TL;DR
The Contrave weight loss pill combines extended-release naltrexone and bupropion. The dose increases over four weeks, followed by 12 weeks at the maintenance dose before the labeled response check. If a patient has lost less than 5% of their starting weight at that point, the FDA prescribing information says to discontinue treatment because meaningful later weight loss is unlikely.
Contrave is not a GLP-1 medicine. It has distinct dosing requirements, side effects, contraindications, and opioid-related risks. A licensed clinician should review these factors before prescribing it.
Contrave weight loss pill: the quick answer
Contrave is a prescription extended-release tablet used for chronic weight management alongside a reduced-calorie diet and increased physical activity. It contains two active ingredients: naltrexone and bupropion.
Contrave is not a GLP-1 pill. It does not contain semaglutide or tirzepatide, and it works through different pathways. It also has its own dosing schedule, contraindications, interactions, monitoring needs, and expected results.
Patients do not begin with the full maintenance dose. The standard schedule increases the dose over four weeks. At maintenance, the patient takes two tablets in the morning and two in the evening.
This gradual increase affects how we interpret early results. A one-month photograph or scale reading comes from a period when the dose is still being increased. It does not show the result of a complete maintenance-dose trial.
The FDA-labeled response check occurs after 12 weeks at the maintenance dose. If a patient has not lost at least 5% of their starting weight by then, the prescribing information says to discontinue Contrave because clinically meaningful later weight loss is unlikely.
In practice, the standard timeline looks like this:
- Complete a medical and medication review.
- Increase the dose over four weeks as prescribed.
- Continue the tolerated maintenance dose for 12 weeks.
- Compare the current weight with the recorded starting weight.
- Discuss discontinuation with the prescriber if weight loss is below 5%.
Contrave is not a controlled substance, but that does not mean it is free of significant drug restrictions. Naltrexone blocks opioid receptors and can interfere with opioid pain medicines.
That effect matters during surgery, dental work, injury, and emergency care. We recommend telling every treating clinician that Contrave contains naltrexone rather than referring to it only as a weight-loss medicine.
Contrave was studied as part of a broader weight-management plan that included changes to diet and physical activity. The clinical trial results do not describe the pill in isolation, and they should not be presented as guaranteed personal outcomes.
Results vary based on factors such as dose tolerance, medication consistency, food intake, movement, sleep, other medicines, and existing health conditions.
What Contrave contains
Each extended-release Contrave tablet contains:
- 8 mg of naltrexone hydrochloride
- 90 mg of bupropion hydrochloride
At the standard maintenance dose of four tablets per day, the daily total is:
- 32 mg of naltrexone hydrochloride
- 360 mg of bupropion hydrochloride
Naltrexone prescribed on its own is not Contrave. Naltrexone has other medical uses, including as part of treatment for alcohol dependence and opioid dependence. Those uses involve different treatment goals and may use different products or doses.
Separate prescriptions for generic naltrexone and bupropion are not automatically equivalent to Contrave. Contrave contains fixed amounts in an extended-release tablet and follows a specific dose-escalation schedule.
The release form, ratio, and timing all matter. A clinician may sometimes prescribe separate drugs for a medically appropriate reason, but patients should not try to reproduce Contrave by splitting tablets, changing release forms, or following dose comparisons found online.
Who may qualify
According to the FDA-approved indication, Contrave may be considered for adults with either:
- A body mass index, or BMI, of 30 kg/m² or higher
- A BMI of 27 kg/m² or higher and at least one weight-related condition, such as high blood pressure, type 2 diabetes, or abnormal blood lipids
BMI is a screening measure, not a complete diagnosis. It does not show body composition, establish that a medicine is safe, or predict which treatment will work.
A prescribing assessment should consider more than height and weight. We expect the review to cover:
- Current and recent medicines
- Blood pressure and heart rate
- Seizure history and other seizure risks
- Current or recent opioid exposure
- Eating-disorder history
- Mood and psychiatric history
- Alcohol and sedative use
- Liver and kidney health
- Pregnancy or pregnancy plans
- Planned surgery, dental care, or pain treatment
Meeting a BMI threshold does not guarantee a prescription. A contraindication, interaction, or competing medical need may make a different treatment safer.
Contrave dosing chart: weeks 1 through 4
Contrave starts at a low dose and increases once each week under the standard schedule. Patients should follow the instructions on their own prescription because medical factors or treatment interruptions may affect how the prescriber manages dosing.
| Treatment period | Morning dose | Evening dose | Total tablets per day |
|---|---|---|---|
| Week 1 | 1 tablet | 0 | 1 |
| Week 2 | 1 tablet | 1 tablet | 2 |
| Week 3 | 2 tablets | 1 tablet | 3 |
| Week 4 onward | 2 tablets | 2 tablets | 4 |
The standard maintenance dose provides 32 mg of naltrexone hydrochloride and 360 mg of bupropion hydrochloride each day. It requires four extended-release tablets, divided between morning and evening.
Each tablet should be swallowed whole. Cutting, chewing, or crushing an extended-release tablet can alter how the medicine is released.
Contrave should not be taken with a high-fat meal. High-fat meals can increase exposure to the medicine, potentially increasing adverse effects and seizure risk.
That instruction is not a reason to skip meals at random or create a restrictive diet without guidance. We recommend asking the prescriber or pharmacist for meal instructions that fit the prescribed dosing schedule.
A dose increase can reveal a new safety or tolerance problem. Patients should contact the prescriber before:
- Delaying a scheduled increase
- Returning to a lower dose
- Changing morning or evening timing
- Stopping treatment
- Restarting after an interruption
For example, a patient may reach two tablets in the morning and two in the evening, then develop persistent nausea. The appropriate next step is to contact the prescriber rather than adjust the dose independently.
Nausea does not prove that Contrave is causing weight loss. It is an adverse effect that should be assessed based on its severity, duration, effect on hydration, and accompanying symptoms.
Why four tablets a day may be hard to sustain
An oral medicine may initially seem simpler than an injection. Four tablets every day can still create a substantial treatment burden.
The maintenance schedule includes two dosing periods. Work shifts, travel, changing sleep patterns, meals, and caregiving can make the evening dose easy to miss. Refills also need to be arranged before the current supply runs out.
Tolerance may change as the dose rises. Someone who feels well on one or two tablets per day may develop more noticeable side effects at three or four tablets.
These are real treatment constraints, not evidence of weak motivation.
Before treatment starts, we recommend discussing practical questions such as:
- Where will the morning and evening doses be stored?
- Will reminders work on weekends as well as workdays?
- How much lead time does the pharmacy need for a refill?
- What should happen if symptoms begin after an increase?
- Who can answer a dosing question after office hours?
- How should travel or a planned procedure affect the schedule?
Medication consistency affects both safety and interpretation. The response checkpoint is harder to evaluate if the maintenance dose was not taken consistently.
Patients should give the prescriber an accurate account of missed doses and interruptions. The clinical team needs reliable information, not a perfect medication log.
What to do after a missed dose
The FDA Medication Guide instructs patients to skip a missed Contrave dose and take the next dose at the regular scheduled time.
Do not take two doses at once or add an extra tablet later to make up for the missed dose.
A patient who has missed several doses or had a longer interruption should contact the prescriber or pharmacist. Restarting may require clinical guidance rather than an immediate return to the previous dose.
When Contrave starts working and when to judge it
Some patients report appetite or craving changes during the first few weeks. Others notice no clear early difference.
An early appetite change does not establish long-term success, and the absence of an immediate change does not answer whether the full treatment trial will work. Neither replaces the labeled weight checkpoint.
During the first four weeks, the dose is still increasing. A week-one result reflects one tablet per day. Even at the end of week four, the patient has spent only a limited amount of time at the maintenance dose.
That makes “Contrave one-month results” difficult to interpret. Reviews and photographs may involve different:
- Starting weights
- Daily doses
- Treatment interruptions
- Diet and activity plans
- Health conditions
- Concurrent medicines
- Follow-up periods
- Reasons for stopping
The labeled timeline offers a clearer framework:
| Stage | What is happening | What the result may show |
|---|---|---|
| Start | Baseline weight and safety review | The recorded starting point |
| Weeks 1–4 | Dose increases each week | Early tolerance and possible appetite changes |
| Next 12 weeks | Maintenance-dose trial | Sustained response at the full dose |
| Response check | Weight is compared with baseline | Whether the 5% threshold was reached |
If a patient has not lost at least 5% of their starting weight after 12 weeks at the maintenance dose, the FDA prescribing information says to discontinue Contrave because meaningful later weight loss is unlikely.
Under the standard schedule, that checkpoint occurs around 16 weeks after treatment begins. An interruption, delayed dose increase, or modified schedule may change the actual date, so the prescribing clinician should identify the relevant checkpoint.
Contrave reviews, Reddit posts, and before-and-after photographs can help people form questions. They cannot establish average results, personal eligibility, or safety.
Online accounts often omit details that would change their meaning. Readers may not know whether the writer reached the maintenance dose, took another medicine, had diabetes, stopped early, or followed the lifestyle program used in a clinical trial.
How to calculate 5% of starting weight
Multiply the recorded starting weight by 0.05:
Starting weight × 0.05 = amount equal to 5% of starting weight
Then subtract that amount from the starting weight to find the corresponding target weight.
| Starting weight | Calculation | Amount equal to 5% | Target weight after a 5% loss |
|---|---|---|---|
| 180 pounds | 180 × 0.05 | 9 pounds | 171 pounds |
| 220 pounds | 220 × 0.05 | 11 pounds | 209 pounds |
| 300 pounds | 300 × 0.05 | 15 pounds | 285 pounds |
For example, someone who starts at 220 pounds would need to lose at least 11 pounds to reach a 5% reduction. That corresponds to a weight of 209 pounds or less at the response check.
These calculations are checkpoints, not forecasts or promises.
The starting weight and date should be recorded in the medical record. Because scales and measurement conditions can differ, the prescriber should explain which measurement will guide the decision.
Why side effects are not evidence of success
Nausea, constipation, headache, and insomnia are adverse effects. They do not show that body fat is decreasing.
One patient may lose weight with few side effects. Another may experience strong side effects without reaching the 5% response threshold.
Someone may also lose weight but need to stop because the adverse effects or safety risks outweigh the benefit. Weight change is only one part of the clinical decision.
More symptoms do not mean the medicine is working better. We recommend reporting adverse effects rather than using them as a measure of progress.
How much weight did people lose in Contrave trials?
The FDA prescribing information describes several trials lasting approximately one year. Results differed according to the study population and the lifestyle program used.
The table below summarizes mean percentage changes reported in the prescribing information. Trial averages should be interpreted alongside the study design, analysis method, lifestyle intervention, and treatment discontinuations.
| Trial and population | Lifestyle program | Mean loss with Contrave | Mean loss with placebo |
|---|---|---|---|
| COR-I, adults with obesity or overweight plus a related condition | Reduced-calorie diet and activity counseling | About 5.4% | About 1.3% |
| COR-II, adults with obesity or overweight plus a related condition | Reduced-calorie diet and activity counseling | About 5.2% | About 1.2% |
| COR-BMOD, adults receiving intensive behavior modification | Structured diet, activity, and behavior program | About 8.1% | About 4.9% |
| COR-Diabetes, adults with type 2 diabetes | Diet and activity program used in the study | About 3.7% | About 1.7% |
The placebo results belong beside the Contrave results because participants in both groups received a lifestyle intervention. The comparison helps prevent all observed weight loss from being attributed to the medicine alone.
COR-BMOD produced the largest mean loss among these trials, but it also included an intensive behavior-modification program. Its result should not be presented as the expected outcome for every Contrave patient.
To make the percentages easier to visualize, consider a starting weight of 220 pounds:
- 3.7% is approximately 8 pounds
- 5.2% is approximately 11 pounds
- 5.4% is approximately 12 pounds
- 8.1% is approximately 18 pounds
These conversions are illustrations, not personal predictions.
Trial averages combine a range of outcomes. Participants may have:
- Lost more than the reported mean
- Lost less than the reported mean
- Had little or no change
- Gained weight
- Stopped treatment
- Been unable to tolerate the maintenance dose
The placebo results also changed with the intensity of the lifestyle program. At a starting weight of 220 pounds, a mean reduction of 4.9% would equal roughly 11 pounds. That context matters when discussing the COR-BMOD result.
Studies of naltrexone alone cannot tell us how much weight someone will lose with Contrave. Contrave also contains extended-release bupropion and uses a specific titration schedule.
The reverse is also true: Contrave trial results should not be used to predict weight change from naltrexone prescribed by itself for alcohol or opioid dependence.
Average result versus individual result
A trial average is not the exact result most likely for one person. It is a summary of measured outcomes under a particular study protocol.
An individual result may be affected by:
- Ability to tolerate the maintenance dose
- Consistency of morning and evening dosing
- Treatment interruptions
- Food intake
- Physical activity
- Sleep
- Other medicines
- Diabetes and other health conditions
- Mood changes or adverse effects
- Early treatment withdrawal
Trial participants may also differ from the patient being evaluated. Study eligibility rules can exclude people with certain health conditions, medicines, or safety risks.
We use trial averages to establish reasonable expectations, not to promise a number. For an individual patient, the 5% response checkpoint is often more practical because it uses that person’s starting weight and measured response after an adequate maintenance-dose trial.
What trial results do not prove
Contrave trials do not prove that stronger nausea leads to more weight loss. Adverse effects and treatment response are separate outcomes.
The research also does not make a selected before-and-after photograph representative. A photograph does not show the full study population, placebo comparison, discontinuation rate, or medical history.
Data for the fixed extended-release product do not establish equivalent outcomes from separately prescribed generic tablets. Different release forms, doses, ratios, and schedules may produce different exposure and risks.
Finally, the studies do not show that every eligible patient should take Contrave. A clinician still needs to weigh possible benefits against contraindications, interactions, adverse effects, cost, treatment burden, and patient preferences.
Side effects during the dose increases
Common adverse effects listed for Contrave include:
- Nausea
- Constipation
- Headache
- Vomiting
- Dizziness
- Insomnia
- Dry mouth
- Diarrhea
A symptom that begins during treatment is not necessarily caused by Contrave. Infection, dehydration, dietary changes, another medicine, or an existing condition may be responsible.
Timing still gives the prescriber useful information. We recommend recording when a symptom began and whether it followed a dose increase.
| Treatment week | Dose level | What to record |
|---|---|---|
| Week 1 | 1 tablet per day | Baseline sleep, bowel pattern, headache, nausea, and blood pressure |
| Week 2 | 2 tablets per day | New symptoms after adding the evening dose |
| Week 3 | 3 tablets per day | Changes after the morning dose increases |
| Week 4 onward | 4 tablets per day | Tolerance of the full morning and evening schedule |
This table does not suggest that symptoms should be managed alone until the end of the week. New or worsening effects may require contact before the next dose increase.
For nonemergency symptoms, patients should contact the prescriber before changing the schedule or stopping. Tablets should not be cut to create an improvised lower dose.
The current FDA Medication Guide and prescribing information provide official instructions. The care team should also explain which symptoms require routine contact, same-day assessment, or emergency care.
Routine symptoms to discuss with the prescriber
Contact the prescriber about symptoms that persist, worsen, interfere with sleep or work, or make it difficult to take the medicine as directed.
Examples include:
- Ongoing nausea
- Vomiting
- Constipation
- Diarrhea
- Headache
- Dizziness
- Dry mouth
- Insomnia or other sleep changes
A short symptom record can make the discussion more useful. It may include:
- Current morning and evening dose
- Date and time the symptom started
- Dose increase closest to the start
- Meal timing
- Symptom severity
- Frequency of vomiting or diarrhea
- Fluids the patient can keep down
- Other medicines taken
- Blood pressure, if available
This information can help the clinician assess whether the symptom may be related to Contrave, another drug, or another condition. It may also affect the titration plan.
Nausea should not automatically be dismissed because it appears on the common side-effect list. Persistent vomiting or an inability to keep fluids down may need prompt medical assessment.
Symptoms that need emergency care
Some symptoms should not wait for a routine portal message. Seek emergency help for:
- A seizure
- Trouble breathing or signs of a severe allergic reaction
- Eye pain or sudden vision changes
- New suicidal thoughts or dangerous behavior
- Possible severe liver injury, including yellow skin or eyes
- A severe blood pressure increase accompanied by concerning symptoms
- Suspected overdose
- Severe confusion, collapse, or loss of consciousness
The bupropion component carries a boxed warning concerning suicidal thoughts and behaviors in children, adolescents, and young adults. Contrave is not approved for pediatric patients.
Mood and behavior changes still deserve attention at any adult age. Patients, family members, and caregivers should know how to contact the care team and emergency services.
A seizure requires emergency assessment even if it ends quickly. The patient should not take another dose while waiting for routine medical advice.
Who should not take Contrave and which medicines conflict
The FDA prescribing information lists several contraindications. Contrave should not be used by patients with:
- Uncontrolled high blood pressure
- A seizure disorder
- Anorexia nervosa or bulimia
- Use of another bupropion-containing product
- Chronic opioid use
- Acute opioid withdrawal
- Monoamine oxidase inhibitor use within the restricted interval
- Abrupt withdrawal from alcohol, benzodiazepines, barbiturates, or antiepileptic medicines
- Pregnancy
- A known allergy to the product’s ingredients
This is not a complete interaction list. A clinician and pharmacist should review all prescription medicines, nonprescription products, supplements, and relevant substance use.
Bupropion can increase seizure risk. That risk may be affected by health conditions, the total dose, other medicines, and abrupt withdrawal from alcohol or sedatives.
Patients should not suddenly stop alcohol, benzodiazepines, seizure medicine, or another sedative to try to qualify for Contrave. Withdrawal can be dangerous and requires medical planning.
Bupropion also inhibits CYP2D6, an enzyme involved in processing several medicines. Some antidepressants, antipsychotics, beta blockers, and heart-rhythm medicines may require closer review or dose adjustment.
Contrave can increase blood pressure and heart rate. Baseline and follow-up measurements matter, including for patients who already take blood pressure medicine.
A normal measurement while taking an antihypertensive does not remove the need for clinical review. The prescriber must determine whether blood pressure is adequately controlled and how it will be monitored.
We recommend providing one complete list that covers:
- Daily prescription medicines
- As-needed medicines
- Antidepressants and mood medicines
- Seizure medicines
- Blood pressure and heart medicines
- Pain medicines
- Cough and diarrhea products
- Sleep aids and sedatives
- Vitamins and supplements
- Alcohol use
- Cannabis and other substance use
Brand names can hide duplicate ingredients. If the exact drug name or strength is unclear, photographs of each package or prescription label can help.
The opioid safety issue
Naltrexone blocks opioid receptors. It can reduce pain relief from opioid medicines and affect opioid-containing products used for cough or diarrhea.
Tramadol also requires careful review. Patients should not assume it falls outside the opioid safety plan because it has a different name or mixed mechanism.
Before Contrave begins, the prescriber must confirm an adequate opioid-free interval. The FDA labeling generally recommends an interval of at least 7 to 10 days after short-acting opioids, but the appropriate period depends on the drug and clinical circumstances.
Methadone or buprenorphine may require a longer interval and more planning. Neither medicine should be stopped without coordination with the clinician managing that treatment.
Trying to overcome naltrexone’s blockade by taking larger opioid doses can cause a fatal overdose. The blockade can also change over time and should never be tested.
Opioid sensitivity may be higher after naltrexone is discontinued. A dose that was previously tolerated could cause an overdose later.
Planning is particularly important before surgery. Someone taking Contrave should tell the:
- Surgeon
- Anesthesiologist
- Dentist or oral surgeon
- Pain specialist
- Emergency department
- Ambulance team
- Contrave prescriber
- Pharmacist
The wording should be specific: “I take Contrave, and it contains naltrexone.” Saying only “I take a weight-loss pill” does not give the medical team enough information.
A planned procedure allows time to create a coordinated pain plan. Emergency treatment may not. Keeping an updated medication list on a phone or in a wallet may reduce delays.
Patients with chronic pain, recurring injuries, or an expected need for opioid treatment should discuss that need before taking the first dose. Contrave may not fit their broader care plan.
Antidepressants and other bupropion products
Contrave already supplies 360 mg of bupropion hydrochloride per day at the standard maintenance dose. It should not be combined casually with another bupropion-containing product.
Common bupropion brands include Wellbutrin and Zyban. Generic labels may list only “bupropion,” without a familiar brand name.
A clinician should assess:
- Duplicate bupropion exposure
- Total daily dose
- Extended-release or sustained-release formulation
- Seizure risk
- Blood pressure
- Psychiatric history
- CYP2D6 interactions
- Other drugs that lower the seizure threshold
Contrave is not simply an antidepressant to which a patient can add naltrexone. The fixed product has its own indication, schedule, contraindications, warnings, and monitoring requirements.
Patients should not stop an antidepressant to begin Contrave without the prescribing clinician. Sudden changes may worsen symptoms or cause withdrawal effects, depending on the medicine.
Contrave versus GLP-1 treatment
Contrave is not a GLP-1 medicine or a direct substitute for one. Its oral route may suit some patients, but its expected results and safety profile differ.
Contrave requires four tablets per day at the maintenance dose. Injectable GLP-1 medicines may be taken daily or weekly, depending on the specific product and indication.
Route alone does not settle the choice. A weekly injection may create less daily work than four tablets, while an oral medicine may suit someone who cannot or does not want to use injections.
Evidence also needs a fair comparison. Contrave’s COR trials and the STEP or SURMOUNT programs for semaglutide, tirzepatide, and related treatments were separate studies, not direct head-to-head trials against Contrave.
We do not recommend comparing a placebo-adjusted result from one trial with a raw average from another. Study duration, analysis methods, lifestyle support, participant health, and treatment discontinuation all affect the numbers.
For a broader evidence review, our guide to the best GLP-1 options for weight loss explains how named products and results differ. Patients dealing with cost, supply, or refill gaps can also review these Ozempic alternatives.
The safety questions differ as much as the dosing:
| Issue | Contrave | GLP-1 treatment |
|---|---|---|
| Route | Oral extended-release tablets | Often a daily or weekly injection, depending on the product |
| Daily burden | Four tablets at maintenance | Depends on the product |
| Common digestive effects | Nausea, vomiting, constipation, and diarrhea | Similar digestive effects may occur |
| Key distinct concerns | Seizures, mood effects, blood pressure, and opioid blockade | Product-specific contraindications and monitoring |
| Meal issue | Do not take with a high-fat meal | Instructions vary by product |
| Opioid restriction | Yes, because of naltrexone | Not a GLP-1 class effect |
| Response check | 5% after 12 weeks at the maintenance dose | Timing depends on the product and clinical plan |
Both paths require clinician review. Eligibility, contraindications, monitoring, availability, and state access may vary.
Oral products marketed online need particular scrutiny. Our guide to tirzepatide pills and their FDA status explains why a familiar drug name does not prove that an oral product is approved or equivalent to an approved medicine.
When an oral route may matter
An oral route may appeal to someone who fears needles, travels often, or cannot store an injectable medicine as directed. It may also be relevant when a preferred injectable product is unavailable.
That possible benefit must be weighed against Contrave’s four-tablet maintenance schedule. Patients need to manage morning and evening doses and avoid taking the medicine with a high-fat meal.
Useful practical questions include:
- Can the patient swallow extended-release tablets whole?
- Is a twice-daily routine realistic?
- Does the patient use opioids or expect surgery?
- Are missed doses common with current medicines?
- Would a weekly treatment be easier than daily tablets?
- Can the selected medicine be stored and transported correctly?
- Which option has a stable and affordable supply?
A pill is not automatically easier than an injection. We consider the better route to be the one a patient can use safely, consistently, and affordably.
Temi access and clinician review
Temi is a cash-pay telehealth option for eligible patients seeking prescription weight-management care. Available medicines, supported states, clinician services, pharmacy terms, and prices can change.
Before paying, patients should verify:
- Whether service is available in their state
- Whether the treatment under discussion is currently offered
- What the clinician review includes
- Which pharmacy may fill the prescription
- Whether shipping is available
- Current medication and visit prices
- Follow-up, renewal, and cancellation terms
Completing an intake does not guarantee a prescription. A licensed clinician must review the medical history and decide whether a treatment is appropriate.
Temi keeps medication care in one place, but state eligibility, medicine availability, and current terms still need to be confirmed when care is requested.
Cash price and access questions to ask before a visit
“Contrave cost without insurance” may refer to several separate charges. A retail pharmacy price is not the same as the total price of a telehealth program.
Retail cash prices, discount-card prices, manufacturer savings, clinician fees, laboratory costs, and shipping charges should be listed separately. Combining them into one monthly claim can hide what a patient will actually pay.
Use this worksheet before booking, and verify each item for the patient’s date, state, pharmacy, prescribed quantity, and coverage:
| Cost item | Amount to verify | Date verified | State or pharmacy | Questions |
|---|---|---|---|---|
| Initial clinician visit | $_____ | _____ | _____ | Is this charged if no prescription is issued? |
| Contrave prescription | $_____ | _____ | _____ | Is this retail cash, discount, or program pricing? |
| Follow-up visits | $_____ | _____ | _____ | How often are visits required? |
| Laboratory work, if ordered | $_____ | _____ | _____ | Which lab provides it, and who sends the bill? |
| Shipping | $_____ | _____ | _____ | Is tracking included, and is a signature required? |
| Other required care | $_____ | _____ | _____ | Does this include blood pressure monitoring? |
| Cancellation or renewal charges | $_____ | _____ | _____ | When must cancellation occur? |
Manufacturer materials may advertise that eligible patients can pay as little as $0 through the CONTRAVE Savings Program, with home shipping available through the program. That advertised minimum is not a universal cash price, and eligibility restrictions apply.
The manufacturer states that patients are not eligible for the savings coupon when the prescription is paid by certain state or federally funded programs. These include Medicare, Medicaid, Medigap, VA, Department of Defense, and TRICARE coverage. Current program rules should be confirmed before a coupon is submitted.
A pharmacy discount may also change by location and date. Any quote should identify:
- The exact drug and strength
- The prescribed quantity
- The number of days supplied
- The selected pharmacy
- The patient’s state
- The date of the quote
It can still be useful to confirm insurance formulary status when paying cash. Coverage may affect whether later refills remain affordable.
Stock should be confirmed as well. Receiving a prescription does not mean the chosen pharmacy has the medicine ready to dispense.
No legitimate service should promise approval before clinician review. Home delivery, an exact final price, and nationwide prescribing should not be assumed.
Five questions for a cash-pay quote
We recommend asking these questions in writing when possible:
-
What is the current prescription price for the prescribed quantity?
Confirm how many days the quantity covers at the maintenance dose. -
Does the quote include the clinician visit, follow-up care, and shipping?
Ask for an itemized answer if the total is unclear. -
Will the price change after the first order or month?
An introductory price may not reflect later renewal costs. -
Does the discount require commercial insurance or exclude government coverage?
Confirm eligibility before submitting a coupon. -
Are clinician services and pharmacy delivery available in the patient’s state?
Prescribing access and delivery access are separate questions.
Save the written response, quote date, and name of the pharmacy or service. Those details make it easier to resolve a later pricing discrepancy.
Other oral weight-loss pills
Several prescription and nonprescription oral weight-loss products exist. They use different mechanisms and have different evidence, dosing schedules, contraindications, and interaction risks.
Examples include orlistat-containing products and other prescription combinations. The phrase “weight-loss pill” does not describe one standard type of treatment.
Readers considering orlistat can use our separate review of Alli weight loss pills. That guide covers Alli’s evidence, costs, and safety questions without treating it as equivalent to Contrave.
A clinician should compare oral options using the patient’s medical history, treatment goals, and current medicines. Selecting a tablet only because it avoids an injection can overlook more important safety and adherence issues.
Questions to take to the prescribing visit
A prescribing visit should end with a clear plan, not just the name of a medicine. We recommend preparing questions before the appointment.
Use this checklist:
- Do any current medicines contain bupropion?
- Do any medicines lower the seizure threshold?
- Are there relevant CYP2D6 interactions?
- Could Contrave affect blood pressure alongside the current regimen?
- Is the patient’s blood pressure adequately controlled?
- How will heart rate and blood pressure be checked?
- How will mood and sleep changes be monitored?
- What should happen if nausea begins after a dose increase?
- Which symptoms should pause titration?
- Which symptoms need same-day contact?
- Which symptoms require emergency care?
- How would planned surgery or dental work be managed?
- What is the plan for emergency opioid pain treatment?
- Which starting weight and date will control the 5% calculation?
- What is the expected date of the response check?
- What happens if the full maintenance dose is not tolerated?
- How often are follow-up visits required?
- What will treatment cost after the initial order?
- Is the medicine available from the selected pharmacy?
- Is prescribing available in the patient’s state?
Ask the clinician to record the starting weight, then calculate the amount equal to 5% during the visit.
A written plan should also explain how longer-term treatment will be reviewed. Reaching the initial response threshold does not remove the need to monitor ongoing benefit, adverse effects, blood pressure, mood, adherence, and cost.
Bring this information
Bring a complete list of medicines and supplements, including products used only as needed.
The list should cover:
- Prescription medicines
- Nonprescription medicines
- Vitamins and supplements
- Cough products
- Pain relievers
- Diarrhea medicines
- Sleep products
- Antidepressants
- Blood pressure medicines
- Seizure medicines
- Recent antibiotics or steroids
Also disclose recent or planned use of:
- Opioids
- Tramadol
- Methadone
- Buprenorphine
- Alcohol
- Benzodiazepines
- Barbiturates
- Other sedatives
Relevant medical history includes:
- Seizures
- Anorexia or bulimia
- High blood pressure
- Liver problems
- Mood changes
- Suicidal thoughts or behavior
- Alcohol or sedative withdrawal
- Pregnancy or pregnancy plans
- Planned surgery or dental procedures
- Chronic or recurring pain
Useful practical records include:
- Starting weight
- Recent blood pressure readings
- Preferred pharmacy
- Insurance or discount information
- Cash-pay budget
- Dates of planned travel or procedures
Do not omit a medicine because it seems unrelated to weight. A cough product, pain tablet, or psychiatric medicine may change the safety assessment.
Use the official safety documents
Read the current FDA-approved Contrave prescribing information and Contrave Medication Guide.
The prescribing information gives clinicians the complete dosing rules, contraindications, warnings, interactions, and trial data. The Medication Guide explains the primary patient safety instructions.
Confirm that the documents are current when treatment begins because labels may change.
This article provides general information. It does not replace an individual clinician assessment, a pharmacist’s interaction review, or emergency care.
FAQ
What are the common side effects of Contrave for weight loss?
Common labeled side effects include nausea, constipation, headache, vomiting, dizziness, insomnia, dry mouth, and diarrhea. A side effect does not prove that the medicine is working.
We recommend contacting the prescriber before changing the dose, especially when symptoms begin after an increase or interfere with sleep, hydration, work, or normal activities.
Are there pills for weight loss?
Yes. Prescription and nonprescription oral weight-loss medicines are available, but they do not work in the same way.
Contrave combines naltrexone and bupropion, while orlistat reduces the absorption of dietary fat. Other prescription products have different ingredients and mechanisms. Each option comes with its own dosing schedule, evidence, contraindications, and interactions, so a clinician should review the patient’s health history and current medicines.
What is naltrexone used for?
Naltrexone is used in treatment plans for alcohol dependence and opioid dependence. It is also one component of Contrave for chronic weight management.
Naltrexone alone is not Contrave. The fixed Contrave tablet also contains extended-release bupropion and follows a specific ratio, schedule, indication, and evidence base.
How much weight can someone lose on naltrexone?
There is no single expected weight-loss result for naltrexone alone that can be applied to Contrave.
In the major Contrave trials summarized in the FDA prescribing information, mean losses varied by study population and lifestyle program. Those findings apply to the fixed naltrexone-bupropion product used under the trial protocols, not to naltrexone prescribed by itself.
How quickly does Contrave work?
Some patients may notice appetite changes during the first few weeks, but the dose is still being increased during that period.
The labeled response check occurs after 12 weeks at the maintenance dose, following the standard four-week titration. If the patient has lost less than 5% of their starting weight at that point, the prescribing information says Contrave should be discontinued.
Can Contrave be taken with opioid pain medicine?
Contrave can block opioid pain relief because it contains naltrexone. Patients should tell prescribers, dentists, surgeons, anesthesiologists, pharmacists, and emergency teams that they take it.
Trying to overcome the blockade with larger opioid doses can cause a fatal overdose. Any plan involving opioids, surgery, or an interruption of Contrave needs to be managed by the relevant clinicians.
Review your weight-loss options with Temi
Use Temi’s online medication platform to check current state access, available treatments, clinician-review terms, and cash-pay pricing. Completing an intake does not guarantee a prescription; a licensed clinician must confirm that treatment is appropriate for the patient’s medical history, current medicines, and safety risks.
