Key takeaways:
Contrave is an oral weight-loss medication. It contains two ingredients: naltrexone and bupropion. Contrave seems to work by adjusting the brain’s appetite and reward centers. This may help you feel less hungry and reduce food cravings.
Contrave works best when combined with a reduced-calorie diet and regular exercise. It also helps to stay hydrated and avoid or limit alcohol.
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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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 a possible option. It’s an oral weight-loss medication with two active ingredients. But how does Contrave work to help you lose weight?
What is Contrave?
Contrave is a weight-loss pill 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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When they’re combined, these medications are effective for weight management.
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.
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 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.
In studies, this combination proved to be an effective option for managing your weight. Participants lost an average of about 8% of their starting body weight after 56 weeks 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. 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 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. And alcohol can raise the risk of seizures if you’re taking Contrave. 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.
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.
Tips for taking Contrave (naltrexone / bupropion): 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.
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. 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 (phentermine / topiramate ER)
Orlistat (Xenical, Alli)
GLP-1-related medications such as semaglutide (Wegovy) and 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 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 a patient assistance program: 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
It can take 4 to 12 weeks to start noticing a difference in your body weight with Contrave. And it can take 6 to 8 months to see the full weight-loss effects of the medication. Keep in mind that everyone responds differently to Contrave. But you can help it work by exercising regularly and choosing nutritious foods. That being said, if you haven’t lost at least 5% of your starting body weight after 12 weeks of taking the full Contrave dosage, your prescriber may recommend a different treatment option.
There are a few reasons why you may not lose weight while taking Contrave. The first is that you haven’t been taking it long enough. It takes time to reach the full recommended dosage. And it can take 6 to 8 months for Contrave to reach its full effects. It’s also harder to lose weight with Contrave without making lifestyle changes. This includes regular exercise and a balanced diet. But Contrave may not work for everyone. If you aren’t noticing weight changes after 12 weeks of treatment, reach out to your prescriber for guidance.
It can take 4 to 12 weeks to start noticing a difference in your body weight with Contrave. And it can take 6 to 8 months to see the full weight-loss effects of the medication. Keep in mind that everyone responds differently to Contrave. But you can help it work by exercising regularly and choosing nutritious foods. That being said, if you haven’t lost at least 5% of your starting body weight after 12 weeks of taking the full Contrave dosage, your prescriber may recommend a different treatment option.
There are a few reasons why you may not lose weight while taking Contrave. The first is that you haven’t been taking it long enough. It takes time to reach the full recommended dosage. And it can take 6 to 8 months for Contrave to reach its full effects. It’s also harder to lose weight with Contrave without making lifestyle changes. This includes regular exercise and a balanced diet. But Contrave may not work for everyone. If you aren’t noticing weight changes after 12 weeks of treatment, reach out to your prescriber for guidance.
The bottom line
Contrave (naltrexone / bupropion) is an oral combination medication for weight loss. It seems to help decrease appetite and raise energy use to help you lose weight. It may also calm the brain’s dopamine-driven reward system to reduce food cravings.
Contrave works best when combined with regular exercise and a reduced-calorie diet. Be sure to include strength training and switch up your workouts regularly to help avoid a weight-loss plateau. While Contrave is an effective weight-loss medication for many people, it may not work for everyone. Talk to your prescriber about the best weight-loss medication for your needs.
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References
le Roux, C. W., et al. (2022). The relationship between early weight loss and weight loss maintenance with naltrexone-bupropion therapy. eClinicalMedicine.
Lee, N. M., et al. (2012). The neurobiology of overeating. Treating overweight individuals should make use of neuroscience research, but not at the expense of population approaches to diet and lifestyle. EMBO Reports.
Nalpropion Pharmaceuticals. (2024). Contrave extended-release- naltrexone hydrochloride and bupropion hydrochloride tablet, extended release [package insert].
Sarwan, G., et al. (2024). Management of weight loss plateau. StatPearls.
Sherman, M. M., et al. (2016). Naltrexone/bupropion ER (Contrave): Newly approved treatment option for chronic weight management in obese adults. Pharmacy & Therapeutics.
