Key takeaways:
Contrave (naltrexone / bupropion) is a weight-loss medication that contains two active ingredients. It’s effective for weight loss when combined with a reduced-calorie diet and regular exercise.
Common Contrave side effects include nausea, constipation, and headache. Dizziness, insomnia, and dry mouth are also possible. These side effects may improve over time as your body adjusts to the medication.
More serious Contrave side effects include high blood pressure, seizures, and suicidal thoughts or behavior. Seek medical care right away for any Contrave side effects that seem severe or life-threatening.
There are ways to save on Contrave. GoodRx can help you access Contrave at an exclusive cash price of $199. A manufacturer savings program is also available.
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Contrave (naltrexone / bupropion) is an oral medication that combines two active ingredients to help you manage your weight. When combined with a reduced-calorie diet and regular exercise, Contrave is effective for weight loss.
If you're taking Contrave, or thinking about taking it, it’s helpful to be aware of its possible side effects. Here, we’ll go over common and rare Contrave side effects and what to do if they occur.
Contrave side effects at a glance
Below, there’s an overview of common and rare Contrave side effects reported in clinical studies. Keep in mind that this isn’t a complete list of possible side effects. Reach out to your healthcare team if you have any questions about what to expect while taking Contrave.
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Common or mild Contrave side effects include:
Nausea, vomiting, and stomach pain
Constipation
Headache
Dizziness
Insomnia
Dry mouth
Diarrhea
Anxiety or irritability
Hot flushes
Fatigue
Tremors
Taste changes
Rare but serious Contrave risks and side effects include:
Suicidal thoughts and behaviors
Mood changes
Seizures
Increased blood pressure and heart rate
Eye problems
Liver problems
Severe allergic reactions
Let’s take a look at nine possible Contrave side effects in more detail.
1. Nausea and vomiting
In the clinical trials for Contrave, nausea and vomiting were among the most common side effects reported. You’ll start with a low dose of Contrave and slowly increase it over time to help lessen nausea. Any nausea you experience may go away over time as your body gets used to the medication.
In the meantime, try sticking to bland foods and avoiding fried or spicy items. Eating smaller, more frequent meals may also help curb nausea. You should also avoid taking Contrave with high-fat meals. Fat increases how much Contrave you absorb, which can raise medication levels in your body and make nausea worse.
If you vomit after taking Contrave, check with your prescriber before taking another dose. You should also let them know if your nausea is severe or doesn’t improve. They may adjust your Contrave dosage or suggest a nausea medication to help you feel more comfortable.
2. Constipation
Constipation is another common Contrave side effect. Staying hydrated and choosing high-fiber foods may help prevent or improve constipation. Regular exercise can also help. Keep in mind that diarrhea is also possible with Contrave, although it’s not as common as constipation.
If lifestyle changes aren’t enough, check with your prescriber about trying an over-the-counter (OTC) constipation medication. And be sure to let them know if you have constipation that doesn’t improve or worsens over time. Untreated constipation can lead to other problems, such as hemorrhoids or a blockage in your intestines.
How to take Contrave: Understand what a typical Contrave dosage is and why it might vary from person to person.
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The science behind weight loss: Discover how your Contrave prescription works to help you achieve your target body weight.
3. Headache
Contrave can also cause headaches. This side effect may improve as your body adjusts to the medication. But there are steps you can take in the meantime to help.
As with constipation, staying hydrated and getting regular exercise can help with headaches. Be sure you’re also getting enough sleep and minimizing your alcohol intake. If needed, try an OTC pain medication, such as acetaminophen (Tylenol).
You should report severe or constant headaches to your healthcare team. There could be something else causing them that requires treatment. Or you may need a lower Contrave dosage.
4. Dizziness
Dizziness is another possible Contrave side effect. This may lessen over time as your body adjusts to the medication. But it’s good to be aware of the possibility of dizziness, as it can raise your risk of falls or accidents.
If you’re feeling dizzy, move slowly and carefully to avoid falls. And use caution when driving or doing other activities that require coordination until you know how Contrave affects you.
Keep in mind that dizziness can also be a sign that you’re not eating enough. So be sure to choose nutrient-dense foods. You can also try eating smaller, more frequent meals if your appetite is low.
If you experience dizziness that’s severe or doesn’t improve with time, talk with your healthcare team about next steps.
5. Insomnia
While it’s not common, Contrave can cause trouble sleeping (insomnia). Some general tips to help improve sleep include:
Have a set sleep schedule.
Keep your bedroom cool and dark.
Avoid using electronics before bedtime.
Avoid caffeine, nicotine, and alcohol before you go to sleep.
Do relaxing activities before bedtime (meditation, listening to music, reading).
Maintain a regular exercise routine.
Avoid naps during the day.
If your prescriber OKs it, taking an OTC sleep medication or supplement, such as melatonin, may also help. But these sleep aids are only meant for short-term use in most cases. If your insomnia continues, talk to your prescriber about other options.
6. Dry mouth
Dry mouth can be a bothersome Contrave side effect. It may go away over time, but it can also persist for some people. It’s a good idea to take steps to manage dry mouth, because it can negatively affect your dental health if left unaddressed.
Strategies to relieve dry mouth include sipping on water throughout the day, chewing sugar-free gum, and using OTC saliva-substitute products. And be sure you’re drinking enough fluids. It’s also a good idea to limit caffeine, alcohol, and nicotine, since they can worsen dry mouth symptoms.
It’s good to stay on top of regular teeth cleanings to make sure dry mouth isn’t causing any dental problems. If this side effect worsens or becomes bothersome, talk with your prescriber (or dentist) about your options.
7. Increased blood pressure and heart rate
Contrave can raise your blood pressure and heart rate while you’re taking it. This side effect is most common in the first 3 months of treatment. But it can happen at any time.
Your prescriber will likely keep an eye on your blood pressure for the first few months that you’re taking Contrave. They may also ask you to check your blood pressure at home. If your blood pressure reading is high or you’re feeling symptoms such as chest pain or heart palpitations, you should seek medical care right away.
Let your prescriber know if you have high blood pressure or other heart problems before starting Contrave. This medication may not be the best option for you.
8. Increased risk of seizures
While rare, Contrave may raise the risk of seizures for some people, especially at high dosages. Seizures are more likely if you have a history of seizures or are taking other medications that can make seizures more likely.
To limit your risk, it’s recommended that you:
Take no more than 4 Contrave tablets per day.
Divide your daily Contrave dosage into two doses.
Gradually increase your Contrave dosage over time.
Avoid taking Contrave with high-fat meals.
If you have a seizure while being treated with Contrave, seek medical care right away. You’ll likely need to stop taking the medication.
9. Suicidal thoughts or behavior
Bupropion, an antidepressant medication, is one of the active ingredients in Contrave. The FDA requires antidepressants to carry a boxed warning, their most serious medication warning, about the potential for an increased risk of suicidal thoughts and behaviors. This increased risk is more likely in people under the age of 25.
Talk to your prescriber immediately if you or a loved one notices mood changes, worsening depression, or thoughts of suicide while you’re taking Contrave.
If you or someone you know is having thoughts of suicide, you’re not alone, and help is available. Call the National Suicide Prevention Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.
How to save on Contrave
There are ways to save on Contrave, which is available as a brand-name medication. GoodRx can help you navigate between GoodRx coupons and copay savings cards to save money on your prescription.
Save with GoodRx: Anyone with a valid prescription, regardless of insurance status, can use GoodRx to purchase a 30-day supply of Contrave at an exclusive cash price of $199.
Save with a copay savings card: If you have commercial insurance that covers Contrave, you may be eligible to pay as little as $20 for Contrave using a savings card from the manufacturer.
Save with CurAccess: Contrave’s manufacturer, Currax Pharmaceuticals, offers a savings program called CurAccess for people with or without insurance. This program can help you access Contrave for $99 or less per month (with free delivery).
Frequently asked questions
We don’t know exactly how Contrave works for weight loss. Contrave combines two medications: bupropion and naltrexone. They work on areas of the brain that are involved in regulating appetite and the brain’s reward system. This seems to help reduce hunger and food cravings.
Studies haven’t shown that taking Contrave raises the risk of serious heart problems. But it may cause a small increase in your blood pressure and heart rate, especially during the first few months of taking it. That’s why Contrave isn’t recommended for people living with uncontrolled high blood pressure. Let your prescriber know if you have high blood pressure or heart problems before starting Contrave so they can help you decide if it’s safe.
Contrave isn’t recommended if you:
Have uncontrolled high blood pressure
Have a seizure disorder
Have experienced an eating disorder (anorexia or bulimia)
Recently stopped drinking alcohol
Recently stopped taking certain anxiety, sleep, headache, or anti-seizure medications
Have taken a monoamine oxidase inhibitor (MAOI) in the past 14 days
Take opioid medications regularly
Take another medication that contains bupropion (Wellbutrin SR, Wellbutrin XL)
Have had an allergic reaction to any of the ingredients in Contrave
Be sure to discuss your health history and current medication list with your prescriber. They can help determine if Contrave is safe for you.
We don’t know exactly how Contrave works for weight loss. Contrave combines two medications: bupropion and naltrexone. They work on areas of the brain that are involved in regulating appetite and the brain’s reward system. This seems to help reduce hunger and food cravings.
Studies haven’t shown that taking Contrave raises the risk of serious heart problems. But it may cause a small increase in your blood pressure and heart rate, especially during the first few months of taking it. That’s why Contrave isn’t recommended for people living with uncontrolled high blood pressure. Let your prescriber know if you have high blood pressure or heart problems before starting Contrave so they can help you decide if it’s safe.
Contrave isn’t recommended if you:
Have uncontrolled high blood pressure
Have a seizure disorder
Have experienced an eating disorder (anorexia or bulimia)
Recently stopped drinking alcohol
Recently stopped taking certain anxiety, sleep, headache, or anti-seizure medications
Have taken a monoamine oxidase inhibitor (MAOI) in the past 14 days
Take opioid medications regularly
Take another medication that contains bupropion (Wellbutrin SR, Wellbutrin XL)
Have had an allergic reaction to any of the ingredients in Contrave
Be sure to discuss your health history and current medication list with your prescriber. They can help determine if Contrave is safe for you.
The bottom line
Contrave (naltrexone / bupropion) is a medication that may help you manage your weight when combined with a reduced-calorie diet and regular exercise. Common Contrave side effects include nausea, constipation, and headache. Dizziness, insomnia, and dry mouth are also possible. These side effects may improve as your body adjusts to Contrave.
More serious Contrave side effects include high blood pressure, seizures, and suicidal thoughts. Let your prescriber know if you experience any side effects that are bothersome or concerning while taking Contrave. And seek emergency care for any side effects that seem dangerous or life-threatening.
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References
CADTH Common Drug Review. (2020). Clinical Review Report: Naltrexone Hydrochloride and Bupropion Hydrochloride (Contrave). Canadian Agency for Drugs and Technologies in Health.
Contrave. (n.d.). Save on Contrave.
Dahlberg, S., et al. (2022). Use of Contrave, naltrexone with bupropion, bupropion, or naltrexone and major adverse cardiovascular events: A systematic literature review. Diabetes, Metabolic Syndrome and Obesity.
MedlinePlus. (2023). Malnutrition.
Nalpropion Pharmaceuticals. (2025). Contrave extended-release - naltrexone hydrochloride and bupropion hydrochloride tablet, extended release [package insert].
National Institute of Dental and Craniofacial Research. (2024). Dry mouth.
