How Does Contrave Work for Weight Loss?

If you’re trying to lose weight and diet and exercise alone aren’t moving the needle, your prescriber may recommend a weight-loss medication to help. And Contrave (naltrexone / bupropion) is a possible option. It’s an oral weight-loss medication with two active ingredients. But how does Contrave work to help you lose weight?

How does Contrave work for weight loss?

Contrave is a weight-loss medication that combines two different medications: naltrexone (Vivitrol) and bupropion (Wellbutrin XL). Each of these ingredients is available on its own for different uses. 

Naltrexone is an opioid blocker (antagonist). It blocks the rewarding effects of substances such as opioids and alcohol. And it's used to treat substance use disorders. Bupropion is an antidepressant. It raises the levels of chemicals in the brain (dopamine and norepinephrine) to improve mood and help you quit smoking.

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We haven’t pinned down exactly how Contrave works for weight loss yet. But we do know that Contrave affects the brain’s appetite and reward centers. This may help you feel less hungry and have fewer food cravings.

Specifically, bupropion seems to increase the production of a hormone that’s connected with decreased appetite, higher energy use, and weight loss. And naltrexone blocks a receptor that stops the production of the same hormone, so it also helps keep hormone levels up.

Contrave may also affect the dopamine-driven reward system of the brain. This system rewards you with dopamine when you eat food, which makes you feel happy. But it can also play a role in weight gain if it isn’t working properly. By dialing this system down, Contrave seems to reduce food cravings, which can make it easier for some people to reduce their food intake and lose weight.

EXPERT PICKS: WHAT TO READ NEXT

• Tips for taking Contrave: Here are some pharmacist-backed tips for taking Contrave — including what foods to avoid — to help you get the most from your medication. 

• Contrave side effects: Learn what side effects to expect when you start taking Contrave, and when to seek medical care.

• Weight-loss medications: This list of weight-loss medication options and how they work can help you choose the best fit for your needs.

Are there steps you can take to help Contrave work better?

There are a few ways you can help Contrave work better for you. Try to integrate these tips into your routine to get the most out of your medication:

• Stick to a regular exercise routine. Contrave is meant to be used alongside regular exercise. Find an exercise that you enjoy and will stick with. Don’t be afraid to think outside the box — activities such as dancing, roller skating, and playing frisbee are all fun exercise options.

• Make nutritious food choices. It’s also recommended to follow a reduced-calorie diet while you’re taking Contrave. Since you may be eating less food overall, try to choose nutritionally dense foods. This will help you get the vitamins and nutrients you need to feel good and stay healthy. A whole-food diet full of fruits and vegetables, grains, and lean proteins may be a good approach. Avoid high-fat foods with Contrave, as they can change how your body absorbs the medication.

• Stay hydrated. Exercising more and eating or drinking less can dehydrate you. This can make you feel tired and foggy headed. So make an extra effort to drink fluids and stay hydrated throughout the day.

• Avoid or limit alcohol. Alcohol can interact with Contrave in several ways. Contrave can make you more sensitive to alcohol’s effects. Alcohol can raise the risk of seizures if you’re taking Contrave. And alcohol can also undermine your weight-loss efforts.

• Increase your dosage as prescribed. Contrave is started at a low dosage and then increased over several weeks. This gives your body time to adjust to the medication. Increasing your dose faster than recommended won’t make you lose more weight. But it will raise the chance that you’ll experience side effects such as nausea and dizziness.

Does Contrave stop working for weight loss after a certain amount of time?

Some people can take Contrave successfully long-term. But others may find they’re not getting the same weight-loss results after taking it for a while. This is called a weight-loss plateau, and it can happen with any weight-loss strategy.

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A weight loss plateau might happen for a few reasons. As you lose excess weight, you may experience a drop in your metabolism. You will also naturally burn fewer calories at a lower body weight.

To get out of a weight-loss slump, try changing up your workouts. Including strength training can help you build lean muscle mass to increase your metabolism. You may also need to adjust your daily calorie intake. A healthcare professional can help guide you if you’re experiencing slowed or stalled weight loss while taking Contrave.

Good to know: Contrave may not work for everyone. Your prescriber will monitor how you respond to Contrave over the first few months of treatment. If you haven’t lost at least 5% of your starting body weight after 12 weeks at the recommended dosage, they may decide a different medication is a better option for you.

Contrave alternatives

Contrave can be an effective weight-loss medication for many people when combined with diet and exercise. Some studies show that about 40% of adults lost at least 5% of their body weight after taking Contrave for 1 year. And over 15% of participants lost at least 10% of their body weight.

But if Contrave isn’t an option or doesn’t work well for you, there are other weight-loss medications available. They include:

• Phentermine (Adipex P, Qsymia)

• Qsymia (phentermine / topiramate ER)

• Orlistat (Xenical, Alli)

• GLP-1 agonists such as semaglutide (Wegovy), tirzepatide (Mounjaro), and liraglutide (Saxenda)

• Tirzepatide (Zepbound)

Your prescriber can talk through the risks and benefits of these medications to help you choose the one that best fits your needs.

How to save on Contrave

There are ways to save on Contrave, which is only available as a brand-name medication. GoodRx can help you navigate between patient assistance programs and copay savings cards to save money on your prescription.

• Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $20 per month for Contrave using a savings card from the manufacturer.

• Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for Contrave’s patient assistance program, which provides a month of medication for $99 or less.

Why trust our experts?

Written by:

Jill Barat, PharmD

Jill Barat, PharmD has nearly 10 years of experience as a pharmacist, including serving as the pharmacist in charge at an independent sterile and non-sterile compounding pharmacy. She also worked as the head of medical content for a telemedicine company.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Tegan Smedley, PharmD, APh

Tegan Smedley, PharmD, APh, has 10 years of experience as a pharmacist. She has worked in a variety of settings, including retail, hospital, and ambulatory care.

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