Medications » Contrave

Drug: Contrave


Medication disclaimers


The “black box” on Contrave® warns that this drug may cause suicidal thinking and behavior in young adults, whether or not patients are taking medicines used to treat depression. It may increase the risk of suicidal thoughts in some young adults within the first few months of treatment. Monitor and report worsening or new suicidal thoughts and behaviors to your health care provider.  Patients taking bupropion for smoking cessation may also experience changes in mood, psychosis, hallucinations, paranoia, delusions, homicidal ideation, hostility, aggression, anxiety, and panic, as well as suicidal ideation, suicide attempt, and completed suicide, high blood pressure, fast, irregular heartbeats, seizures, acute angle-closure glaucoma, and death. 

If you experience a medical emergency, call 911 or go to the nearest emergency room.

Tell your health care provider about your medical history prior to taking Contrave®. 

The safety and effectiveness of Contrave®, in combination with other products intended for weight loss, including prescription and over-the-counter drugs, and herbal preparations, have not been established.

Avoid alcohol while taking this medication. If you’re taking diabetes medications, please discuss this with your prescribing doctor before starting Contrave®, as your diabetes medications may need to be adjusted as you lose weight.

Do not use this medication if you are or suspect you may be allergic to any of the ingredients in Contrave® including naltrexone and bupropion.

Notify your doctor if you experience:

  • Anxiety
  • Buzzing or ringing in ears
  • Chest discomfort
  • Confusion or trouble concentrating
  • Depression
  • Dry mouth
  • Fainting
  • Hallucinations
  • Headaches
  • Hyperventilation
  • Impulsivity
  • Irregular heartbeats
  • Irritability
  • Lightheadedness
  • Mood or mental changes
  • Restlessness
  • Seizures
  • Shaking
  • Skin hives, rashes, or itching
  • Suicidal thoughts
  • Sweating
  • Trouble sleeping
  • Unusual tiredness
  • Vision changes or eye pain

Stop using Contrave® and get medical help immediately if you have any symptoms of a serious allergic reaction, including swelling of your face, lips, tongue, or throat; problems breathing or swallowing; severe rash or itching; fainting or feeling dizzy; or very rapid heartbeat. 

Tell your health care provider about your medical history. You should not take Contrave® if you:

  • Have uncontrolled high blood pressure
  • Have anorexia or bulimia
  • Have or have had seizures
  • Use other medicines that contain bupropion such as Wellbutrin®, Wellbutrin® SR, Wellbutrin® XL, Aplenzin®, or Zyban®
  • Are undergoing an abrupt discontinuation of alcohol, benzodiazepines, barbiturates, and antiepileptic drugs 
  • Drink a lot of alcohol and abruptly stop drinking
  • Have kidney disease
  • Have liver disease (it may cause liver dysfunction or hepatitis)
  • Are depressed or have suicidal feelings
  • Have current or recent (within the past 7-14 days) use of opioids or opiate drugs

You should not take Contrave® under these circumstances either:

  • If you’re pregnant, breastfeeding, or planning to become pregnant
  • If you’ve taken an MAOI (monoamine oxidase inhibitor), such as Nardil®, Parnate®, or Marplan® in the past 14 days
  • If you’re taking any opioids or opiate drugs
  • If you’re dependent on opioids or using methadone or buprenorphine
  • If you are in opioid withdrawal

If you take opioids or opiates right after stopping Contrave®, you may be more sensitive to them and require lower doses—which poses a risk of overdose. Please talk to your provider before initiating any opioids or opiates after stopping Contrave®.

While some people experience no side effects while taking Contrave®. Some of the most common side effects are:

  • Nausea
  • Constipation
  • Headache
  • Vomiting
  • Dizziness
  • Insomnia
  • Dry mouth
  • Diarrhea
  • Anxiety
  • Hot flushes
  • Fatigue
  • Tremors
  • Upper abdominal pain
  • Viral gastroenteritis
  • Influenza (flu) 
  • Tinnitus (ringing in the ears) 
  • Urinary tract infection 
  • Excessive sweating
  • Irritability
  • Increased blood pressure
  • Changes in taste and smell 
  • Rashes 
  • Muscle strains
  • Palpitations (heart racing)  

Additional but less common side effects may include:

Fast heart rate, heart attack, dizziness, motion sickness, lower abdominal pain, gas, lip swelling, rectal bleeding, hernia, inflamed gallbladder, pneumonia, staph infection, kidney infection, increased blood creatinine, increased hepatic enzymes, decreased hematocrit, feeling jittery, feeling abnormal, feeling weak or a loss of energy, thirst, feeling hot, disturbance in attention, feeling sleepy, tremors, balance disorder, impaired memory, amnesia, abnormal dreams, nervousness, feeling spacey, tension, agitation, mood swings, abnormal and frequent urination, dehydration, bulging or herniated discs, jaw pain, feeling faint, hair loss, erectile dysfunction, vaginal dryness, and irregular menstrual cycles (periods).

These symptoms often subside as your body adjusts to the medication. Please notify your provider if side effects persist. For a complete list of side effects, review the medication packaging inserts.

If you take diabetes medications, please discuss this with your prescribing clinician before taking Contrave® since your diabetes medications may need to be adjusted as you lose weight. 

As with other medications, Contrave® can interact with alcohol and certain prescription and OTC medications and herbal products. Some drugs and other substances can interact with Contrave®, including alcohol, MAOIs (like isocarboxazid, linezolid, phenelzine, selegiline, or tranylcypromine), drugs that increase dopamine levels in your system (like levodopa and amantadine), drugs that affect the central nervous system (like antihistamines or medicine for allergies or colds, sedatives, tranquilizers, or sleeping medication), drugs for depression or anxiety, antipsychotics, theophylline, systemic corticosteroids, prescription pain medicine or narcotics, medicine for attention deficit and hyperactivity disorder (ADHD), medicine for seizures or barbiturates, muscle relaxants, anesthetics, including some dental anesthetics, dextromethorphan, diarrhea medication (such as diphenoxylate), disulfiram, opioid pain or cough relievers (such as codeine and hydrocodone), thioridazine.

Avoid drinking alcohol while taking Contrave®.

Please consult the pharmaceutical packaging for a full list of side effects, warnings, interactions, and additional information.

To report suspected adverse reactions to Contrave®, contact the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

In case of emergencies, please call 911 or go to the nearest emergency room.