Endocrinology Book

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Contrave

Aka: Contrave, Naltrexone and Bupropion
  1. See Also
    1. Obesity Medication
  2. Efficacy
    1. Results in 9 pounds weight loss more than Placebo in one year
  3. Mechanism: Combination Agent
    1. Bupropion suppresses appetite
    2. Naltrexone decreases food cravings
  4. Dosing
    1. Contrave (90 mg Bupropion with 8 mg Naltrexone)
      1. Start: one tablet orally daily for 1 week
      2. Titrate gradually to 2 tablets twice daily over 4 weeks
  5. Contraindications
    1. Seizure disorder (due to Bupropion)
    2. Concurrent Opioid pain management (due to Naltrexone)
    3. Uncontrolled Hypertension
  6. Drug Interactions
    1. Opioids (due to Naltrexone)
  7. Adverse effects
    1. See Naltrexone and Bupropion
    2. Nausea is most common (up to 30% of patients)
    3. Up to 12% of patients stop due to adverse effects (only 50% of patients completed the first Contrave trial)
    4. Suicidality (FDA black box warning)
  8. Disadvantages
    1. Expensive: $7 per day (or $210 per month) for an agent that is marginally better than Bupropion alone (see efficacy below)
  9. Efficacy
    1. Contrave (Bupropion and Naltrexone) results in 9 to 10.8 lb (up to 4.9 kg) weight loss more than Placebo in one year
    2. Bupropion alone results in 6 pounds weight loss more than Placebo in one year
    3. Contrast with Qsymia (Phentermine and Topiramate) which results in 20 pounds weight loss more than Placebo at 1 year
    4. Contrast with 250 calorie deficit per day results in 26 pounds weight loss per year
  10. References
    1. (2014) Presc Lett 21(11): 62
Medication Costs
contrave (on 5/1/2017 at Medicaid.Gov Pharmacy Drug pricing)
CONTRAVE ER 8-90 MG TABLET $1.95 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information.

Contrave (C3252139)

Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH C562296
English Contrave
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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