20 for a month’s supply if you use the Contrave Coupon Savings Card Program

Federal programs such as Medicare Part D, Tricare, and Medicaid typically do not cover the cost of Contrave. However, people who use these programs may qualify for the CurAccess program. Those who qualify may pay $99 or less, plus free shipping, for a monthly Contrave prescription. 

Without insurance

If you do not have insurance, the typical cost of Contrave is around $199 for a month’s supply if you use the Coupon Savings Card. The cost may also be less expensive if you purchase it through Ridgway Mail Order Pharmacy, which is partnered with Currax Pharmaceuticals LLC, the manufacturer of Contrave. To learn about ways to save, visit the manufacturer’s site

Drug Interactions and Warnings

Contrave may interact with certain medications and make them work differently. It is important that your medical provider knows all medications and supplements you take before taking Contrave. 

Drug interactions

Here are some commonly known Contrave drug interactions:

  • Monoamineoaxidase inhibitors (MAOI): Taking MAOIs along with Contrave can increase the risk of high blood pressure or cause toxicity.
  • Opioid analgesics: People who need opioid-containing medications may not benefit from the full effect of the opioid while taking Contrave. 
  • CYP2B6 inducers: Taking ritonavir, lopinavir, and efavirenz may decrease bupropion exposure. 
  • Drugs metabolized by the CYP2D6 enzyme: The metabolism of these medications may be disrupted if taken with Contrave. These include certain antidepressants, beta-blockers, and antiarrhythmics. 
  • Digoxin (Lanoxin): Taking Contrave with digoxin may increase the digoxin level in the bloodstream.
  • CYP2B6 inhibitors: Taking ticlopidine or clopidogrel with Contrave may increase the amount of bupropion you are exposed to.
  • Drugs that increase your risk for seizures: Use extreme caution when taking Contrave with medications that lower seizure threshold, such as antipsychotics, antidepressants, theophylline, or systemic corticosteroids.
  • Dopaminergic drugs: Taking bupropion, levodopa, and amantadine may cause central nervous system toxicity causing tremors, agitation, or gait disturbances. 
  • Alcohol: There are rare reports of adverse neuropsychiatric events when people drank alcohol while being treated with bupropion. Because Contrave contains bupropion, alcohol should be avoided.

Warnings

Contrave contains the antidepressant bupropion; however, Contrave is not approved for treating depression. Nevertheless, the ingredient may possibly increase the risk of suicidal thoughts and behaviors in young adults. Advise family members and friends of the risk so they can watch for changes in behavior.

Bupropion can also cause seizures. Because of this, Contrave should not be prescribed to certain people, including those who:

  • Have had a seizure or have a seizure disorder
  • Have anorexia nervosa or bulimia
  • Are detoxing from alcohol, benzodiazepines, or barbiturates
  • Have a history of head trauma or stroke
  • Have diabetes

It is not recommended to take Contrave after eating a high-fat meal. This may increase the risk of seizures. 

Do not take Contrave if you are pregnant, planning to get pregnant, or are nursing.

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Alternatives To Contrave For Weight Loss

While there are numerous medications available that may aid in weight loss, many of them have side effects or stimulants that can be dangerous. Eating a lower-calorie diet and engaging in regular physical exercise remain the best options when it comes to safely and effectively losing weight. These activities help reduce overall body fat, leading to weight loss.

However, if diet and exercise alone aren’t providing the desired results, there are still other alternative forms of treatment out there. These include: 

  • Bariatric surgery
  • Meal replacement plans
  • Eating a low-calorie diet
  • Behavioral modifications
  • Other weight loss medications such as Saxenda, Wegovy, phentermine, semaglutide, or Alli

It is important to speak with your healthcare provider before beginning any diet or exercise routine to make sure it is safe for you given your health conditions and preferences.

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Frequently Asked Questions

How much weight can you lose with Contrave?
How much weight you lose with Contrave depends on a number of things, like how well you can stick to a low-calorie diet and get regular exercise. During clinical trials, participants who took Contrave along with exercise and followed a calorie-reduced diet lost 2–4 times more weight than those who did not.
How long does it take to lose weight with Contrave?
It takes four weeks of gradually increasing your dose until you reach the recommended dosage amount. However, it is possible to start losing weight during that time as well. How much weight you lose depends on several factors, such as your ability to follow the program, your starting weight, and how quickly your body reacts to the medication.
Is Contrave just an appetite suppressant?
Contrave works by targeting the areas of the brain that control hunger and cravings. However, it is not just an appetite suppressant.
What are the side effects of Contrave?
Common side effects of Contrave include nausea, vomiting, changes in bowel movements, and headaches.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Jennifer Nadel, MD

Dr. Jennifer Nadel is a board certified emergency medicine physician and received her medical degree from the George Washington University School of Medicine. She has worked in varied practice environments, including academic urban level-one trauma centers, community hospital emergency departments, skilled nursing facilities, telemedicine, EMS medical control, and flight medicine.

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