Contrave

• Risk factors: History of depression or any mental health condition | Age 24 years or younger

Bupropion, one of the ingredients in Contrave, can raise the risk of worsening depression and unusual changes in behavior. It can also raise the risk of suicidal thoughts or actions. The risk might be higher if you have a history of depression or if you're 24 years or younger.

To be safe, you and your loved ones should watch for changes in behavior while you're taking Contrave (naltrexone / bupropion). This is especially important when you first start the medication and when your dose goes up. Talk to your prescriber if you have worsening depression or unusual changes in behavior. Call 911 right away if you start to think about hurting yourself.

• Risk factors: History of depression or mental health condition

Contrave (naltrexone / bupropion) isn't approved to help you quit smoking. People who’ve taken bupropion by itself for smoking cessation have had changes in thoughts, behavior, and mood. This included depression, hallucinations, paranoia, and anxiety. It's also included suicidal thoughts or behavior. Some people taking naltrexone by itself have also had depression or thoughts or behaviors of self-harm.

Watch out for signs of depression and feelings of uneasiness. Also be aware of any strange changes of behavior, thoughts, or feelings. Stop taking Contrave (naltrexone / bupropion) and get medical help right away if you or your loved ones notice any unusual thoughts, behavior, or mood.

• Risk factors: History of seizures | History of an eating disorder | History of head injury or medical conditions that can cause seizures | Drink a lot of alcohol | Recently quit drinking alcohol | Take too much sedatives | Addiction to cocaine or stimulants | Recently stopped taking sedatives or seizure medications | Taking other medications that can raise seizure risk | Taking higher doses of Contrave (naltrexone / bupropion) | Taking insulin or certain other diabetes medications

Although rare, the bupropion in Contrave can cause seizures. The risk is greater with higher doses of Contrave (naltrexone / bupropion).

Before starting Contrave (naltrexone / bupropion), tell your prescriber about your medical history. Also tell them about all the medications you take. Some health problems and medications can raise your risk of seizure. Let your care team know if you've recently stopped drinking alcohol or stopped taking certain medications. This can also put you in danger of seizures. Your prescriber can check your risk and see if Contrave (naltrexone / bupropion) is safe for you.

Get medical help right away if you have a seizure while you're taking Contrave (naltrexone / bupropion). You won't be able to take this medication anymore if a seizure happens.

Don't take Contrave (naltrexone / bupropion) with opioid medications. Contrave contains naltrexone, which can block the effects of opioids and make them work less well. This can lead to two possible dangerous and life-threatening problems.

First, it can make people think they need to take more of the opioid to get enough pain relief. This can cause serious side effects, like slow breathing or loss of consciousness. It can raise the risk of an opioid overdose.

Second, because naltrexone blocks the effects of opioids, it can be like suddenly stopping the opioid medication. This can lead to opioid withdrawal symptoms.

Before you start Contrave (naltrexone / bupropion), tell your prescriber if you're already taking an opioid. Also if you need opioids for any reason during treatment, tell your care teams that you're taking Contrave (naltrexone / bupropion). In both cases, your care teams can tell you what to do to keep you safe.

• Risk factors: History of high blood pressure

Contrave (naltrexone / bupropion) can make your resting heart rate and blood pressure go up. In studies, these changes generally happened during the first few months of treatment. For some, blood pressure went back closer to usual 3 months after starting the medication.

To be safe, your prescriber will check these vital signs before you start Contrave (naltrexone / bupropion). They'll also check your heart rate and blood pressure during your follow-up visits. And they might recommend you to regularly check your blood pressure at home.

Tell your care team if your blood pressure stays higher than usual or if you feel your heart racing. Don't take Contrave (naltrexone / bupropion) if you have high blood pressure that's not controlled.

• Risk factors: History of liver problems | Taking medications that can harm the liver

Some people who've taken naltrexone, an ingredient in Contrave, have had liver problems. Most times, there were other potential reasons for liver injury. Examples include having medical conditions or taking certain medications that can damage the liver.

Before starting Contrave (naltrexone / bupropion), tell your care team if you have any liver problems. Depending on how serious it is, your prescriber might tell you to take a lower dose. But this medication isn't recommended for people with severe liver problems.

Stop taking Contrave (naltrexone / bupropion) and get medical help right away if you see any signs of liver damage. They can include yellow skin or eyes, nausea, stomach pain, fatigue, or fever.

• Risk factors: Personal or family history of bipolar disorder | Family history of depression or suicide

It's possible that bupropion, an ingredient in Contrave, can cause some people to have a manic, mixed, or hypomanic episode. The risk is higher if you have bipolar disorder. It's also higher if you're at risk of bipolar disorder, like if someone in your family has bipolar disorder or depression. Tell your prescriber if you or your family has mental health issues. Your prescriber can check to see if you're at risk.

If you or a loved one thinks you're having an episode while taking this medication, call your care team. You might be more talkative or irritable than usual, have racing thoughts, or have very elevated or sad mood.

• Risk factors: Have "narrow-angle eyes" and haven't had eye surgery

Bupropion, which is in Contrave, can sometimes cause eye problems in some people. Tell your prescriber if your eye specialist has said you have narrow-angle eyes and you haven't had laser eye surgery. Your risk of a serious eye problem called angle-closure attack might be higher. Your prescriber can make sure this medication is safe for you.

Call your eye specialist right away if you suddenly have blurry vision, severe eye pain, or see halos around lights. These could be signs of an angle-closure attack.

• Risk factors: Using insulin | Taking sulfonylureas like glipizde

Weight loss can put certain people with Type 2 diabetes at risk of having low blood sugar. People at risk are those who use insulin or take sulfonylureas like glipizide.

If you have Type 2 diabetes, you should get your blood sugar checked before you start Contrave (naltrexone / bupropion). Then, continue to regularly check your blood sugar at home while you're taking this medication. Your primary care provider might adjust your diabetes medications to lower your risk of very low blood sugar.

Make sure you can recognize the symptoms of low blood sugar. Look out for sweating, shakiness, dizziness, racing heart, and confusion. If this happens, check your blood sugar as soon as possible and follow the “15-15 rule" to help get your sugars back up. Call for medical help if needed. Tell your primary care provider if your blood sugar drops too low while you're taking Contrave (naltrexone / bupropion).