Contrave Costs, Side Effects and Typical Results

If you need to lose weight and you're looking for a prescription weight loss medication, you have several choices. Your doctor may talk to you about BelviqQsymiaSaxenda or a medication called Contrave (bupropion and naltrexone). Here's what you need to know about Contrave, including costs, weight loss results, and side effects.

What Is Contrave?

Contrave is a combination of two different medications: naltrexone hydrochloride and bupropion hydrochloride. Each extended-release tablet contains:

  • Eight milligrams of naltrexone, an opioid agonist that is often prescribed for alcohol dependence, opioid dependence, or smoking cessation
  • 90 milligrams of bupropion, an aminoketone antidepressant that is used to treat depression and seasonal affective disorder

The combination of the two medications is prescribed to improve weight loss. The drug affects your central nervous system to increase the number of calories you burn and reduce your appetite. The tablets are prescribed along with a reduced-calorie diet and exercise program to help certain people lose weight. Contrave is manufactured by Orexigen and distributed by Takeda.

Who Can Take Contrave?

Contrave is approved to help adults with a body mass index (BMI) of 30 or greater. It is also approved for adults with a BMI of 27 or greater who have at least one weight-related condition such as high cholesterol, type 2 diabetes, or high blood pressure. Certain people should not take Contrave. Avoid the medication if you:

  • Have uncontrolled high blood pressure
  • Have a seizure disorder, anorexia nervosa, or bulimia
  • Are undergoing abrupt withdrawal from alcohol or other drugs (such as benzodiazepines, barbiturates, and antiepileptic medications) 
  • Are taking other medications that contain bupropion (such as Wellbutrin and Aplenzin)
  • Are a chronic opioid user
  • Are pregnant or breastfeeding
  • Are allergic to any of the ingredients of Contrave
  • Are taking monoamine oxidase inhibitors (MAOIs) or have taken them within 14 days

Scientists do not know how taking Contrave affects long-term cardiovascular health. So if you are already at risk for cardiovascular disease, you may want to speak to your doctor about the potential for harm if you take this diet pill. The drugmaker is conducting studies to see how the diet pill interacts with heart health, but results are not due until 2021.

Lastly, researchers also do not know how Contrave interacts with other weight loss products, including prescription medications, over-the-counter drugs, and herbal supplements. Be sure to let your doctor know if you are taking any other prescription or non-prescription treatment when you discuss whether or not the medication is right for you.

Weight Loss Results

According to clinical studies, Contrave can help to promote weight loss, but the numbers aren't staggering. In a study of patients without diabetes, 42% of patients lost at least 5% of their body weight after a year. That means that most people taking Contrave did not meet the 5% goal.

In another study, 57% of patients who took Contrave lost at least 5% of their body weight. But 42% of the study participants dropped out of the program before the research was completed. Most dropped out within the first few weeks.

In patients with diabetes, the numbers are modest as well. Thirty-six percent of patients lost at least 5% of their body weight after a year. In both studies (patients with and without diabetes) the group taking placebo lost significantly less weight than the patients taking Contrave. All patients in both groups received lifestyle modification that consisted of a low-calorie diet and regular exercise.

In each study, patients taking Contrave were also making changes to their diet and exercise program. So even though they did lose some weight with the diet pill (about 12 pounds in about a year) some of that weight loss was due to lifestyle changes (diet and exercise) and not the medication. The amount of weight you lose may have a great deal to do with how well you maintain a calorie-controlled diet and an exercise program. 

Risks and Side Effects

The most common side effects reported by patients taking Contrave include nausea, constipation, headache, vomiting, dizziness, insomnia, dry mouth, and diarrhea. In the clinical trials, 24% of people stopped taking Contrave because of side effects. Only 12% of people taking the placebo discontinued treatment.

Black Box Warning

Contrave is required to carry a black box warning stating that users should be cautious about an increased risk of suicidal thoughts and behaviors in adolescents and young adults. People who have suffered from depression or mania may see their conditions return while on Contrave. 

Since the drug was approved by the FDA, several medical experts have expressed concern about the potential for cardiovascular risk. Others have voiced frustration over television ads that minimize the risks and side effects of Contrave.

As a result, in 2017, the U.S. Food and Drug Administration issued a warning to the drugmaker stating that the way the television advertisement was formatted "undermines the communication of important risk information and thereby misleadingly minimizes the risks associated with the use of Contrave."

If you consider Contrave, be sure to tell your healthcare provider about every medication you are taking. Once you've started taking the weight loss pill, talk to your doctor about any unusual symptoms. After 12 weeks, if you have not lost at least 5% of your body weight, your doctor will probably discontinue your treatment with the drug as it is not likely that this medication will work for you.


The number of Contrave diet pills that you take each day will determine the overall cost. According to prescribing information provided by the company, your dose is likely to vary as you continue with the treatment.

When you first start taking Contrave, you may take just one pill per day. As you continue on the medication, the dose usually increases. During week two, you take one pill in the morning and one at night. During week three, you take two tablets in the morning and one at night. After four weeks, the dose may increase to four pills per day, two in the morning and two at night.

The cost of Contrave varies from about $99 per month to over $250 per month depending on dose, location, and insurance coverage. The drugmaker offers a discount coupon plan for patients whose insurance does not cover Contrave or who do not have insurance coverage. With the savings card, you may be able to pay no more than $4 a day for a monthly prescription.

A Word From Verywell

There is no weight loss medication that works perfectly for everyone. Talk to your doctor about your diet and exercise experience and your medical history to determine if Contrave might work for you. You will need to stay in contact with your healthcare team and have a strong commitment to nutritious eating and regular physical activity to make sure that your body stays strong and healthy. 

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Article Sources
Verywell Fit uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Sherman MM, Ungureanu S, Rey JA. Naltrexone/Bupropion ER (Contrave): Newly approved treatment option for chronic weight management in obese adults. P T. 2016;41(3):164-172.

  2. Yanovski SZ, Yanovski JA. Naltrexone extended-release plus bupropion extended release for treatment of obesity. JAMA. 2015;313(12):1213-1214. doi:10.1001/jama.2015.1617

  3. Sharfstein JM, Psaty BM. Evaluation of the cardiovascular risk of naltrexone-bupropion: A study interrupted. JAMA. 2016;315(10):984-986. doi:10.1001/jama.2016.1461

  4. U.S. Food and Drug Administration. Orexigen Therapeutics, Inc. (Contrave) Untitled Letter 5/18/2017. Updated May 23, 2017.

  5. CONTRAVE Prescribing Information. La Jolla, CA: Orexigen Therapeutics, Inc. 2017.

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