Foods to Avoid With Contrave (Plus 6 More Pharmacist-Backed Tips for Taking It)

If diet changes and exercise aren’t enough to help you reach your weight-loss goals, your healthcare provider may recommend a prescription medication to help. Contrave (naltrexone / bupropion) is an oral medication that’s used for chronic weight management. It helps reduce food cravings, lower your appetite, and may also reduce emotional eating.

With Contrave, there are some best practices to keep in mind so that you can get the most out of your medication while also limiting side effects. Below, we’ll discuss seven pharmacist-backed tips for taking Contrave to help you meet your health goals.

1. Avoid taking Contrave with a high-fat meal

You’ll take Contrave twice a day in the morning and evening. You can take it with or without food, but you should avoid taking it with high-fat meals.

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High-fat meals can significantly increase Contrave’s absorption. This could raise your risk of experiencing side effects, including seizures. Foods that are high in fat can also work against your weight-loss goals. So there’s more than one reason to limit the amount of fat you’re eating while you’re taking Contrave.

Examples of high-fat foods include cheese, pastries, and bacon. Even healthier high-fat options could cause an issue, such as avocado, nut butter, and salmon. It’s fine to eat these foods in moderation. But it’s best to aim for a balanced diet and avoid taking Contrave with high-fat meals. 

If you have questions about meal planning with Contrave, reach out to your healthcare provider for guidance.

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2. Increase your Contrave dose slowly to reduce side effects

It’s recommended to start with a low dose of Contrave and increase it over 3 weeks or so. It may be tempting to try and raise your dose faster, but it’s best to follow your provider’s instructions. Contrave can cause side effects such as nausea, headache, and high blood pressure. Slowly increasing your dose gives your body time to adjust to the medication and lowers the risk of side effects like these.

The maximum recommended Contrave dosage is 2 tablets twice a day. You may need a lower daily dose if you have liver or kidney problems, or if you’re taking medications that interact with Contrave. Taking more Contrave than recommended won’t help you lose more weight. And it can increase your risk of dangerous side effects, such as seizures.

Your healthcare provider will likely keep an eye on your progress in the first weeks to months of use and may adjust your Contrave dosage if needed. Be sure to let them know if any side effects are an issue for you.

3. Keep an eye on your blood pressure

It’s a good idea to keep an eye on your blood pressure while you’re taking Contrave. As mentioned, this medication may increase your blood pressure and heart rate. If you already have high blood pressure, Contrave may not be the best treatment for you. That’s because there’s a higher risk of this side effect. But it can happen to anyone taking Contrave.

Increased blood pressure and heart rate seem to be more likely in the first 3 months of Contrave treatment. Your healthcare provider will likely keep a closer eye on you during this time. But you can keep an eye out for signs and symptoms of these side effects, too. If you notice your heart is racing or you have chest pain, vision changes, or trouble breathing, seek medical care right away.

4. Don’t cut, chew, or crush Contrave tablets

You should always swallow Contrave tablets whole. They shouldn’t be split, crushed, or chewed. The reason for this is that Contrave is an extended-release tablet. It’s designed to slowly release medication over time. If you damage the tablet, you could receive an entire day’s worth of medication all at once. Not only can this make Contrave less effective, it can raise your risk of harmful side effects.

If you’re having trouble swallowing Contrave, try placing it in a spoonful of applesauce or reduced-fat pudding. There are also devices, such as specialized cups and straws, that help make it easier to swallow a pill. 

If you’re still having trouble swallowing Contrave, talk to your provider about a different weight-loss medication. An injectable medication, such as Wegovy (semaglutide), may be a better option for you.

5. Stay hydrated

It’s easier to become dehydrated when you’re eating and drinking less than usual. Hydration is key to keep your organs working properly. And it can help support your weight-loss goals, too. So it’s a good idea to pay attention to how much water (or other preferred liquids) you’re drinking while taking Contrave. 

Early signs of dehydration include dry mouth and skin, darker urine, and constipation. More severe symptoms include weakness, confusion, and heart problems. If you’re having trouble with these symptoms after starting Contrave, talk to your provider. They can help determine if you’re dehydrated or if something else is going on.

6. You should avoid or limit alcohol with Contrave

When you’re taking Contrave, hydration is important — but that doesn’t include alcohol. It’s best to limit or avoid drinking alcohol with Contrave for several reasons:

• Contrave may make you more sensitive to alcohol’s effects. This can make it easier to become intoxicated and raise your risk of alcohol-related harm.

• Combining alcohol and Contrave raises your risk of seizures, liver damage, and abnormal thoughts or behaviors

• Alcohol can interfere with your weight-loss goals

If you drink alcohol regularly, talk with your provider before starting Contrave to ensure it’s a safe option for you. They can give you guidance on how much (if any) alcohol is OK while you’re taking it. Your provider can also give you tips and support to cut back or stop drinking alcohol, if needed.

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.

7. Combining Contrave with lifestyle changes is the best way to get results

While Contrave can help with weight loss, it’s not meant to be a stand-alone treatment. You should combine Contrave with a reduced-calorie diet and regular exercise. In fact, these lifestyle changes were part of the treatment plan used in the clinical studies of Contrave that showed more significant weight loss.

Contrave may make you feel less hungry and eat less food. So it’s a good idea to choose nutritious foods to make sure you’re getting the vitamins and nutrients you need. Including regular exercise in your routine can further help you burn calories and build lean muscle mass. It also has benefits for your heart, bones, and general health.

The key to making these changes is to find foods and workouts you enjoy and can stick to long term. Crash diets or brutal exercise plans aren’t the answer for weight loss that lasts. If you’re having trouble making lifestyle changes, reach out to your provider for support.

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.

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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:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

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