Contrave® Medication Guide

How Contrave® Works


Contrave® is prescription medication which contains 2 medicines (naltrexone and bupropion) that may help some obese and overweight adults, who also have weight related medical problems, lose weight and keep weight off.

The exact neurochemical effects of Contrave® leading to weight loss are not fully understood. Contrave® is believed to work on two areas of the brain—the hypothalamus (your hunger center) to help reduce hunger and the mesolimbic reward system to help control cravings—that can get in the way of weight loss.

Dosing and Storage Instructions

How To Take Contrave®

You should take Contrave® exactly as your doctor tells you to. Contrave® dosing should be increased slowly according to the dosing schedule below. A total of 4 Contrave® pills, 2 pills taken twice per day, should be reached at the start of week 4.
Starting: Week 1
1 tablet
None
Week 2
1 tablet
1 tablet
Week 3
2 tablet
1 tablet
Week 4 Onward
2 tablets
2 tablets
Contrave® tablets should be taken whole. Do not cut, chew or crush your Contrave® tablets. Do not take more than 2 tablets in the morning and 2 tablets in the evening. Do not take more than 2 tablets at the same time or more than 4 tablets in 1 day.
  • Contrave® tablets should be taken whole. Do not cut, chew or crush your Contrave® tablets.
  • Do not take more than 2 tablets in the morning and 2 tablets in the evening.
  • Do not take more than 2 tablets at the same time or more than 4 tablets in 1 day.
  • Do not take Contrave® with high-fat meals. It may increase your risk of seizure.

What If I Miss a Dose of Contrave®

If you miss a dose of Contrave® (which could be 1 or 2 tablets), skip that dose and take your next dose at your regularly scheduled time. You should not add the tablets you missed to your next dose. Only one dose of Contrave® should be taken at a time.

How To Store Your Contrave® Tablets

  • Store your Contrave® tablets at room temperature, between 68°F to 77°F.
  • Keep your Contrave® tablets out of the reach of children. 

When Should I Stop Taking Contrave®?

  • At the beginning of the Pine Medical program, you communicate your goal weight to your Pine Medical physician. If you achieve your goal weight or achieve a body mass index (BMI) less than 27, message your doctor. Your doctor may recommend you transition to a maitenance dose to maintain your weight loss.
  • If you believe you may have a BMI less than 30, please proactively communicate with your doctor every month regarding your current weight because it may inform the dosage for future prescriptions.

Refilling Your Prescription &
Communicating with Your Pine Medical Physician

How To Refill Your Contrave® Prescription

For the first one to three months of the Pine Medical program, refilling your Contrave® prescription requires a monthly check-in with your Pine Medical physician. During this check-in, your physician will evaluate your weight-loss progress and determine whether it is safe to prescribe a refill of Contrave®.

Every month, we will reach out to via email during Week 3 to initiate your check-in with your physician. You can also initiate a checkin by emailing support@pinemedical.com.

When You Should Message Your Pine Medical Physician

You are able to message your physician at any time through the Pine Medical messaging portal. In addition, below are specific times you should reach out to your Pine Medical physician:

  • Any time you experience severe side effects.
  • Any time you have been hospitalized with other medical conditions, or started new medications.
  • Any time your BMI is less than 27.

Additional Contrave® FAQs

What Are the Serious Side Effects of Contrave®?

Even though it may be rare, some people may experience very bad and sometimes deadly side effects when taking a medication. If you experience any of the following serious side effects and feel like you are experiencing a medical emergency, you should stop taking Contrave® and call 911 or go to an emergency room:

  • Suicidal thoughts or actions
  • Seizures (you should not take Contrave® again if you have a seizure).
  • Risk of opioid overdose. One of the ingredients in Contrave® (naltrexone) can increase your chance of having an opioid overdose if you take opioid medicines while taking Contrave®.
  • Sudden opioid withdrawal. People who take Contrave® must not use any type of opioid for at least 7-10 days before starting Contrave®.
  • Severe allergic reactions, including signs and symptoms include rash, itching, hives, fever, swollen lymph glands, painful sores in your mouth or around your eyes, swelling of your lips or tongue, chest pain, or trouble breathing.
  • Increases in blood pressure or heart rate
  • Liver damage or hepatitis, including symptoms such as stomach area pain lasting more than a few days, dark urine, yellowing of the whites of your eyes, or tiredness.
  • Manic episodes
  • Visual problems, including symptoms such as of angle-closure glaucoma include eye pain, changes in vision, swelling, or redness in or around the eye.
  • Low blood sugar (hypoglycemia) in people with type 2 diabetes mellitus who also take medicines to treat their diabetes (such as insulin or sulfonylureas)
  • See Full Prescribing Information or the Medication Guide to learn more about the possible side effects of Contrave®.

What Are the Common Side Effects of Contrave®?

  • Common side effects of Contrave® include nausea, constipation, headache, vomiting, dizziness, trouble sleeping (insomnia), dry mouth, and diarrhea.
  • To manage common side effects, it is recommended you drink plenty of water like taking Contrave®. If you experience nausea, you may also want to eat a small amount of dry toast with your dose.
  • Visit the Contrave® Full Prescribing Information or the Contrave® Medication Guide to learn more about the possible side effects of Contrave.

Who Should Not Take Contrave®?

Your Pine Medical physician evaluated your health history prior to writing your initial prescription based on the medical intake form you filled out when signing up for Pine Medical. As a result, some patients may not be eligible to take Contrave®. If you develop any of these conditions after starting your prescription, please stop using Contrave® and reach out to your Pine Medical physician right away.

  • Have uncontrolled hypertension
  • Have or have had any seizures
  • Use other medications that constrain bupropion such as Wellbutrin, Wellbutrin SR, Wellbutrin XL, Aplenzin, and Zyban
  • Have or have had an eating disorder called anorexia (eating very little) or bulimia (eating too much and vomiting to avoid gaining weight)
  • Are dependent on opioid pain medicines or use medicines to help stop taking opioids, or are in opiate withdrawal
  • Drink a lot of alcohol or abruptly stop drinking, or use medicines called sedatives (these make you sleepy), benzodiazepines, or anti-seizure medicines and you stop using them all of a sudden
  • Are taking medicines called monoamine oxidase inhibitors (MAOIs). Ask your healthcare provider or pharmacist if you are not sure if you take an MAOI, including linezolid. Do not start Contrave® until you have stopped taking your MAOI for at least 14 days
  • Are allergic to naltrexone or bupropion or any of the ingredients in Contrave®. See the Contrave® Medication Guide for a complete list of ingredients in Contrave®

Additional Online Resources

Last Updated: 06/04/2023

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