Contrave combines two medications—naltrexone and bupropion—to help adults with obesity or overweight conditions lose weight. Approved by the FDA for chronic weight management, it targets brain pathways that control appetite and cravings. When paired with a reduced-calorie diet and increased physical activity, it offers an option for those struggling with traditional methods alone.
Many people turn to Contrave when lifestyle changes fall short of significant results. Clinical studies show it can lead to meaningful weight loss for a portion of users. However, like any prescription medication, it comes with potential side effects and considerations that vary by individual.
Understanding both the advantages and limitations helps make an informed decision. Always consult a healthcare provider to see if it fits your health profile. This balanced view supports realistic expectations for long-term success.
What Is Contrave and How Does It Work
Contrave contains extended-release naltrexone, an opioid antagonist, and extended-release bupropion, an antidepressant and smoking cessation aid. Together, they influence the hypothalamus and mesolimbic dopamine system in the brain. This dual action reduces hunger signals and curbs food cravings.
The medication does not work through metabolism boosting or fat absorption blocking. Instead, it helps users feel fuller sooner and resist emotional eating triggers. Dosing starts low and gradually increases over four weeks to minimize side effects.
It requires ongoing use alongside diet and exercise for sustained benefits. Discontinuing often leads to weight regain if habits revert. Regular medical monitoring ensures safe continuation.
Pros and Cons of Contrave
Many appreciate Contrave for its non-surgical approach to weight loss. It suits those who prefer oral medication over injections. User experiences highlight reduced cravings as a key benefit.
Potential drawbacks include gastrointestinal issues that affect daily comfort. Not everyone achieves substantial weight loss. Cost and insurance factors play a role in accessibility.
Weighing these elements personally matters most. A doctor’s guidance tailors the decision to individual needs. Monitoring progress helps determine if benefits outweigh any challenges.
Key Advantages of Using Contrave
Clinical trials demonstrate average weight loss of about 5-6% of starting body weight over one year. Some participants lose 10% or more with consistent adherence. This level often improves related health markers like blood pressure.
Reduced food cravings stand out as a major plus. Many report easier portion control and fewer urges for high-calorie snacks. This supports better adherence to calorie-restricted plans.
The combination of ingredients draws from established drugs. Bupropion’s energizing effects sometimes boost mood and motivation. Naltrexone helps block reward pathways tied to overeating.
Potential Drawbacks and Side Effects
Common side effects include nausea, constipation, headache, and dizziness. These often occur early and may improve with time or dose adjustments. Vomiting, dry mouth, and insomnia also appear frequently.
More serious risks involve increased blood pressure or heart rate in some users. Rare but important concerns include seizure risk, especially with certain predispositions. Mood changes or suicidal thoughts warrant immediate attention.
Gastrointestinal discomfort leads some to discontinue treatment. Tolerance varies widely among individuals. Long-term data on cardiovascular outcomes remains limited.
Effectiveness in Clinical Studies
In major trials, around 40-50% of participants achieved at least 5% weight loss compared to 15-20% on placebo. This threshold links to meaningful health improvements. Results appeared within the first few months for responders.
Early weight loss predicts longer-term success. Those losing 5% by week 12 or 16 often continued progressing. Diet and exercise amplified outcomes across studies.
Real-world experiences align with trial data for many. Some achieve 20-40 pounds lost over months. Others see modest or no change despite effort.
Cost and Accessibility Considerations
Without insurance, Contrave can cost several hundred dollars monthly. Manufacturer savings programs reduce this to around $99 per month for eligible patients. Free shipping often applies through official channels.
Many insurance plans cover it partially or fully with prior authorization. Medicare coverage varies by plan specifics. Checking benefits early avoids surprises.
Generic versions remain unavailable currently. This keeps costs higher than some alternatives. Patient assistance programs help bridge gaps for qualifying individuals.
Comparing Contrave to Lifestyle Changes Alone
| Aspect | Contrave with Diet & Exercise | Diet & Exercise Alone |
|---|---|---|
| Average Weight Loss | 5-6% body weight (about 12 lbs from 200 lbs starting) over 1 year in trials | 3-5% body weight typically sustained long-term |
| Appetite Control | Strong reduction in cravings and hunger signals via brain pathways | Relies on willpower; gradual adaptation possible |
| Speed of Results | Noticeable within 4-12 weeks for responders | Slower, often 1-2 lbs per week max |
| Side Effects/Risks | Common: nausea, headache; Rare: BP increase, seizures | Minimal medication risks; possible fatigue or injury from overexercise |
| Sustainability | Requires ongoing medication; weight regain common upon stopping | Builds lasting habits; higher maintenance without meds |
| Cost | $99-$500+/month depending on insurance/savings | Low ongoing cost beyond food/exercise resources |
| Suitability | For BMI ≥30 or ≥27 with comorbidities | Broadly suitable; first-line recommendation |
This comparison highlights how Contrave augments lifestyle efforts. It does not replace them entirely. Individual factors determine the best fit.
Who Might Benefit Most from Contrave
Adults with obesity (BMI 30+) or overweight (BMI 27+) plus conditions like hypertension or type 2 diabetes often qualify. Those with strong cravings or emotional eating patterns may respond well. Motivation to combine medication with behavioral changes proves essential.
People who failed previous diet attempts sometimes find added support helpful. Early responders—those losing 5% in initial months—tend to continue successfully. Healthcare providers assess contraindications carefully.
Avoidance applies to those with uncontrolled hypertension, seizure history, or opioid use. Eating disorders or certain psychiatric conditions require extra caution. Personalized evaluation ensures safety.
Important Safety Warnings and Monitoring
Contrave carries a boxed warning for increased suicidal thoughts in some users, particularly younger adults. Close monitoring during initial weeks helps catch mood shifts early. Report any concerning changes promptly.
Blood pressure and heart rate checks occur regularly. Ophthalmic exams screen for rare risks. Avoid abrupt discontinuation to prevent withdrawal effects.
Interactions with other medications, like MAOIs or opioids, pose dangers. Full disclosure to prescribers prevents complications. Pregnancy and breastfeeding contraindicate use.
Lifestyle Integration for Best Results
Pairing Contrave with a 500-1000 calorie daily deficit promotes steady progress. Focus on nutrient-dense foods to combat potential constipation. Regular physical activity, starting with walking, enhances outcomes.
Tracking food intake and weight supports accountability. Behavioral strategies address emotional triggers. Support groups or counseling reinforce long-term habits.
Hydration and fiber intake ease common side effects. Patience during dose titration prevents discouragement. Consistent routines maximize medication benefits.
Summary
Contrave offers a valuable tool for weight management by curbing appetite and cravings through its unique combination. Clinical evidence supports modest but meaningful loss for many, especially when combined with diet and exercise. Side effects remain a common hurdle, though often manageable.
Pros include reduced hunger, potential mood benefits, and non-invasive delivery. Cons encompass gastrointestinal issues, cost barriers, and variable efficacy. Careful medical supervision ensures appropriate use.
Ultimately, success depends on individual response and commitment to lifestyle changes. Discuss options thoroughly with a provider. Sustainable health improvements prioritize safety and realism.
FAQ
How much weight can I expect to lose on Contrave?
Most users lose 5-6% of starting body weight over a year with diet and exercise. Some achieve 10% or more if they respond well early. Results vary based on adherence and individual factors.
Early progress, like 5% loss in the first months, predicts better long-term outcomes. Not everyone reaches significant loss. Regular check-ins help assess effectiveness.
What are the most common side effects of Contrave?
Nausea, constipation, headache, and dizziness top the list for many users. Vomiting, dry mouth, insomnia, and diarrhea occur frequently too. These often lessen after the first few weeks.
Starting with lower doses helps minimize discomfort. Staying hydrated and eating fiber-rich foods eases digestive issues. Report persistent problems to your doctor promptly.
Is Contrave covered by insurance?
Coverage depends on your specific plan and medical necessity. Many insurers require prior authorization for approval. Manufacturer savings can reduce costs significantly if denied.
Check with your provider or pharmacy for exact details. Programs often cap out-of-pocket at around $99 monthly for eligible patients. Explore all options early.
Can I take Contrave long-term?
Yes, Contrave is approved for chronic weight management with ongoing use. Many continue if benefits persist and side effects remain tolerable. Periodic evaluations monitor safety.
Weight regain commonly occurs upon stopping. Sustained lifestyle changes support maintenance. Your doctor guides duration based on progress and health.
Does Contrave interact with other medications?
It can interact with opioids, MAO inhibitors, and certain antidepressants or seizure drugs. These combinations raise serious risks like withdrawal or seizures. Full medication lists prevent issues.
Alcohol or stimulants may amplify side effects like blood pressure changes. Always inform prescribers of all substances used. Professional review ensures compatibility.
Who should not take Contrave?
People with uncontrolled high blood pressure, seizure disorders, or eating disorders face higher risks. Those using opioids or in acute opioid withdrawal should avoid it. Pregnancy and breastfeeding contraindicate use.
History of suicidal thoughts requires careful consideration. Certain allergies or liver issues may preclude it too. A thorough medical history determines suitability.
Dr. Hamza is a medical content reviewer with over 12+ years of experience in healthcare research and patient education. He specializes in evidence-based health information, medications, and chronic conditions. His reviews are grounded in trusted medical sources and current clinical guidelines to ensure accuracy, transparency, and reliability. Content reviewed by Dr. Hamza is intended for educational purposes and is not a substitute for professional medical advice.