Bupropion Naltrexone Brand Name– CONTRAVE
What is Bupropion Naltrexone
Bupropion naltrexone is a combination product containing an antidepressant (bupropion) and an opioid antagonist (naltrexone).
The combination is used as an adjunct to lifestyle modifications for weight loss and chronic weight management in obese adults, or in overweight adults with at least 1 weight-related comorbidity (e.g., hypertension, type 2 diabetes mellitus, or dyslipidemia).
According to the American Association of Clinical Endocrinologists and American College of Endocrinology (AACE/ACE) Obesity Clinical Practice Guidelines, weight loss medications should be offered as chronic treatment along with lifestyle modifications to obese patients when the potential benefits outweigh the risks.
Short-term pharmacotherapy has not been shown to produce longer-term health benefits and cannot be generally recommended. A generalized hierarchy for medication preferences that would apply to all obese patients cannot currently be scientifically justified.
Individualized weight loss pharmacotherapy is recommended, based on factors such as the specific characteristics of each weight loss medication, the presence of weight-related complications, and the medical history of the patient.
Due to the risk for seizure, patients must not take other bupropion products concurrently.
The boxed warning in the label also alerts to risks for depression, suicidal thoughts, and potential for neuropsychiatric events.
Bupropion naltrexone was FDA-approved in 2014.
Indications
- obesity
- weight management
For the treatment of obesity and for chronic weight management as an adjunct to a reduced-calorie diet and increased physical activity
Side Effects
- abdominal pain
- agitation
- alopecia
- amnesia
- anaphylactic shock
- anaphylactoid reactions
- angioedema
- anxiety
- arthralgia
- cholecystitis
- constipation
- dehydration
- diarrhea
- dizziness
- dysgeusia
- dyspnea
- elevated hepatic enzymes
- emotional lability
- eructation
- erythema multiforme
- fatigue
- fever
- hallucinations
- headache
- hepatitis
- hostility
- hot flashes
- hyperhidrosis
- hypertension
- impotence (erectile dysfunction)
- infection
- influenza
- insomnia
- irritability
- lethargy
- malaise
- mania
- memory impairment
- menstrual irregularity
- muscle cramps
- myalgia
- myocardial infarction
- nausea
- ocular hypertension
- palpitations
- paranoia
- polydipsia
- pruritus
- psychosis
- rash
- seizures
- serum sickness
- sinus tachycardia
- Stevens-Johnson syndrome
- suicidal ideation
- syncope
- tinnitus
- tremor
- urinary urgency
- urticaria
- vaginal bleeding
- vertigo
- vomiting
- xerostomia
Monitoring Parameters
- blood pressure
- heart rate
- LFTs
- weight
Contraindications
- abrupt discontinuation
- acute opioid withdrawal
- alcoholism
- anorexia nervosa
- arteriovenous malformation
- bariatric surgery
- behavioral changes
- benzodiazepine withdrawal
- bipolar disorder
- brain tumor
- breast-feeding
- bulimia nervosa
- cardiac arrhythmias
- cardiac disease
- cerebrovascular disease
- children
- closed-angle glaucoma
- contraception requirements
- depression
- diabetes mellitus
- dialysis
- geriatric
- head trauma
- heart failure
- hepatic disease
- hepatitis
- hepatotoxicity
- hypertension
- hypoglycemia
- hyponatremia
- hypoxemia
- infants
- laboratory test interference
- mania
- MAOI therapy
- myocardial infarction
- neonates
- pregnancy
- psychiatric event
- renal disease
- renal failure
- renal impairment
- schizophrenia
- seizure disorder
- seizures
- stroke
- substance abuse
- suicidal ideation
Interactions
- Acamprosate
- Acetaminophen; Aspirin, ASA; Caffeine
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Codeine
- Acetaminophen; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Pentazocine
- Acetaminophen; Propoxyphene
- Acetaminophen; Pseudoephedrine
- Acetaminophen; Tramadol
- Acetazolamide
- Acrivastine; Pseudoephedrine
- Alfentanil
- Alosetron
- Alvimopan
- Amantadine
- Amifampridine
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amobarbital
- Amoxapine
- Amphetamine
- Amphetamine; Dextroamphetamine
- Amphetamine; Dextroamphetamine Salts
- Anticonvulsants
- Aripiprazole
- Armodafinil
- Asenapine
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Oxycodone
- Atazanavir; Cobicistat
- Atropine
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Atropine; Difenoxin
- Atropine; Diphenoxylate
- Atropine; Edrophonium
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Azelastine; Fluticasone
- Barbiturates
- Beclomethasone
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Benzphetamine
- Benztropine
- Betamethasone
- Bethanechol
- Bremelanotide
- Brexpiprazole
- Brimonidine; Timolol
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Brompheniramine; Pseudoephedrine
- Budesonide
- Budesonide; Formoterol
- Buprenorphine
- Buprenorphine; Naloxone
- Butabarbital
- Butorphanol
- Caffeine
- Caffeine; Ergotamine
- Cannabidiol
- Carbamazepine
- Carbetapentane; Pseudoephedrine
- Carbidopa; Levodopa
- Carbidopa; Levodopa; Entacapone
- Carbinoxamine; Dextromethorphan; Pseudoephedrine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Carbinoxamine; Pseudoephedrine
- Cariprazine
- Carvedilol
- Cenobamate
- Cetirizine; Pseudoephedrine
- Cevimeline
- Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
- Chlordiazepoxide; Clidinium
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Pseudoephedrine
- Chlorpromazine
- Ciclesonide
- Cimetidine
- Citalopram
- Clomipramine
- Clopidogrel
- Clozapine
- Cobicistat
- Cocaine
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Corticosteroids
- Corticotropin, ACTH
- Cortisone
- Cyclobenzaprine
- Dabrafenib
- Dalfampridine
- Darifenacin
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Deflazacort
- Desipramine
- Desloratadine; Pseudoephedrine
- Deutetrabenazine
- Dexamethasone
- Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
- Dexmethylphenidate
- Dextroamphetamine
- Dextromethorphan; Guaifenesin; Pseudoephedrine
- Dextromethorphan; Promethazine
- Dicyclomine
- Diethylpropion
- Digoxin
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Disulfiram
- Dorzolamide; Timolol
- Doxepin
- Doxercalciferol
- Doxorubicin
- Dronabinol
- Duloxetine
- Dutasteride; Tamsulosin
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Encainide
- Ethanol
- Ethotoin
- Felbamate
- Fentanyl
- Fexofenadine; Pseudoephedrine
- Flavoxate
- Flecainide
- Fludrocortisone
- Flunisolide
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluphenazine
- Fluticasone
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Fluvoxamine
- Formoterol; Mometasone
- Fosphenytoin
- Gabapentin
- Gefitinib
- Glycopyrrolate
- Glycopyrrolate; Formoterol
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Guaifenesin; Pseudoephedrine
- Guanfacine
- Haloperidol
- Homatropine; Hydrocodone
- Hydantoins
- Hydrochlorothiazide, HCTZ; Metoprolol
- Hydrochlorothiazide, HCTZ; Propranolol
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydrocortisone
- Hydromorphone
- Hydroxyprogesterone
- Hyoscyamine
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Iloperidone
- Imipramine
- Indacaterol; Glycopyrrolate
- Iobenguane I 131
- Isavuconazonium
- Isocarboxazid
- Isoniazid, INH
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Ivosidenib
- Lacosamide
- Lamotrigine
- Lasmiditan
- Lemborexant
- Levetiracetam
- Levodopa
- Levomethadyl
- Levorphanol
- Linezolid
- Lisdexamfetamine
- Lofexidine
- Loperamide
- Loperamide; Simethicone
- Lopinavir; Ritonavir
- Loratadine; Pseudoephedrine
- Lorcaserin
- Loxapine
- Lumacaftor; Ivacaftor
- Lumacaftor; Ivacaftor
- Lurasidone
- Maprotiline
- Mepenzolate
- Meperidine
- Meperidine; Promethazine
- Mephobarbital
- Mesoridazine
- Methadone
- Methamphetamine
- Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
- Methohexital
- Methscopolamine
- Methylene Blue
- Methylnaltrexone
- Methylphenidate
- Methylprednisolone
- Metoclopramide
- Metoprolol
- Mexiletine
- Midazolam
- Mifepristone
- Modafinil
- Molindone
- Mometasone
- Monoamine oxidase inhibitors
- Morphine
- Morphine; Naltrexone
- Nabilone
- Nalbuphine
- Naldemedine
- Naloxegol
- Naproxen; Pseudoephedrine
- Nebivolol
- Nebivolol; Valsartan
- Nelfinavir
- Nicotine
- Nitroglycerin
- Non-Ionic Contrast Media
- Nortriptyline
- Olanzapine
- Ombitasvir; Paritaprevir; Ritonavir
- Opiate Agonists-Antagonists
- Oxcarbazepine
- Oxybutynin
- Oxycodone
- Oxymorphone
- Paliperidone
- Paroxetine
- Pemoline
- Pentazocine
- Pentazocine; Naloxone
- Pentobarbital
- Perphenazine
- Perphenazine; Amitriptyline
- Phendimetrazine
- Phenelzine
- Phenobarbital
- Phenothiazines
- Phentermine
- Phentermine; Topiramate
- Phenylephrine; Promethazine
- Phenytoin
- Pimozide
- Pitolisant
- Prednisolone
- Prednisone
- Primidone
- Procarbazine
- Prochlorperazine
- Promethazine
- Propafenone
- Propantheline
- Propoxyphene
- Propranolol
- Protriptyline
- Pseudoephedrine
- Ranolazine
- Rasagiline
- Remifentanil
- Rifampin
- Risperidone
- Ritonavir
- Scopolamine
- Secobarbital
- Selegiline
- Sertraline
- Sodium Oxybate
- Solriamfetol
- Sufentanil
- Tamoxifen
- Tamsulosin
- Tapentadol
- Theophylline, Aminophylline
- Thiethylperazine
- Thiopental
- Thioridazine
- Thiotepa
- Thiothixene
- Tiagabine
- Ticlopidine
- Timolol
- tobacco
- Tolterodine
- Topiramate
- Tramadol
- Tranylcypromine
- Triamcinolone
- Triazolam
- Tricyclic antidepressants
- Trifluoperazine
- Trihexyphenidyl
- Trimipramine
- Trospium
- Valproic Acid, Divalproex Sodium
- Vigabatrin
- Vortioxetine
- Warfarin
- Ziprasidone
- Zolpidem
- Zonisamide