Bupropion Naltrexone: Comprehensive Guide to Weight Loss Medication

Summary

Bupropion Naltrexone is a combination medication used to treat obesity, depression, and substance use disorders. It works by affecting brain chemicals that regulate cravings and mood. This prescription medication should be taken under the guidance of a healthcare provider. Always consult your doctor before making any changes to your treatment plan. You can also schedule a telemedicine appointment with one of our providers for personalized care.

Names of Medication

US Brand Name: Contrave (Bupropion Naltrexone)

The generic name refers to the active ingredients in the medication, listed in parentheses. It is the scientific name of the drug, while the brand name is the name under which the drug is marketed.

Pharmacologic Category

Naltrexone: Opioid Antagonist

Bupropion: Dopamine/Norepinephrine Reuptake Inhibitor (DNRI)

Bupropion Naltrexone Dosage

Bupropion Naltrexone is prescribed for various conditions. Below are the recommended doses for adults. Always consult your healthcare provider before adjusting your dose. If you need assistance, our telemedicine providers are available to help.

Bupropion Naltrexone for Obesity Treatment

Initial Dose: 8 mg/90 mg (one tablet) once daily in the morning for the first week.

Maintenance Dose: Increase to 8 mg/90 mg twice daily (one tablet in the morning and one in the evening) by the fourth week.

Duration: The length of treatment depends on your weight loss goals and how you respond to the medication. Consult your doctor for a personalized plan.

Major Depressive Disorder

Initial Dose: 8 mg/90 mg once daily in the morning.

Maintenance Dose: Gradually increase to 8 mg/90 mg twice daily, as tolerated.

Duration: The duration of treatment varies based on individual response. Your doctor will monitor your progress and adjust the plan as needed.

Alcohol Use Disorder

Initial Dose: 8 mg/90 mg once daily.

Maintenance Dose: Increase to 8 mg/90 mg twice daily after the first week.

Duration: Treatment may continue for several months, depending on your progress. Consult your healthcare provider for ongoing guidance.

Nicotine Dependence

Initial Dose: 8 mg/90 mg once daily.

Maintenance Dose: Gradually increase to 8 mg/90 mg twice daily.

Duration: The length of treatment will depend on your progress in quitting smoking. Your doctor will tailor the plan to your specific needs.

Dosage Forms and Strengths

Tablet: 8 mg of Naltrexone and 90 mg of Bupropion

Administration Instructions for Bupropion Naltrexone

Take Bupropion Naltrexone exactly as prescribed by your healthcare provider. Swallow the tablet whole; do not crush, chew, or split it. It is typically taken twice daily, once in the morning and once in the evening. You can take it with or without food, but avoid high-fat meals, as they may increase the risk of side effects. If you miss a dose, do not double up; simply take the next dose as scheduled. Always follow your doctor’s instructions, and if you have any questions, our telemedicine team is here to assist you.

Contraindications for Bupropion Naltrexone

A contraindication is a specific condition where a medication should not be used because it may cause harm. It’s important to know if you have any conditions that would make taking Bupropion Naltrexone unsafe.

Contraindications for Bupropion Naltrexone

Uncontrolled high blood pressure (hypertension): Bupropion Naltrexone can raise blood pressure, which may worsen uncontrolled hypertension and increase the risk of heart attack or stroke.

Seizure disorders: Bupropion lowers the seizure threshold, increasing the likelihood of seizures in individuals with a history of them.

Eating disorders (e.g., bulimia, anorexia nervosa): People with eating disorders are at a higher risk of seizures, and Bupropion can further elevate this risk.

Chronic opioid use or opioid withdrawal: Naltrexone blocks the effects of opioids. If you are dependent on opioids, taking Naltrexone can trigger severe withdrawal symptoms.

Recent use of monoamine oxidase inhibitors (MAOIs): Taking Bupropion Naltrexone within 14 days of using MAOIs can lead to dangerous interactions, including high blood pressure and seizures.

Severe liver or kidney disease: Both Naltrexone and Bupropion are processed by the liver and kidneys. If these organs are not functioning properly, the medication may accumulate in your system and cause harmful effects.

Pregnancy: Bupropion Naltrexone is not recommended during pregnancy due to potential risks to the developing fetus (see more below).

Drug to Drug Interactions

Bupropion Naltrexone can interact with other medications, increasing the risk of side effects or reducing the effectiveness of either drug. Always inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements.

Medications that Interact with Bupropion Naltrexone

Opioid medications: (e.g., OxyContin [oxycodone], Vicodin [hydrocodone]) – Naltrexone blocks the effects of opioids, which can cause withdrawal symptoms in those dependent on them.

Antidepressants: (e.g., Zoloft [sertraline], Prozac [fluoxetine]) – Combining Bupropion with other antidepressants can increase the risk of seizures and serotonin syndrome, a potentially life-threatening condition.

Antipsychotics: (e.g., Abilify [aripiprazole], Seroquel [quetiapine]) – These medications can increase the risk of seizures when taken with Bupropion.

Beta-blockers: (e.g., Inderal [propranolol], Tenormin [atenolol]) – These medications may interact with Bupropion, leading to changes in blood pressure or heart rate.

Blood thinners: (e.g., Coumadin [warfarin]) – Bupropion can affect how your body processes blood thinners, increasing the risk of bleeding.

Naltrexone-Bupropion in Pregnancy

Is it safe to take Bupropion Naltrexone during pregnancy?

Bupropion Naltrexone is generally not recommended during pregnancy. Animal studies have indicated potential risks to the developing fetus, and there is limited information on its safety in pregnant women. If you are pregnant or planning to become pregnant, it is important to consult your healthcare provider to explore safer alternatives. If you are already taking Bupropion Naltrexone and find out you are pregnant, contact your provider right away to discuss the most appropriate next steps.

Naltrexone-Bupropion while Breastfeeding

Is it safe to take Bupropion Naltrexone while breastfeeding?

Bupropion Naltrexone is not recommended for use while breastfeeding. Both Naltrexone and Bupropion can be passed through breast milk, and their effects on a nursing infant are not well understood. If you are breastfeeding, it’s essential to talk to your healthcare provider about alternative treatments to ensure the safety of your baby.

Estimated Cost of Bupropion Naltrexone Medication

The cost of a 30-day supply of Bupropion Naltrexone without insurance can vary. With a GoodRx coupon, the price typically ranges from $90 to $130, depending on the pharmacy. Prices may fluctuate, so it’s a good idea to check with your local pharmacy or use a prescription savings tool like GoodRx to find the most affordable option for your prescription.

Possible Alternatives to Bupropion Naltrexone

If Bupropion Naltrexone is not suitable for you, there are other treatments and lifestyle changes that may help manage your condition. Always consult your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine appointment with one of our providers to discuss these alternatives.

Obesity Treatment Alternatives

1. Other weight-loss medications (e.g., Saxenda [liraglutide], Qsymia [phentermine-topiramate])
2. Dietary changes, such as adopting a low-calorie or low-carbohydrate diet
3. Increasing physical activity
4. Bariatric surgery for severe cases

Major Depressive Disorder Treatment Alternatives

1. Other antidepressants (e.g., Zoloft [sertraline], Lexapro [escitalopram])
2. Cognitive-behavioral therapy (CBT)
3. Exercise and mindfulness practices

Alcohol Use Disorder Treatment Alternatives

1. Other medications (e.g., Antabuse [disulfiram], Campral [acamprosate])
2. Counseling and support groups (e.g., Alcoholics Anonymous)
3. Behavioral therapy

Nicotine Dependence Treatment Alternatives

1. Nicotine replacement therapy (e.g., nicotine patches, gum)
2. Other medications (e.g., Chantix [varenicline])
3. Counseling and support programs

Attention Deficit Hyperactivity Disorder (ADHD) Treatment Alternatives

1. Stimulant medications (e.g., Adderall [amphetamine], Ritalin [methylphenidate])
2. Non-stimulant medications (e.g., Strattera [atomoxetine])
3. Behavioral therapy

Anxiety Disorders Treatment Alternatives

1. Other medications (e.g., Xanax [alprazolam], Zoloft [sertraline])
2. Cognitive-behavioral therapy (CBT)
3. Mindfulness and relaxation techniques

Bipolar Disorder Treatment Alternatives

1. Mood stabilizers (e.g., Lithium, Depakote [valproate])
2. Antipsychotic medications (e.g., Seroquel [quetiapine])
3. Psychotherapy

Post-Traumatic Stress Disorder (PTSD) Treatment Alternatives

1. Other medications (e.g., Zoloft [sertraline], Prazosin)
2. Trauma-focused cognitive-behavioral therapy (CBT)
3. Eye movement desensitization and reprocessing (EMDR)

Eating Disorders Treatment Alternatives

1. Cognitive-behavioral therapy (CBT)
2. Nutritional counseling
3. Other medications (e.g., Prozac [fluoxetine])

Substance Use Disorder Treatment Alternatives

1. Other medications (e.g., Suboxone [buprenorphine-naloxone], Methadone)
2. Counseling and support groups (e.g., Narcotics Anonymous)
3. Behavioral therapy

Recent Updates on Bupropion Naltrexone Research

Recent studies have explored the effectiveness of Bupropion Naltrexone in treating obesity and substance use disorders. A 2021 study found that Bupropion Naltrexone significantly reduced body weight in patients with obesity, particularly when combined with lifestyle changes such as diet and exercise. Additionally, ongoing research is investigating the potential of this combination for treating alcohol use disorder and aiding smoking cessation, with promising early results. However, more long-term studies are needed to fully understand the benefits and risks of Bupropion Naltrexone in these areas.

James Kingsley

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