Bupropion Naltrexone

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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

  1. abdominal pain
  2. agitation
  3. alopecia
  4. amnesia
  5. anaphylactic shock
  6. anaphylactoid reactions
  7. angioedema
  8. anxiety
  9. arthralgia
  10. cholecystitis
  11. constipation
  12. dehydration
  13. diarrhea
  14. dizziness
  15. dysgeusia
  16. dyspnea
  17. elevated hepatic enzymes
  18. emotional lability
  19. eructation
  20. erythema multiforme
  21. fatigue
  22. fever
  23. hallucinations
  24. headache
  25. hepatitis
  26. hostility
  27. hot flashes
  28. hyperhidrosis
  29. hypertension
  30. impotence (erectile dysfunction)
  31. infection
  32. influenza
  33. insomnia
  34. irritability
  35. lethargy
  36. malaise
  37. mania
  38. memory impairment
  39. menstrual irregularity
  40. muscle cramps
  41. myalgia
  42. myocardial infarction
  43. nausea
  44. ocular hypertension
  45. palpitations
  46. paranoia
  47. polydipsia
  48. pruritus
  49. psychosis
  50. rash
  51. seizures
  52. serum sickness
  53. sinus tachycardia
  54. Stevens-Johnson syndrome
  55. suicidal ideation
  56. syncope
  57. tinnitus
  58. tremor
  59. urinary urgency
  60. urticaria
  61. vaginal bleeding
  62. vertigo
  63. vomiting
  64. 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

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