Contrave for Weight Loss
Are you looking to add Contrave to your weight loss plan? Scroll down to learn if Contrave is the right medication for you.
What is Contrave?
Contrave is an FDA-approved prescription weight loss medication that can be used for people struggling with obesity. It is a combination of two medications: Naltrexone and Bupropion.
How Does Contrave Work?
As mentioned, two drugs make Contrave: naltrexone and bupropion. Naltrexone reduces food cravings by working on the reward systems within the brain. Bupropion is an antidepressant that can also help suppress appetite and increase metabolism. Together, these drugs can help people lose weight by reducing their calorie intake and increasing their energy expenditure. Though one of the components of Contrave is an antidepressant, Contrave is not indicated for depression.
Who Qualifies for Contrave?
Contrave is approved for the treatment of obesity. If you have a BMI greater than or equal to 30 or a BMI greater than 27 with at least one other weight-related condition (diabetes, high blood pressure, high cholesterol), you may be eligible for this medication.
Can Contrave Be Used For Weight Loss?
Contrave has shown to be very effective with weight management for people who struggle with obesity. In the COR-1 trial published in 2010, researchers examined Contrave’s benefits for obesity and weight management. This was a large trial published in 2010 that looked at the weight loss effects of Contrave in overweight and obese patients. Participants were given oral Contrave for 52 weeks, along with a calorie-restricted diet and regular exercise. The results showed that after 52 weeks, the average percent change in body weight was around 5%.
Also, almost half the participants taking Contrave saw at least a 5% weight reduction. It is important to note that the best results are seen when Contrave is taken with a calorie-restricted diet and regular moderate exercise (150 minutes/week).
Contrave vs Other Prescription Weight Loss Medications
Contrave vs GLP-1 Medications
The GLP-1 agonist medications were all made to treat type 2 diabetes. They mimic the effects of the naturally produced hormone, GLP-1, released from cells in the gut to regulate blood sugar and slow food movement through the gut. There are many different kinds of GLP-1 agonist medications on the market today. Some are FDA-approved to treat obesity (Wegovy, Saxenda), while others can be used off-label for weight loss (Mounjaro, Ozempic, Rybelsus, Victoza, Trulicity).
These medications have been shown to reduce body weight anywhere from 10-20%, depending on which GLP-1 agonist is used. This is seen especially when a GLP-1 agonist is used with diet and regular exercise.
For example, in the SURMOUNT-1 Trial, people taking Mounjaro over 72 weeks noticed an average reduction in body weight of 15% (2). Though these medications may be more effective, Contrave may be a better option for those who do not wish to use injectable medications. Contrave may also benefit people with depression or who wish to stop smoking.
Contrave vs Orlistat (Alli/Xenical)
Orlistat has been on the market for weight loss for over two decades. It is sold under the brand names Alli and Xenical. It prevents fat absorption in the intestines by inhibiting an enzyme called “lipase.” It has fallen out of favor for most providers due to the side effects and existence of better working medications.
In a study published in 1998, researchers looked into how effective Orlistat was on weight loss and preventing weight regain for patients struggling with obesity (1). Participants were given 120 mg of Orlistat and placed on a calorie-restricted diet (600kcal/day deficit) for 52 weeks. When the study concluded, participants taking orlistat lost around 10.3 kg (22 lbs) after the year, significantly more than the placebo group. When the placebo group was started on Orlistat and monitored for an additional year, they noticed an additional 0.9kg loss in weight.
Though Orlistat seems more effective in the long run, the side effects may turn people away from this medication. Orlistat's most common side effects are abdominal pain, greasy stools, and oily stains found on undergarments. For this reason, Contrave may be a better option.
Contrave vs Qsymia
Qsymia is a prescription weight loss medication that contains a combination of two drugs: phentermine and topiramate. Phentermine is an appetite suppressant that affects the central nervous system and helps to reduce food cravings. Topiramate is an anti-seizure drug that can also help with weight loss by reducing appetite and increasing feelings of fullness. It also increases the effects of phentermine.
In the CONQUER Trial published in 201, researchers examined how effective Qsymia was at treating obesity. The study was done over a 52-week period where participants took different doses of Qsymia. Depending on the dose, people on Qsymia lost around 8-10 kg (18-22 lbs). They also saw that around 68% of people noticed at least a 5% reduction in weight after one year (5).
Contrave and Qsymia are both effective at managing obesity. However, more people noticed at least a 5% reduction in body weight when taking Qsymia compared to Contrave.
Contrave may be the better option for those with a history of heart disorders, specifically arrhythmias. Both medications should be taken in conjunction with diet and regular exercise.
Contrave Side Effects
The most common side effects of Contrave vary. They are usually only mild to moderate in severity and go away with time. These side effects include:
- Nausea (35%)
- Constipation (19%)
- Headache (18%)
- Vomiting (11%)
- Dizziness (10%)
- Insomnia (9%)
- Dry Mouth (8%)
- Diarrhea (7%)
Contrave Dosage and Administration
Contrave is given as two tablets taken twice daily in the morning and evening. It is dosed at 8 mg/90mg and cannot exceed a maximum dose of 32 mg/360 mg per day (there are two doses together because it is a combination of two medications). The titration period takes about three weeks before you reach the recommended dosage.
Your provider may adjust the dose if you have a liver or kidney disease history. Do not crush, chew or split the tablets.
Contrave Contraindications and Warnings
Severe Allergic Reaction
You may experience a severe allergic reaction to Contrave when first taking it. Signs of a severe allergic reaction include swelling of your face, lips, tongue, or throat, problems breathing or swallowing, severe rash or itching, fainting or feeling dizzy, and very rapid heartbeat. Let your provider know immediately if you have experienced this when taking Contrave in the past.
History of Seizures
Contrave can increase the risk of seizures depending on the dose. This is particularly dangerous for those who have a history of seizure disorders. If you have had seizures in the past, notify your provider before starting Contrave.
Opioid Use
Contrave should not be given to anyone who uses opioids chronically for the risk of overdose. It can also precipitate withdrawal for those taking Suboxone (buprenorphine) or methadone.
Anorexia or Bulimia
People suffering from eating disorders like Bulimia and Anorexia may be at a higher risk for seizures when taking Contrave.
Uncontrolled High Blood Pressure
Contrave can increase blood pressure which is an issue for those with a history of uncontrolled high blood pressure. People taking Contrave should see their provider regularly to check their blood pressure and monitor for significant changes.
Liver Disease
Naltrexone can potentially cause clinically significant liver dysfunction and hepatitis (liver inflammation). Therefore, you should inform your provider if you are having symptoms of hepatitis while taking Contrave or have a history of liver dysfunction before starting Contrave.
Pregnancy
Contrave is not recommended for pregnant patients or patients thinking of becoming pregnant. The weight loss caused by Contrave may not benefit people who are pregnant and have the potential to harm the fetus.
Drug Interactions
You should not take Contrave if you are on any other medication that contains bupropion, such as Wellbutrin or Zyban. Review your medications with your provider before starting Contrave.
Contrave Coverage and Cost
Contrave can be pricey depending on what a particular insurance plan covers. The average cost for a 30-day supply of Contrave is around $515. There is a Contrave Savings Card that you may be eligible for depending on your insurance plan. The amount covered depends on the plan, but you could save more than out-of-pocket. Regardless of insurance coverage, you can pay up to $99 or less with free shipping with the CurxAccess Program. Click the provided link to see how to apply for the CurxAccess program. Contrave is currently FDA-approved for the management of obesity, so call your insurance provider to see if they can assist with costs or to see if your insurance plan covers it.
Where Can I Get Contrave?
If you would like to learn more about Contrave or want to see if you might be eligible for medication-assisted weight loss, check out Mochi Health, where board-certified obesity medicine physicians can offer expertise in this realm!
Mochi Health is a virtual obesity medicine practice that connects you with medical providers, like licensed physicians and nurse practitioners, to help you optimize your weight loss journey. We provide monthly video chats with actual medical providers to provide guidance about weight management and to get you started on prescription weight loss medications to supplement your weight loss plan.
Frequently Asked Questions
Check out our Mochi Health Blogs to learn about different topics on weight loss medications.
Mounjaro vs Contrave
References
- Greenway FL, Fujioka K, Plodkowski RA, Mudaliar S, Guttadauria M, Erickson J, Kim DD, Dunayevich E; COR-I Study Group. Effect of naltrexone plus bupropion on weight loss in overweight and obese adults (COR-I): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2010 Aug 21;376(9741):595-605. doi: 10.1016/S0140-6736(10)60888-4. Epub 2010 Jul 29. Erratum in: Lancet. 2010 Aug 21;376(9741):594. Erratum in: Lancet. 2010 Oct 23;376(9750):1392. PMID: 20673995.
- Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Connery L, Alves B, Kiyosue A, Zhang S, Liu B, Bunck MC, Stefanski A; SURMOUNT-1 Investigators. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med. 2022 Jul 21;387(3):205-216. doi: 10.1056/NEJMoa2206038. Epub 2022 Jun 4. PMID: 35658024.
- Sjöström L, Rissanen A, Andersen T, Boldrin M, Golay A, Koppeschaar HP, Krempf M. Randomised placebo-controlled trial of orlistat for weight loss and prevention of weight regain in obese patients. European Multicentre Orlistat Study Group. Lancet. 1998 Jul 18;352(9123):167-72. doi: 10.1016/s0140-6736(97)11509-4. PMID: 9683204.
- Gadde KM, Allison DB, Ryan DH, Peterson CA, Troupin B, Schwiers ML, Day WW. Effects of low-dose, controlled-release, phentermine plus topiramate combination on weight and associated comorbidities in overweight and obese adults (CONQUER): a randomised, placebo-controlled, phase 3 trial. Lancet. 2011 Apr 16;377(9774):1341-52. doi: 10.1016/S0140-6736(11)60205-5. Epub 2011 Apr 8. Erratum in: Lancet. 2011 Apr 30;377(9776):1494. PMID: 21481449.
