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. 

Contrave (naltrexone / bupropion) is one possible option that comes as an oral tablet. But how does Contrave work to help you lose weight? And are there steps you can take to help it work? Here’s what you should know.

How does Contrave work for weight loss?

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.

Contrave 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 levels of the brain chemicals dopamine and norepinephrine to improve mood. It can also help you quit smoking.

When it comes to weight management, bupropion seems to increase the production of a hormone called alpha-MSH that’s connected with decreased appetite, higher energy use, and weight loss. Naltrexone helps keep this hormone active by stopping your body from turning it off too quickly.

Contrave may also affect the dopamine-driven reward system of the brain. This system releases 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. Contrave seems to reduce food cravings by dialing this system down. This can make it easier for some people to reduce their food intake and lose weight.

In studies, Contrave proved to be an effective option for weight loss. Participants lost an average of about 8% of their starting body weight after 56 weeks (a little over 1 year) of treatment.

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. A good starting point is 30 minutes of activity 3 days a week. Find an exercise 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 taking Contrave. Since you may be eating less 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 can be a good approach. But don’t take Contrave with high-fat meals, as they can change how your body absorbs the medication.

• Stay hydrated. Exercising more and consuming less food 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 interacts with Contrave in several ways. Contrave can make you more sensitive to alcohol’s effects. And drinking alcohol with Contrave can raise the risk of seizures, a rare but serious side effect of the medication. Alcohol can also undermine your weight-loss efforts.

• Increase your dosage as prescribed. Contrave is started at a low dosage, which is 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 your chances of experiencing 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-management strategy.

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

To get out of a weight-loss slump, try changing up your workout routine. 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 (3 months) at the highest 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. But if Contrave isn’t an option or doesn’t work well for you, there are other weight-loss medications available. Options include:

• Phentermine (Adipex P, Lomaira)

• Qsymia (phentermine / topiramate ER)

• Orlistat (Xenical, Alli)

• GLP-1-related medications, such as semaglutide (Wegovy, Wegovy HD), tirzepatide (Zepbound), and orforglipron (Foundayo)

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

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 options like GoodRx coupons and copay savings cards to help you 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.

• Save with a copay savings card. If you have commercial insurance that covers Contrave, you may be eligible to pay as little as $0 for Contrave using a savings card from the manufacturer.

• Save with a patient support program. Contrave’s manufacturer, Currax Pharmaceuticals, offers a savings program called CurAccess for people with or without insurance. If you’re eligible, this program could help you access Contrave for $99 or less per month (with free delivery).

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Written by:

Jill Barat, PharmD

Jill Barat, PharmD has 10 years of experience as a pharmacist, including as the pharmacist in charge at an independent sterile and non-sterile compounding pharmacy. She was also 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:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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