What goes with Wellbutrin to lose weight?

Naltrexone and bupropion combination is used together with a reduced-calorie diet and proper exercise to help lose weight and keep it off. This medicine is used in people who are overweight or very overweight and who also have weight-related medical problems.

mayoclinic.org - Naltrexone And Bupropion (Oral Route) Precautions - Mayo Clinic

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Description and Brand Names

Drug information provided by: IBM Micromedex

US Brand Name

Contrave

Descriptions

This medicine is available only with your doctor's prescription.

This product is available in the following dosage forms:

Tablet, Extended Release

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of naltrexone and bupropion combination in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of naltrexone and bupropion combination in the elderly. However, elderly patients may be more sensitive to the effects of this medicine and are more likely to have age-related kidney problems, which may require caution and an adjustment in the dose for patients receiving this medicine.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Alfentanil

Alphaprodine

Anileridine

Benzhydrocodone

Bromopride

Buprenorphine

Butorphanol

Codeine

Diacetylmorphine

Difenoxin

Dihydrocodeine

Diphenoxylate

Eliglustat

Ethylmorphine

Fentanyl

Furazolidone

Hydrocodone

Hydromorphone

Iproniazid

Isocarboxazid

Ketobemidone

Levorphanol

Linezolid

Meperidine

Methadone

Methylene Blue

Moclobemide

Morphine

Morphine Sulfate Liposome

Nalbuphine

Nialamide

Nicomorphine

Opium

Opium Alkaloids

Oxycodone

Oxymorphone

Ozanimod

Papaveretum

Paregoric

Phenelzine

Piritramide

Procarbazine

Propoxyphene

Rasagiline

Remifentanil

Selegiline

Sufentanil

Tapentadol

Tilidine

Tramadol

Tranylcypromine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acetophenazine

Aclidinium

Acrivastine

Acyclovir

Alcaftadine

Alfentanil

Almotriptan

Amantadine

Ambenonium

Amdinocillin

Amdinocillin Pivoxil

Amiloride

Amineptine

Aminophylline

Amitriptyline

Amitriptylinoxide

Amoxapine

Amphetamine

Amphotericin B

Ampicillin

Anileridine

Anisotropine

Antazoline

Aripiprazole

Astemizole

Atomoxetine

Atovaquone

Atropine

Azatadine

Azelastine

Azlocillin

Aztreonam

Bacampicillin

Baclofen

Balofloxacin

Belladonna Alkaloids

Benperidol

Benzhydrocodone

Benzphetamine

Bepotastine

Besifloxacin

Betamethasone

Bornaprine

Bremelanotide

Brexpiprazole

Bromodiphenhydramine

Bromperidol

Brompheniramine

Buclizine

Budesonide

Bupivacaine

Buprenorphine

Buspirone

Busulfan

Butorphanol

Butriptyline

Butylscopolamine

Carbamazepine

Carbenicillin

Carbimazole

Carbinoxamine

Carvedilol

Chlorambucil

Chloroquine

Chlorotrianisene

Chlorpheniramine

Chlorphenoxamine

Chlorpromazine

Chlorprothixene

Cimetidine

Cimetropium

Cinnarizine

Ciprofloxacin

Citalopram

Clemastine

Clemizole

Clidinium

Clobetasone

Clomipramine

Clopidogrel

Clothiapine

Clovoxamine

Cloxacillin

Clozapine

Cocaine

Codeine

Conjugated Estrogens

Corticotropin

Cortisone

Cosyntropin

Cyclacillin

Cyclizine

Cyclobenzaprine

Cyclopentolate

Cyclosporine

Cyproheptadine

Dalfampridine

Danazol

Darifenacin

Deflazacort

Delavirdine

Demecarium

Desipramine

Desonide

Desvenlafaxine

Deutetrabenazine

Dexamethasone

Dexbrompheniramine

Dexchlorpheniramine

Dextroamphetamine

Dextromethorphan

Dibenzepin

Dicloxacillin

Dicyclomine

Dienestrol

Diethylstilbestrol

Difenoxin

Dihydroartemisinin

Dihydrocodeine

Dimenhydrinate

Dimethindene

Diphenhydramine

Diphenoxylate

Diphenylpyraline

Distigmine

Dixyrazine

Dolasetron

Donepezil

Dopamine

Dothiepin

Doxepin

Doxofylline

Doxorubicin

Doxorubicin Hydrochloride Liposome

Doxylamine

Droperidol

Duloxetine

Ebastine

Echothiophate

Edrophonium

Efavirenz

Eletriptan

Emedastine

Enflurane

Enoxacin

Epinastine

Escitalopram

Esterified Estrogens

Estradiol

Estramustine

Estriol

Estrone

Estropipate

Ethinyl Estradiol

Ethopropazine

Ethylmorphine

Etomidate

Famotidine

Femoxetine

Fenfluramine

Fentanyl

Fesoterodine

Fexinidazole

Flavoxate

Flecainide

Floxacillin

Fludrocortisone

Flumequine

Flunarizine

Flunisolide

Fluoxetine

Fluphenazine

Fluticasone

Fluvoxamine

Foscarnet

Fosphenytoin

Frovatriptan

Galantamine

Ganciclovir

Gatifloxacin

Glycopyrrolate

Granisetron

Guanidine

Halofantrine

Haloperidol

Hetacillin

Homatropine

Hydrocodone

Hydrocortisone

Hydromorphone

Hydroxyamphetamine

Hydroxychloroquine

Hydroxytryptophan

Hydroxyzine

Hyoscyamine

Ifosfamide

Imipenem

Imipramine

Indalpine

Iobenguane I 123

Iobenguane I 131

Iprindole

Isoflurane

Isoflurophate

Isoniazid

Isopropamide

Ketamine

Ketobemidone

Ketotifen

Lasmiditan

Lemborexant

Levocabastine

Levodopa

Levofloxacin

Levomilnacipran

Levorphanol

Lidocaine

Lindane

Lisdexamfetamine

Lithium

Lofepramine

Lomefloxacin

Lopinavir

Lorcaserin

Loxapine

Maprotiline

Mebeverine

Mebhydrolin

Meclizine

Mefenamic Acid

Mefloquine

Melitracen

Melperone

Memantine

Mepenzolate

Meperidine

Meropenem

Mesoridazine

Mestranol

Metformin

Methadone

Methamphetamine

Methantheline

Methdilazine

Methenolone

Methicillin

Methimazole

Methixene

Methotrimeprazine

Methylphenidate

Methylprednisolone

Methyltestosterone

Metoclopramide

Metopimazine

Metronidazole

Mexiletine

Mezlocillin

Midostaurin

Milnacipran

Mirtazapine

Mizolastine

Morphine

Morphine Sulfate Liposome

Moxifloxacin

Nadifloxacin

Nafcillin

Nalbuphine

Naldemedine

Nalidixic Acid

Naloxegol

Nandrolone

Naratriptan

Nebivolol

Nefazodone

Neostigmine

Nevirapine

Niaprazine

Nicomorphine

Norfloxacin

Nortriptyline

Ofloxacin

Olanzapine

Olopatadine

Ondansetron

Opipramol

Opium

Opium Alkaloids

Oxacillin

Oxaliplatin

Oxandrolone

Oxatomide

Oxybutynin

Oxymetholone

Oxymorphone

Palonosetron

Papaveretum

Paramethasone

Paregoric

Paroxetine

Pazufloxacin

Pefloxacin

Penicillin G

Penicillin V

Pentazocine

Perazine

Periciazine

Perphenazine

Phenindamine

Pheniramine

Phenobarbital

Phenylpropanolamine

Phenyltoloxamine

Phenytoin

Physostigmine

Pimozide

Pipamperone

Piperacillin

Piperaquine

Pipotiazine

Pirenzepine

Piritramide

Pitolisant

Pivampicillin

Pizotyline

Polyestradiol Phosphate

Prednisolone

Prednisone

Procainamide

Procaine

Prochlorperazine

Proguanil

Promazine

Promestriene

Promethazine

Propafenone

Propantheline

Propicillin

Propiverine

Propizepine

Propofol

Propoxyphene

Propranolol

Protriptyline

Prulifloxacin

Pyrilamine

Quetiapine

Quinacrine

Quinestrol

Ranitidine

Remifentanil

Rifampin

Rimexolone

Risperidone

Ritonavir

Rivastigmine

Rizatriptan

Rufloxacin

Safinamide

Scopolamine

Sertraline

Sevoflurane

Sibutramine

Solifenacin

Sparfloxacin

Stanozolol

Sufentanil

Sulbenicillin

Sultamicillin

Sumatriptan

Tacrine

Tapentadol

Temocillin

Terfenadine

Testosterone

Theophylline

Thiethylperazine

Thiopropazate

Thioproperazine

Thioridazine

Thiotepa

Thiothixene

Thonzylamine

Tianeptine

Tibolone

Ticarcillin

Ticlopidine

Tilidine

Timiperone

Timolol

Tolterodine

Tramadol

Trazodone

Trifluoperazine

Triflupromazine

Trimeprazine

Trimipramine

Tripelennamine

Triprolidine

Tropicamide

Trospium

Tryptophan

Umeclidinium

Valbenazine

Valethamate

Varenicline

Venlafaxine

Vilazodone

Vortioxetine

Zidovudine

Ziprasidone

Zolmitriptan

Zuclopenthixol

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Aripiprazole Lauroxil

Digoxin

Isavuconazonium Sulfate

Lofexidine

Nirmatrelvir

St John's Wort

Tipranavir

Yohimbine

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

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Ethanol

Alcohol use, if stopped suddenly, or

Eating disorders (eg, anorexia, bulimia), history of or

Hypertension (high blood pressure), uncontrolled or

Seizure medicine use, if stopped suddenly (eg, carbamazepine (Tegretol®), phenobarbital, phenytoin (Dilantin®)), or

Seizures, or history of or

Sleeping or anxiety medicine use, if stopped suddenly (eg, alprazolam (Xanax®), lorazepam (Ativan®), temazepam (Restoril®), triazolam (Halcion®))—Should not be used in patients with these conditions.

Arteriovenous malformation (circulation problem) or

Brain tumor or infection or

Diabetes or

Drug or alcohol abuse or

Head injury or

Hypoglycemia (low blood sugar) or

Hyponatremia (low sodium in the blood) or

Hypoxia (low oxygen in the blood) or

Liver disease, severe or

Stroke, severe or history of—May increase risk for seizures.

Bipolar disorder (type of depression), or risk of or

Glaucoma, angle closure or

Hypertension (high blood pressure) or

Mania or hypomania (type of mental disease), history of or

Psychosis (type of mental disease)—Use with caution. May make these conditions worse.

End-stage kidney disease or

Liver disease, severe—Use is not recommended in patients with these conditions.

Kidney disease, moderate or severe or

Liver disease, moderate—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects. This medicine comes with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions. Follow your doctor's instructions carefully on a reduced-calorie diet plan and regular exercise. Talk with your doctor before starting any exercise program.

Swallow the tablet whole. Do not crush, break, or chew it.

Take this medicine with food. However, do not take it with high-fat meals. This may increase your risk of seizures.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. For oral dosage form (extended-release tablets): For weight loss: Adults—At first, one tablet in the morning taken on week 1. Your doctor will increase your dose to one tablet in the morning and one tablet in the evening on week 2. Then, two tablets in the morning and one tablet in the evening on week 3. On week 4, two tablets in the morning and two tablets in the evening. Children—Use is not recommended.

Missed Dose

If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and to check for unwanted effects. Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant during therapy. If you think you have become pregnant while using this medicine, tell your doctor right away. Do not take naltrexone and bupropion combination with a monoamine oxidase (MAO) inhibitor (eg, isocarboxazid [Marplan®], phenelzine [Nardil®], selegiline [Eldepryl®], tranylcypromine [Parnate®]). Do not start taking naltrexone and bupropion combination during the 2 weeks after you stop a MAO inhibitor. Wait 2 weeks after stopping naltrexone and bupropion combination before you start taking a MAO inhibitor. If you take them together or do not wait 2 weeks, you may have confusion, agitation, restlessness, stomach or bowel symptoms, a sudden high body temperature, an extremely high blood pressure, or severe seizures. Do not use naltrexone and bupropion combination if you are also using Zyban® to quit smoking or Aplenzin® or Wellbutrin® for depression, because they also contain bupropion. Also, do not take this medicine if you are using or have used narcotic drugs (eg, buprenorphine, methadone, or other habit-forming painkillers) within the past 7 to 10 days. This medicine may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. Make sure the doctor knows if you have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. Also tell the doctor if you have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. If you or your caregiver notice any of these side effects, tell your doctor right away. You have a higher risk of accidental overdose, serious injury, or death if you use heroin or any other narcotic medicine while you are being treated with naltrexone and bupropion combination. Also, naltrexone prevents you from feeling the effects of heroin if you use it. Do not stop taking this medicine without checking first with your doctor. Your doctor may want you to gradually reduce the amount you are taking before stopping it completely. This is to decrease the chance of having certain side effects when you stop the medicine, such as agitation, anxiety, dizziness, a feeling of constant movement of self or surroundings, headaches, increased sweating, nausea, trembling or shaking, trouble with sleeping or walking, or unusual tiredness. Your blood pressure might get too high while you are using this medicine. This may cause headaches, dizziness, or blurred vision. You might need to measure your blood pressure at home. If you think your blood pressure is too high, call your doctor right away.

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This medicine may cause a serious type of allergic reaction called anaphylaxis, which can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, swelling of the face, tongue, or throat, trouble breathing, or chest pain. Serious skin reactions (eg, Stevens-Johnson syndrome) can occur with this medicine. Check with your doctor right away if you have blistering, peeling, or loosening of the skin, red skin lesions, severe acne or skin rash, sores or ulcers on the skin, or fever or chills with this medicine. Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem. Check with your doctor right away if blurred vision, eye pain, or any other change in vision occurs during or after treatment. Your doctor may want your eyes be checked by an ophthalmologist (eye doctor). This medicine may increase the risk of hypoglycemia (low blood sugar) in patients with diabetes. Low blood sugar must be treated before it causes you to pass out (unconsciousness). People feel different symptoms of low blood sugar. It is important that you learn which symptoms you usually have so you can treat it quickly. You should check your blood sugar before you start treatment and while you are taking this medicine. Drinking alcoholic beverages should be limited or avoided, if possible, with this medicine. Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of some tests may be affected by this medicine. Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur:

More common

Blurred vision discouragement dizziness fear or nervousness feeling sad or empty headache irritability lack of appetite loss of interest or pleasure pounding in the ears slow or fast heartbeat trouble concentrating trouble sleeping unusual tiredness or weakness

Less common

Bladder pain bloody or cloudy urine difficult, burning, or painful urination fast, irregular, pounding, or racing heartbeat or pulse frequent urge to urinate lower back or side pain shakiness in the legs, arms, hands, or feet trembling or shaking of the hands or feet

Less common or rare

Chest pain or discomfort nausea pain or discomfort in the arms, jaw, back, or neck sweating vomiting

Rare

Changes in behavior thoughts of killing oneself

Incidence not known

Aggressive or angry anxiety blistering, peeling, or loosening of the skin chills clay colored stools cough dark urine delusions of persecution, mistrust, suspiciousness, or combativeness diarrhea difficulty with moving difficulty with swallowing dry mouth false beliefs that cannot be changed by facts feeling that others are watching you or controlling your behavior feeling, seeing, or hearing things that are not there fever hives, itching, or rash hyperventilation joint or muscle pain large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs muscle stiffness puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue red, irritated eyes restlessness severe mood or mental changes sore throat sores, ulcers, or white spots in the mouth or on the lips stomach pain or tenderness swelling of the feet or lower legs tightness in the chest unusual behavior yellow eyes or skin Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Blue lips, fingernails, or skin change in or loss of consciousness confusion decreased awareness or responsiveness dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position muscle cramps or spasms severe sleepiness Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Difficulty having a bowel movement

Less common

Change or loss of taste continuing ringing or buzzing or other unexplained noise in the ears feeling of warmth hearing loss increased sweating redness of the face, neck, arms, and occasionally, upper chest stomach pain

Rare

Feeling of constant movement of self or surroundings indigestion sensation of spinning severe nausea or vomiting thinning of the hair or hair loss Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

mayoclinic.org - Naltrexone And Bupropion (Oral Route) Precautions - Mayo Clinic

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