Key takeaways:
Contrave is an FDA-approved weight-loss medication. It’s a combination of two different drugs: naltrexone and bupropion. You shouldn’t take other medications that contain these ingredients or other weight-loss medications with Contrave.
Combining Contrave and alcohol isn’t recommended due to the risk of seizures and other negative side effects. Some other common Contrave interactions include antidepressants, beta blockers, and antipsychotic medications.
You should also avoid monoamine oxidase inhibitors (MAOIs) and opioids while you’re taking Contrave. Use caution when taking Contrave with medications that can lower the seizure threshold or raise dopamine levels.
Be sure to share your medication list with your prescriber and pharmacist before starting Contrave. They can help check for any interactions.
Save on related medications
Losing weight isn’t always as simple as eating healthy and staying active. When lifestyle changes aren’t enough, your healthcare team may suggest a prescription weight-loss medication. One option is Contrave (naltrexone / bupropion), an oral tablet that can help curb hunger and manage cravings.
As with any medication, it’s important to understand how Contrave might interact with other substances. Contrave interactions can involve other medications, supplements, and even certain foods and drinks. Here, we’ll cover potential drug interactions to watch out for, including Contrave and alcohol.
Contrave interactions at a glance
Below is a list of Contrave interactions reported in the package insert. Keep in mind that this doesn’t include all possible Contrave interactions. It’s best to have your prescriber or pharmacist review your medication list before taking Contrave.
Search and compare options
Common Contrave interactions include:
Monoamine oxidase inhibitors (MAOIs)
Opioid pain medications
Some selective serotonin reuptake inhibitors (SSRIs)
Certain tricyclic antidepressants (TCAs)
Oral steroids, such as prednisone
Paxlovid (nirmatrelvir / ritonavir) and other medications that contain ritonavir (Norvir)
Some beta blockers
Other weight-loss medications, including GLP-1 related options
Certain heart rhythm medications (antiarrhythmics)
Other medications that contain bupropion (Wellbutrin SR, Wellbutrin XL)
Other medications that contain naltrexone (Vivitrol)
Plavix (clopidogrel)
Ticlopidine
Sustiva (efavirenz)
Strattera (atomoxetine)
Digtek (digoxin)
Theo-Dur (thephylline)
Alcohol
Let’s take a closer look at eight Contrave interactions to be aware of.
1. Monoamine oxidase inhibitors
MAOIs are used to treat depression and Parkinson’s disease. But if they’re combined with Contrave, it raises your risk for dangerously high blood pressure. In severe cases, a hypertensive crisis is possible, which can be life-threatening.
Symptoms of this Contrave interaction include a headache, dizziness, and blurry vision. You may also feel confused and have trouble breathing.
This likely happens because bupropion and MAOIs both raise the levels of certain chemicals in the brain: dopamine and norepinephrine. If these levels get too high, they can cause a dangerous increase in your blood pressure.
Examples of MAOIs include selegiline (Emsam, Eldepryl) and rasagiline (Azilect). You shouldn’t take MAOIs at the same time or within 14 days of starting Contrave. If you’re currently taking an MAOI, your prescriber can recommend a safer weight-loss medication for you.
2. Opioid pain medications
Opioids are medications that treat different types of pain. If you’re taking Contrave, opioid medications won’t work as well for you. This is because naltrexone blocks the effect of opioids.
If you need to take an opioid pain medication while you’re taking Contrave, your prescriber may have you stop taking Contrave for a short time. But you shouldn’t stop taking it on your own. Be sure your prescriber is aware of any opioids you’re prescribed while you’re taking Contrave.
How to take Contrave: Understand what a typical Contrave dosage is and why it might vary from person to person.
Exploring your options: Get the scoop on how two popular weight-loss medications, Wegovy and Contrave, stack up to one another.
The science behind weight loss: Discover how your Contrave prescription works to help you achieve your target body weight.
Good to know: If you take opioids regularly for pain, Contrave is likely not the best choice for you. If you start taking Contrave with opioids, not only can it block their effect, but it can also cause withdrawal symptoms. You shouldn’t start taking Contrave until at least 7 to 10 days after you’ve stopped taking any opioid medications.
3. Medications that lower the seizure threshold
Certain medications, including bupropion, can make seizures more likely. This is known as lowering the seizure threshold. Combining Contrave (which contains bupropion) with other medications that lower the seizure threshold can raise your risk of seizures.
Other medications that make seizures more likely include:
Antipsychotics such as clozapine (Clozaril)
TCAs such as amitriptyline
Theophylline
Prednisone
Caffeine products, such as Vivarin and some forms of Excedrin (acetaminophen / aspirin / caffeine) and Midol (acetaminophen / caffeine / pyrilamine)
In some cases, your prescriber may decide it’s OK for you to take Contrave with one of these medications. If they’re combined, it’s best to start with a low dose of Contrave and raise the dose slowly over time. That way, your prescriber can watch for any signs of this interaction. If you have a seizure while taking Contrave, seek medical care right away, and be sure to let your healthcare team know. You'll likely need a different weight-loss medication.
4. Alcohol
It’s best to avoid combining Contrave and alcohol. They can interact in several ways:
Contrave can make you more sensitive to alcohol. This can make it harder for you to judge your level of impairment. And it can raise the chance of unwanted side effects from alcohol.
In rare cases, combining alcohol and Contrave can cause mental health problems. It can also make seizures more likely, especially if you consume large amounts of alcohol over time and then stop.
Alcohol can interfere with weight loss. Drinking alcohol can slow your metabolism and add extra calories. This works against Contrave when it comes to helping you maintain a healthy weight.
It’s best to limit or avoid alcohol while taking Contrave. If you drink alcohol regularly, it’s best to discuss this with your healthcare team before you start taking Contrave. They can help decide if it’s safe for you to take.
If you or someone you know struggles with substance use, help is available. Call SAMHSA’s National Helpline at 1-800-662-4357 to learn about resources in your area.
5. Other weight-loss medications
In addition to Contrave, there are several other FDA-approved weight-loss medications. And even more are expected in the coming years. But it’s best to avoid combining Contrave with another weight-loss medication unless your prescriber tells you to. Doing so can raise your risk of side effects or have a negative impact on your health. Typically, if one weight-loss medication isn’t working, you’ll stop taking it before trying a new one.
You should also talk to your prescriber before taking any over-the-counter (OTC) herbs or supplements that promote weight loss while you’re taking Contrave. They can help decide if the combination is safe for you.
6. Medications that affect dopamine levels
As mentioned, bupropion raises dopamine levels in the body. If you take Contrave with other medications that increase or act like dopamine, it could cause unwanted side effects. High dopamine levels can cause symptoms such as:
Restlessness
Dizziness
Trouble walking
Agitation
In studies, this interaction was mainly seen with medications used to treat Parkinson’s disease, such as amantadine and Sinemet (carbidopa / levodopa). You should only combine Contrave with one of these medications if your prescriber OKs it. If you’re taking Contrave with one of these medications, be sure to let your prescriber know if any of the above symptoms appear.
7. Medications that affect Contrave levels
Certain medications affect liver enzymes (proteins) that can change Contrave levels in the body.
Medications that can lower Contrave levels include:
Certain HIV medications, such as Kaletra (lopinavir / ritonavir) and Norvir
Lower levels can make Contrave less effective. So talk to your prescriber about a different weight-loss option if you’re taking one of these medications long term. But you can likely continue taking Contrave with a short course of Paxlovid.
Other medications, such as Plavix and ticlopidine, can raise Contrave levels. This can make Contrave side effects more likely. A lower Contrave dosage is recommended if you’re taking it with one of these medications.
Good to know: The medications in Contrave, naltrexone and bupropion, can also be prescribed on their own for other health conditions. But you shouldn’t take either one along with Contrave. It could raise your levels too high and cause side effects. Let your healthcare team know if you’re already taking either medication before you start taking Contrave.
8. Other medications
Contrave can affect the levels of other medications in the body as well. For example, taking Contrave with digoxin (a medication for heart conditions) can lower your digoxin levels. You may need your digoxin levels checked more often if you’re taking it with Contrave.
Contrave can also raise the levels of certain medications in the body if they’re combined. Examples include:
Selective serotonin reuptake inhibitors, such as fluoxetine (Prozac)
TCAs
Antipsychotics, such as risperidone
Beta blockers, such as metoprolol (Lopressor, Toprol XL)
Antiarrhythmics, such as propafenone and flecainide
You may need a lower dose of these medications while taking Contrave. But don’t make any changes on your own. Your prescriber can see if anything on your medication list requires an adjustment before you start taking Contrave.
Frequently asked questions
It depends. Contrave contains bupropion, an antidepressant medication. So you may not need another antidepressant while you’re taking it. If you do, you’ll need to avoid other antidepressants that also contain bupropion, such as Wellbutrin XL, Aplenzin, and Forfivo XL. Bupropion also interacts with certain other antidepressants, raising the medication levels in your body. Your prescriber can help you find a treatment option that’s safe to take with Contrave if needed.
It’s not that you can’t specifically eat eggs while taking Contrave — it’s that the fat content of eggs can pose a problem. You should avoid taking Contrave with high-fat meals because fat can increase how much medication your body absorbs.That extra absorption can raise your risk of serious side effects, including seizures. Egg yolks contain a moderate amount of fat. So it’s likely OK to eat an egg with Contrave as long as you balance the fat content with other low or non-fat foods, such as whole grains, fruits, or vegetables.
It’s best to limit your caffeine intake while taking Contrave. The bupropion in Contrave can increase your risk of seizures, and too much caffeine may raise that risk even more. Caffeine can also cause side effects like irritability, insomnia, or high blood pressure, especially when combined with Contrave. Coffee, energy drinks, and some over-the-counter medications contain caffeine, so be sure to read labels and watch your intake. If you’re unsure how much is too much for you, check with your healthcare team.
It depends. Contrave contains bupropion, an antidepressant medication. So you may not need another antidepressant while you’re taking it. If you do, you’ll need to avoid other antidepressants that also contain bupropion, such as Wellbutrin XL, Aplenzin, and Forfivo XL. Bupropion also interacts with certain other antidepressants, raising the medication levels in your body. Your prescriber can help you find a treatment option that’s safe to take with Contrave if needed.
It’s not that you can’t specifically eat eggs while taking Contrave — it’s that the fat content of eggs can pose a problem. You should avoid taking Contrave with high-fat meals because fat can increase how much medication your body absorbs.That extra absorption can raise your risk of serious side effects, including seizures. Egg yolks contain a moderate amount of fat. So it’s likely OK to eat an egg with Contrave as long as you balance the fat content with other low or non-fat foods, such as whole grains, fruits, or vegetables.
It’s best to limit your caffeine intake while taking Contrave. The bupropion in Contrave can increase your risk of seizures, and too much caffeine may raise that risk even more. Caffeine can also cause side effects like irritability, insomnia, or high blood pressure, especially when combined with Contrave. Coffee, energy drinks, and some over-the-counter medications contain caffeine, so be sure to read labels and watch your intake. If you’re unsure how much is too much for you, check with your healthcare team.
The bottom line
Contrave (naltrexone / bupropion) is an oral weight-loss medication. It’s best to avoid taking Contrave (naltrexone / bupropion) with opioids, MAOIs, and other weight-loss medications. Other common Contrave interactions include antidepressants, beta blockers, and antipsychotic medications. And you shouldn’t combine Contrave and alcohol due to the risk of unwanted side effects.
Use caution when taking Contrave with medications that lower the seizure threshold or raise dopamine levels. And don’t take it with other medications containing bupropion or naltrexone. Be sure to share your medication list with your prescriber and pharmacist before starting Contrave to help avoid serious interactions.
Why trust our experts?
References
Alley, W. D., et al. (2023). Hypertensive emergency. StatPearls.
Myers, M., et al. (2023). Eggs: Healthy or risky? A review of evidence from high quality studies on hen’s eggs. Nutrients.
Nalpropion Pharmaceuticals. (2025). Contrave extended-release- naltrexone hydrochloride and bupropion hydrochloride tablet, extended release [package insert].
Singh, D., et al. (2023). Naltrexone. StatPearls.
Smith, M. D., et al. (2024). Norepinephrine. StatPearls.
Tek, C. (2016). Naltrexone HCI/bupropion HCI for chronic weight management in obese adults: Patient selection and perspectives. Patient Preference and Adherence.
