Thinking about trying a prescription pill to shed stubborn pounds? You’ve probably heard the name Contrave tossed around in forums and doctor’s offices. The promise is simple: a medication that curbs appetite and boosts metabolism so you can lose weight without extreme dieting. But before you pop a pill, you need to know how it actually works, who should consider it, what results you can expect, and which risks are real enough to worry about. This guide walks you through every practical piece of the puzzle so you can decide if Contrave belongs in your weight‑loss plan.
- Quick TL;DR: Contrave is a combo of bupropion and naltrexone that targets hunger and cravings.
- Typical users are adults with BMI≥30 or BMI≥27 with weight‑related health issues.
- Clinical trials show an average 5‑10% body‑weight loss after a year, when paired with diet and exercise.
- Common side‑effects include nausea, headaches, and constipation; serious issues are rare but include elevated blood pressure.
- Start low, go slow: the dose titrates over four weeks to minimize side‑effects.
How Contrave Works and Who It’s Intended For
Contrave isn’t a magic‑bullet; it’s a brain‑focused formula. The drug pairs two older medicines:
- bupropion - an antidepressant that also ramps up dopamine and norepinephrine, neurotransmitters that keep you alert and help control appetite.
- naltrexone - originally used for alcohol and opioid dependence, it blocks opioid receptors that can trigger intense food cravings.
When these agents sit together in a single tablet, they create a feedback loop: bupropion stimulates the hypothalamus to reduce hunger, while naltrexone dampens the reward signals that make you reach for that extra slice of pizza. The result is fewer cravings and a steadier feeling of fullness.
Regulatory agencies (FDA, TGA) only approve Contrave for adults who meet one of two criteria:
- BMI≥30kg/m² (obesity) regardless of other health issues.
- BMI≥27kg/m²+at least one weight‑related condition (type2 diabetes, hypertension, high cholesterol, or sleep apnea).
If you’re under those numbers, the medication isn’t recommended because the risk‑benefit balance tips toward lifestyle changes alone. Talk to a doctor to confirm you fit the profile and that there aren’t any contraindications (e.g., seizure history, uncontrolled hypertension, or current opioid use).
What to Expect: Benefits, Dosing, and Real‑World Results
When you start Contrave, the first few weeks are about finding the right dose. The prescription follows a four‑step titration schedule designed to let your body adjust:
- Week1‑2: 1 tablet (8mg naltrexone+90mg bupropion) once daily.
- Week3‑4: 1 tablet twice daily.
- Week5‑6: 2 tablets twice daily (the full dose).
Most patients stay on the full dose for the remainder of treatment, unless side‑effects force a step‑down.
Clinical data give a realistic picture of weight loss. In the pivotal COR‑I and COR‑II trials (over 4,500 participants), the average weight change after 56weeks looked like this:
| Group | Mean % Body‑Weight Loss | ≥5% Loss (participants) | ≥10% Loss (participants) |
|---|---|---|---|
| Contrave + Lifestyle | 7.5% | 44% | 22% |
| Placebo + Lifestyle | 3.9% | 19% | 5% |
What does that mean for a person weighing 100kg? On average, you might see a 7-8kg drop after a year, provided you stick to the recommended diet‑exercise plan. The biggest gains happen in the first 12‑16weeks, then the curve flattens as your body adapts.
Key lifestyle tips to maximize results:
- Track calories for the first month - awareness alone cuts intake by ~200kcal/day.
- Aim for 150minutes of moderate aerobic activity each week (walking, cycling, swimming).
- Prioritize protein (20‑30% of daily calories) to preserve lean muscle.
- Stay hydrated - thirst is often mistaken for hunger.
Remember, Contrave is not a substitute for a healthy lifestyle. It’s an aid that makes those lifestyle changes easier to maintain.
Risks, Side‑Effects, and Frequently Asked Questions
Every medication carries a risk profile, and Contrave is no exception. Most users report mild to moderate symptoms that fade as the dose stabilizes. The most common side‑effects (≥5% of users) are:
- Nausea (often the first sign to appear during titration).
- Headache.
- Constipation.
- Dizziness.
- Dry mouth.
Serious but less frequent concerns include:
- Increased blood pressure or heart rate - monitor weekly for the first two months.
- Seizure risk - heightened if you have a seizure disorder or are on other seizure‑lowering meds.
- Psychiatric changes - rare, but watch for new or worsening depression, anxiety, or suicidal thoughts.
If any of these become severe, contact your prescriber immediately. Most clinicians advise a temporary pause or dose reduction before considering discontinuation.
Below are the top queries people ask after hearing about Contrave:
- Can I take Contrave with other weight‑loss pills? Generally no. Combining appetite‑suppressants can raise heart‑rate and blood‑pressure risks.
- Do I need to stop drinking alcohol? Moderate drinking (up to 1 drink per day for women, 2 for men) is usually acceptable, but heavy use worsens liver strain and can trigger nausea.
- What happens if I miss a dose? Take the missed tablet as soon as you remember, unless it’s almost time for the next dose - then skip the missed one. Never double‑dose.
- Is Contrave safe during pregnancy? No. Both bupropion and naltrexone cross the placenta and are listed as Category C. Women planning pregnancy should discuss alternatives with their doctor.
- How long can I stay on the medication? The FDA approves long‑term use as long as benefits continue and adverse effects are managed. Most prescribers reassess every 3‑6months.
Typical troubleshooting steps:
- Persistent nausea after reaching full dose - try taking the tablet with a small snack, or split the dose (morning/evening) if your doctor agrees.
- Blood‑pressure rise >140/90mmHg - confirm with home readings, cut back on sodium, and schedule a check‑in with your GP.
- Plateau after 6 months - revisit your diet log, increase activity intensity, or discuss a brief drug holiday with your clinician.
Bottom line: Contrave works best when you treat it as a tool, not a miracle cure. Pair it with realistic diet changes, regular movement, and routine medical monitoring, and you’ll set yourself up for sustainable weight loss.
Quick Reference Checklist
- Confirm BMI≥30, or≥27+weight‑related condition.
- Rule out seizure history, uncontrolled hypertension, current opioid use.
- Start with low dose: 1tablet daily, titrate over 4weeks.
- Track weight, blood pressure, and side‑effects weekly for the first 2months.
- Maintain a calorie‑controlled diet (≈500kcal deficit) and ≥150min/week exercise.
- Revisit progress with your doctor every 3‑6months.
Ready to see if Contrave fits your weight‑loss journey? Talk to a healthcare professional, get a prescription, and follow the plan above. With the right expectations and a steady routine, many people find the medication gives them the mental edge they need to finally drop those extra pounds.
