Naltrexone and Bupropion Medication Guide

How Naltrexone and Bupropion Works


Naltrexone and Bupropion are prescription medication which contains 2 medicines 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 Naltrexone and Bupropion leading to weight loss are not fully understood. Naltrexone and Bupropion are 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.

Naltrexone and Bupropion Dosing and Storage Instructions

How To Take Naltrexone and Bupropion

You should take Naltrexone and Bupropion as directed. Naltrexone and Bupropion dosing should be increased slowly according to the dosing schedule below. Please contact your physician if you have questions.
Starting: Week 1 & 2
1 Bupropion XL Tablet (150mg) + 1/2 (cut in half) Naltrexone Tablet (25mg)
None
Week 3-4
2 Bupropion XL Tablet (150mg) + 1 Naltrexone Tablet (50mg)
None
Maintenance (Rx#2)
1 Bupropion XL tablet (300mg) + 1 Naltrexone tablet (50mg)
None
Note: Please use the provided pill cutter to cut your Naltrexone tablet in half to get the correct dosage. Your doctor may recommend you increase to 300mg Bupuprion tablets after week 3 based on your results and side effects to the medications.
  • Bupropion tablets should be taken whole. Do not cut, chew or crush your Bupropion tablets.
  • Naltrexone tablets may be cut in half using the provided pill cutter. Do not chew or crush your Naltrexone tablets.
  • Do not take Naltrexone and Bupropion with high-fat meals. It may increase your risk of seizure.

What If I Miss a Dose of Naltrexone and Bupropion? 

If you miss a dose of Naltrexone and Bupropion (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.

How To Store Your Naltrexone and Bupropion Tablets

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

When Should I Stop Taking Naltrexone and Bupropion?

  • 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 25, message your doctor. Your doctor may recommend you transition to a maintenance dose to maintain your weight loss.
  • If you believe you may have a BMI less than 27, please proactively communicate with your doctor every month regarding your current weight because it may inform the dosage for future prescriptions.
  • You should stop taking Naltrexone and Bupropion if you, are experiencing any of these severe side effects: GoodRx® (Naltrexone) and GoodRx® (Bupropion).

Refilling Your Prescription &
Communicating with Your Pine Medical Physician

How To Refill Your Naltrexone and Bupropion Prescription

For the first one to three months of the Pine Medical program, refilling your Naltrexone and Bupropion 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 Naltrexone and Bupropion.

Every month, we will reach out via email during Week 3 to initiate your check-in with your physician. You can also initiate a check in 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 Naltrexone and Bupropion FAQs

What Are the Serious Side Effects of Naltrexone and Bupropion?

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 Naltrexone and Bupropion and call 911 or go to an emergency room:

  • Sudden opioid withdrawal. People who take Naltrexone must not use any type of opioid for at least 7-10 days before starting Naltrexone. Common opiate medications include Suboxone, methadone, buprenorphine, Norco, Vicodin, Percocet, T3, Hydrocodone, oxycodone, MS Contin, morphine, Dilaudid, hydromorphone, tramadol, Ultram, or codeine.
  • Suicidal thoughts or actions
  • Seizures (you should not take Naltrexone and Bupropion again if you have a seizure).
  • Risk of opioid overdose. Naltrexone can increase your chance of having an opioid overdose if you take opioid medicines while taking Naltrexone.
  • 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)
  • Learn more about Naltrexone at the possible side effects, visit GoodRx®
  • Learn more about Bupropion at the possible side effects, visit GoodRx®

What Are the Common Side Effects of Naltrexone and Bupropion?

  • Common side effects of Naltrexone and Bupropion 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 Naltrexone and Bupropion. If you experience nausea, you may also want to eat a small amount of dry toast with your dose.
  • Learn more about Naltrexone at the possible side effects, visit GoodRx®
  • Learn more about Bupropion at the possible side effects, visit GoodRx®

Who Should Not Take Naltrexone and Bupropion?

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 Naltrexone and Bupropion. If you develop any of these conditions after starting your prescription, please stop using Naltrexone and Bupropion 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 Contrave, 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. Common opiate medications include Suboxone, methadone, buprenorphine, Norco, Vicodin, Percocet, T3, Hydrocodone, oxycodone, MS Contin, morphine, Dilaudid, hydromorphone, tramadol, Ultram, or codeine.
  • 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 Naltrexone and Bupropion until you have stopped taking your MAOI for at least 14 days
  • Are allergic to naltrexone or bupropion or any of the ingredients in Naltrexone and Bupropion.

Additional Online Resources

Last Updated: 06/04/2023

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