Contrave (Bupropion + Naltrexone) — Patient Information (UK)
Contrave is a prescription weight‑management medicine that contains two active ingredients: bupropion and naltrexone. It is used as part of a wider plan that includes healthy eating, increased physical activity and behaviour changes. This page explains how Contrave works, how it is taken, what to expect, and key safety and interaction information for people in the United Kingdom.
At a glance
- What it contains: Bupropion + Naltrexone
- What it’s used for: Weight management in appropriate adults, typically when combined with lifestyle changes
- How it’s taken: Tablets taken in a gradual dose “titration” schedule to reduce side effects
- When you may notice effects: Some appetite/behaviour changes may begin within weeks; weight changes take longer
- Important safety points: Not suitable for everyone; interactions and certain health conditions require caution
Basic product information
| Feature | Details |
|---|---|
| Brand | Contrave |
| Active ingredients | Bupropion + Naltrexone |
| Medicine type | Weight‑management medicine (acts on appetite and reward pathways) |
| Form | Tablets (dose strengths vary by brand presentation) |
| Typical use setting | Alongside diet, physical activity and behaviour strategies |
| Country context | Available in the UK via authorised channels (availability may vary) |
How Contrave works (mechanism of action)
Contrave combines two medicines that target systems in the brain involved in appetite, cravings and “reward” responses to food.
Bupropion
Bupropion influences the brain’s chemical messengers, particularly noradrenaline and dopamine. This can help reduce appetite and may affect cravings and motivation to eat in response to cues.
Naltrexone
Naltrexone helps block opioid receptors. In the context of eating, this may reduce the rewarding or “pleasurable” aspects of food and can help limit overeating driven by reward pathways.
Combined effect
Together, bupropion and naltrexone are thought to improve weight‑related behaviours by reducing hunger, decreasing cravings and helping support healthier eating patterns over time.
Pharmacokinetics (how the body handles the medicine)
Pharmacokinetics describes what happens after you take a dose—how it is absorbed, broken down, and eliminated. The exact numbers can vary between individuals, but the key practical points for patients are:
- Absorption: After oral dosing, both active components are absorbed through the digestive system and reach the bloodstream.
- Metabolism: Bupropion is extensively metabolised in the body. A key active metabolite is often discussed clinically in relation to bupropion’s effects. Naltrexone is also metabolised.
- Time to effect: Because effects depend on brain chemistry and behaviour patterns, weight changes usually develop gradually, even though medication reaches the bloodstream after dosing.
- Elimination: The medicine and its metabolites are eliminated mainly via the liver metabolism pathways and subsequent clearance processes.
- Steady use pattern: The titration schedule is designed to build tolerability and maintain consistent exposure to help manage side effects and improve adherence.
If you have liver or kidney problems, dosing and monitoring may need extra attention. Always follow the guidance provided by your clinician or the medicine instructions supplied with your pack.
Typical use in the UK
In the UK, Contrave is intended for weight management in adults who meet agreed clinical criteria and who are supported with a structured lifestyle plan. It is not a “quick fix” and works best when paired with:
- Reduced calorie intake and healthier food choices
- Regular physical activity
- Behaviour change strategies (for example, meal planning, limiting triggers, and building routines)
- Long‑term follow‑up to review progress and decide whether to continue
Many weight‑management plans also set measurable goals (such as early weight‑loss targets) to confirm whether treatment is helping. Your clinician will guide what “success” looks like for you.
Indications (who it may be suitable for)
Contrave is used to support weight loss in adults with overweight or obesity where lifestyle changes alone have not been sufficient. Suitability depends on individual risk factors and medical history.
Important: Contrave is not appropriate for everyone. It may be unsuitable if you have certain medical conditions or take certain medicines.
Common reasons to review suitability or avoid Contrave
- Seizure risk: Bupropion can increase seizure risk in susceptible individuals.
- Eating disorders: Some eating disorders (for example, bulimia or anorexia nervosa) may raise seizure risk.
- Use of opioid medicines: Because naltrexone blocks opioid receptors, it can interfere with opioid pain relief and may precipitate symptoms in certain situations.
- Acute alcohol problems: Heavy alcohol use or abrupt changes in alcohol intake can increase risk of adverse effects.
- Major drug interactions: Several medicines can interact with bupropion, including some antidepressants and other drugs that affect brain chemistry.
- Uncontrolled high blood pressure or cardiovascular issues: These require careful assessment.
Your clinical team will consider your medical history, current medicines and health measurements before starting Contrave.
Dosing and timing (how to take Contrave)
Contrave is typically taken using a gradual titration schedule. This means the dose increases step‑by‑step over several weeks so your body can adjust and side effects are reduced.
Because the exact step calendar depends on the specific product pack and prescribed regimen, always follow the dosing schedule provided with your medicine. The instructions below describe the usual approach and practical timing guidance.
Typical daily timing
- Start low and spread doses: Early doses are usually taken once daily, then increased to twice daily later in titration.
- Avoid late evening doses: Bupropion can sometimes cause stimulation or insomnia in some people. If your plan includes an evening dose, take it earlier in the evening rather than close to bedtime—unless your clinician advises otherwise.
- Take consistently: Try to take doses at the same times each day.
- Swallow whole: Follow tablet instructions. Do not crush or chew unless advised.
What to do if you miss a dose
If you miss a dose, take it when you remember unless it is close to the next scheduled dose. Do not take a double dose to make up for a missed tablet. If you are unsure, check the patient instructions in your pack or ask your pharmacist.
Food interactions and taking with meals
Food can affect how medicines are absorbed for some formulations. For Contrave, the key practical approach is to take it with food or as directed to help reduce stomach discomfort.
Practical guidance
- Take with meals if you get nausea: Many people find gastrointestinal side effects easier to manage when dosing is aligned with food.
- Stay consistent: If you usually take it after breakfast, keep a similar routine.
- Hydration helps: Drink water and maintain regular meals—especially during titration.
Always check the specific “take with food” instructions on your pack or in the leaflet supplied with your medicine.
Alcohol and medicine interactions
Alcohol can increase risk of side effects with medicines that affect the brain and can also influence seizure risk. With Contrave, it is particularly important to discuss your alcohol intake with your clinician.
Alcohol
- Avoid heavy drinking: If you drink alcohol regularly, discuss safe limits with a healthcare professional.
- Avoid abrupt changes: Sudden stopping after heavy use can increase risk of adverse effects.
- Do not drive if unwell: Alcohol combined with treatment may worsen drowsiness or dizziness in some people.
Other medicines that may interact
Contrave can interact with a range of medicines, including those affecting mood, seizures, and opioid use. Examples (not exhaustive) include:
- Opioid-containing medicines (including some painkillers): may be blocked by naltrexone. This can reduce pain relief and can be unsafe in certain opioid withdrawal situations.
- Other antidepressants or medicines that influence noradrenaline/dopamine pathways: may increase side effects or seizure risk when combined.
- Medicines that reduce seizure threshold: combining may raise seizure risk.
- Enzyme-affecting medicines (some that influence liver metabolism): may change Contrave exposure.
- Medicines for diabetes or blood pressure: weight changes and improved metabolic health can affect dosing needs over time; monitoring may be required.
- Stimulants or certain cough/cold preparations: discuss suitability if they contain substances that may increase jitteriness or interact with mood/attention pathways.
Before starting Contrave, provide your pharmacist/clinician with a full list of medicines, including over‑the‑counter products, herbal remedies and supplements.
Safety profile and common side effects
Like all medicines, Contrave can cause side effects. Many are more noticeable during the titration phase and may improve as the body adjusts. If side effects are severe or worrying, seek medical advice promptly.
Common side effects (often during dose increase)
- Nausea
- Dry mouth
- Constipation or changes in bowel habits
- Headache
- Dizziness
- Sleep problems (such as insomnia)
- Increased blood pressure or fast heartbeat in some people
Less common but serious risks
- Seizures: risk may be higher in those with certain medical histories or risk factors. Stop the medicine and seek urgent medical help if a seizure occurs.
- Severe allergic reactions: seek urgent help if you develop facial/lip swelling, breathing difficulty, or widespread rash.
- Mood changes: seek advice if you experience severe agitation, unusual mood swings, or symptoms of depression worsening.
- Suicidal thoughts: report immediately to a healthcare professional or emergency services if they occur.
- Serious cardiovascular symptoms: if you get chest pain, severe shortness of breath, fainting, or a marked change in heart rhythm, seek urgent care.
- Medication misuse concerns: take exactly as directed and do not share the medicine.
Who should take extra care
Extra caution is needed if you have:
- a history of seizures
- bipolar disorder or significant psychiatric illness
- liver disease
- significant high blood pressure or heart disease
- regular opioid use, current opioid dependence, or need for opioid pain relief
- heavy alcohol use or a recent pattern of abrupt alcohol change
Practical use tips for better results
Contrave works best when you combine it with consistent habits. Below are practical tips many patients find helpful.
1) Stick to the titration schedule
The gradual dose increase is designed to reduce side effects. Even if appetite changes happen early, avoid changing your dose schedule without professional guidance.
2) Track progress
- Weigh yourself regularly (for example, weekly) rather than daily fluctuations.
- Track hunger/cravings and typical eating triggers.
- Note side effects and what time of day they happen—this can help improve your routine.
3) Use strategies to prevent “trigger eating”
- Plan meals and snacks to reduce impulsive choices.
- Keep high‑calorie snacks out of easy reach.
- Try alternatives when cravings hit (for example, a planned snack, herbal tea, or a short walk).
4) Support your sleep
Because insomnia can occur, keep a consistent bedtime, limit caffeine in the late afternoon, and take doses earlier in the day if you’re prone to sleeplessness.
5) Manage common stomach symptoms
- Take the dose with food if advised or if nausea occurs.
- Stay hydrated and consider high‑fibre foods if constipation occurs.
- Speak to your pharmacist if side effects persist—do not stop suddenly unless advised.
What to expect from treatment (timing and effectiveness)
Many people want to know when weight loss will happen. Responses vary, but typical patterns include:
- First few weeks: The focus is tolerating the medicine while gradually increasing dose.
- Appetite/cravings: Some people notice changes earlier; others notice later.
- Weight changes: Usually develop over months with lifestyle support.
- Review points: Clinicians commonly reassess progress after an initial period to decide whether to continue based on measurable results and tolerability.
If you are not losing weight or side effects are troublesome, discuss options early—adjustments may be possible, or another approach may be considered.
Alternative options for weight management in the UK
Weight management can involve a range of treatments depending on your health profile, BMI, comorbidities, previous attempts and local commissioning guidance. Alternatives may include:
- Other prescription weight‑management medicines: depending on availability and eligibility.
- Structured lifestyle programmes: diet plans, exercise coaching and behavioural therapy.
- Referral to specialist obesity services: for tailored plans and monitoring.
- Surgical options: for people with severe obesity meeting criteria (not suitable for everyone).
Your clinician can compare benefits, risks and suitability. If Contrave isn’t right for you, alternative treatments may offer different mechanisms and side‑effect profiles.
Market and legal context (UK)
In the United Kingdom, medicines are regulated by the Medicines and Healthcare products Regulatory Agency (MHRA) and the National Institute for Health and Care Excellence (NICE) provides evidence‑based guidance on medicines and interventions. Weight‑management medicines are evaluated in the context of clinical need, effectiveness, and safety.
Treatment decisions typically align with established clinical pathways for obesity and may involve local formularies and funding criteria. Guidance can evolve as new evidence emerges and as safety monitoring requirements are updated.
Recent guidance and monitoring (what to watch)
Over time, UK guidance may emphasise:
- Structured lifestyle support alongside medication
- Regular monitoring of blood pressure and tolerability
- Clear stop/continue criteria based on early progress
- Review of mental health symptoms and seizure risk assessment
Your healthcare team should provide the most up‑to‑date advice for your situation.
Delivery and availability (UK)
Availability of Contrave can vary depending on supply and local pharmacy stock levels. When ordering online in the UK, delivery is typically arranged through authorised supply routes.
What you can expect when ordering online
- Dispatch times: commonly next‑day or within a few working days, depending on stock.
- Packaging: shipped in secure, tamper‑evident packaging.
- Cold-chain: generally not required for tablets.
- Substitutions: your pharmacy may advise if a pack/strength is temporarily unavailable.
If you need your medicine urgently, contact the online pharmacy’s support team before ordering so they can check stock and dispatch options.
Safety checklist before starting (patient checklist)
Use this checklist to prepare for a safe start. Confirm each point with your clinician or pharmacist.
- I have reviewed my medical history, including seizures, eating disorders, bipolar disorder and liver problems.
- I understand how my current medicines may interact (especially antidepressants, opioids and seizure‑risk medicines).
- I have discussed my alcohol intake and any plans to change drinking patterns.
- I know what side effects to expect and when to seek help.
- I understand the titration schedule and the importance of taking doses at the right times.
FAQ (Frequently asked questions)
1) What is Contrave used for?
Contrave is used as a weight‑management medicine in appropriate adults to help with weight loss as part of a broader plan including healthy eating, physical activity and behaviour changes.
2) When should I take Contrave during the day?
Usually, it is taken once daily at the start, then may become twice daily during the titration schedule. To reduce the chance of sleep problems, many people prefer to avoid taking doses late at night. Follow the specific schedule given with your medicine.
3) Can I take Contrave with food?
Taking with food can help reduce stomach discomfort for many people. Use the instructions on your pack and keep a consistent routine.
4) What if I feel nauseous?
Nausea is common, especially early on. Try taking the tablet with food, drink water, and stick to the titration schedule. If nausea is persistent, severe, or affects your ability to function, seek advice from your pharmacist or clinician.
5) Can I drink alcohol while taking Contrave?
You should discuss your alcohol intake with a healthcare professional. Heavy or sudden changes in alcohol intake may increase risks. If you drink, aim for minimal use and follow professional advice.
6) Will Contrave interfere with pain relief?
Naltrexone can block the effect of opioid pain medicines and may affect other opioid‑related treatments. Tell your clinician/pharmacist about any pain relief you use before starting or if you later need treatment.
7) Does Contrave cause insomnia?
Some people experience sleep problems. Taking the dose earlier in the day (as appropriate to your schedule), limiting caffeine later in the afternoon, and maintaining good sleep habits may help.
8) Is Contrave safe for everyone?
No. Contrave is not suitable for all patients. It may be unsafe in people with certain seizure risks, specific psychiatric conditions, opioid use, or other medical factors. Your clinician will assess your suitability.
9) What happens if I stop taking it?
Stop decisions should be made with medical advice. If you stop early due to side effects or other concerns, ask a clinician how to manage the change safely and what alternative options you have.
10) How long does it take to see results?
Appetite and cravings may change within weeks for some people. Noticeable weight changes usually take longer and vary by individual. Ongoing review helps decide whether treatment is benefiting you.
11) What should I do if I miss a dose?
Take it when you remember unless it is close to the next dose. Do not take a double dose. If unsure, check your medicine instructions or speak with a pharmacist.
12) Are there alternatives if Contrave isn’t suitable?
Yes. Alternatives include other weight‑management medicines (where appropriate) and structured lifestyle programmes. Your clinician can help identify options that best match your needs and health profile.
When to seek urgent help
Seek urgent medical advice if you experience symptoms such as:
- a seizure
- signs of a serious allergic reaction (face/lip swelling, breathing difficulty)
- thoughts of self‑harm or severe mood changes
- chest pain, severe shortness of breath, fainting
- rapid or severe worsening of side effects
If you are concerned about safety at any time, contact a healthcare professional or local emergency services.
Note: This information is intended to help you understand Contrave in a patient‑friendly way. Always follow the instructions supplied with your medicine and the guidance from your healthcare professional for your personal situation.
