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    DEA Class;  Rx

    Common Brand Names; Contrave

    • Antidepressants, Dopamine Reuptake Inhibitors; 
    • Opioid Antagonists

    Combination of an aminoketone antidepressant (bupropion) and an opioid antagonist (naltrexone)
    Used for weight loss and management in obese adults or overweight adults with at least 1 weight-related comorbidity
    Do not take with other bupropion products; monitor for depression, mood changes, and neuropsychiatric events

    Indicated for the treatment of obesity and for chronic weight management as an adjunct to a reduced-calorie diet and increased physical activity.

    Uncontrolled hypertension

    Seizure disorder or a history of seizures

    Use of other bupropion-containing products

    Bulimia or anorexia nervosa, which may increase risk of seizures

    Long-term opioid or opiate agonists use or acute opiate withdrawal

    Patients undergoing abrupt discontinuation of alcohol, benzodiazepines, barbiturates, or antiepileptic drugs

    Within 14 days of monoamine oxidase inhibitor therapy



    • Nausea (32.5%)
    • Constipation (19.2%)
    • Headache (17.6%)
    • Vomiting (10.7%)
    • Dizziness (9.9%)
    • Insomnia (9.2%)
    • Dry mouth (8.1%)
    • Diarrhea (7.1%)
    • Anxiety (4.2%)
    • Hot flash (4.2%)
    • Fatigue (4%)
    • Tremor (4%)
    • Upper abdominal pain (3.5%)
    • Viral gastroenteritis (3.5%)
    • Influenza (3.4%)
    • Tinnitus (3.3%)
    • Urinary tract infection (3.3%)
    • Hypertension (3.2%)
    • Abdominal pain (2.8%)
    • Hyperhidrosis (2.6%)
    • Irritability (2.6%)
    • Increased blood pressure (2.4%)
    • Dysgeusia (2.4%)
    • Rash (2.4%)
    • Muscle strain (2.2%)
    • Palpitations (2.1%)
    • Tachycardia
    • Myocardial infarction
    • Vertigo
    • Motion sickness
    • Lower abdominal pain
    • Eructation
    • Lip swelling
    • Hematochezia
    • Hernia
    • Feeling jittery
    • Thirst
    • Feeling hot
    • Asthenia
    • Cholecystitis
    • Pneumonia
    • Staphylococcal infection
    • Kidney infection
    • Increased creatinine clearance
    • Increased hepatic enzymes
    • Decreased hematocrit

    Monitor patients for suicidal ideation or behavior and for unusual changes in behavior (see black box warning)

    Discontinue therapy and do not restart if seizure occurs while on therapy; use caution when prescribing to patients with predisposing risk factors for seizures

    Not for administration to patients receiving long-term opioids, owing to naltrexone component (opioid antagonist); discontinue therapy if long-term opiate therapy required

    Following therapy, patients may be more sensitive to opioids, even at lower doses

    A patient should not attempt to overcome naltrexone opioid blockade by administering large amounts of exogenous opioids; may lead to fatal overdose

    Opioid-dependent patients, including those being treated for alcohol dependence, should be opioid-free (including tramadol) before therapy is initiated; opioid-free interval of a minimum of 7-10 days is recommended for patients previously dependent on short-acting opioids; patients transitioning from buprenorphine or methadone may need as long as 2 weeks

    Blood pressure and pulse should be measured prior to starting therapy and should be monitored at regular intervals, particularly among patients with controlled hypertension prior to treatment

    Discontinue therapy if symptoms or signs of acute hepatitis occur

    Screen patients for a history of bipolar disorder and the presence of risk factors for bipolar disorder; therapy was not studied in patients receiving antidepressant medications patients with a history of bipolar disorder or recent hospitalization foor psychiatric illness were excluded from clinical trials

    Angle-closure attack may occur in patients with anatomically narrow angles that do not have a patent iridectomy

    Measure blood glucose levels prior to and during therapy; patients who develop hypoglycemia after initiating Contrave therapy should adjust antidiabetic drug regimen

    Use caution in patients with history of tumor or infection of the brain or spine

    Initiation of therapy in patients receiving linezolid or intravenous (IV) methylene blue

    Use caution in hepatic impairment

    May precipitate a manic, mixed, or hypomanic episode; risk higher in patients with bipolar disorders or have risk factors for bipolar disorder, including family history of bipolar disorder, suicide, or depression; not FDA approved for bipolar depression

    Weight loss offers no benefit to a pregnant patient and may cause fetal harm; when a pregnancy is recognized, advise pregnant patient of risk to fetus

    Data from published literature report the presence of bupropion and its metabolites in human milk


    32 mg naltrexone/360 mg bupropion PO daily.


    32 mg naltrexone/360 mg bupropion PO daily; use with caution.


    Safety and efficacy have not been established.


    Safety and efficacy have not been established.


    Safety and efficacy have not been established.


    Safety and efficacy have not been established.

    Bupropion hydrochloride/naltrexone hydrochloride

    Oral Tab ER: 8-90mg