WARNING

Bupropion, an active element in this medication and several antidepressants (Wellbutrin, Aplenzin), as well as a drug used to assist people quit smoking (Zyban), is also used to treat depression. During clinical investigations, a tiny percentage of kids, teenagers, and young adults (aged up to 24) who were given antidepressants (also known as “mood elevators”) like bupropion developed suicide thoughts or plans, or suicidal behavior itself. Antidepressants may increase the risk of suicide thoughts among children, adolescents, and young adults compared to those who do not take them to treat depression or other mental diseases. It is not recommended that youngsters under the age of 18 take the naltrexone and bupropion combo.

Even if you’re an adult over 24 years old, you should be aware that taking the drug combination of naltrexone and bupropion may cause unanticipated changes in your mental health. If your dose is changed or raised, you run the risk of becoming suicidal, especially at the beginning of your treatment. If any of the following signs appear, you, your family, or your caretaker should contact your doctor straight away: depression that has recently shown or has gotten worse; plans or attempts to injure or kill oneself; Extreme worry, agitation, anxiety or panic attacks, trouble falling asleep or staying asleep, aggressive, angry or violent behavior, irritability, acting without thinking, extreme restlessness, unusual thoughts or sensations, the impression that others are against you, hallucinations (hearing voices or seeing things that are not there), confusion, frenzied abnormal excitement, or any other abrupt or unusual changes in behavior. Make sure your family or caregiver is aware of any potentially critical symptoms so they can contact the doctor on your behalf if you are unable to call for help.

While you are on the drug combination naltrexone and bupropion, your doctor will want to visit you frequently, particularly at the start of your therapy. Keep in mind to show up for all scheduled doctor’s appointments.

When you start therapy with the combination of naltrexone and bupropion as well as each time you renew your prescription, your doctor or pharmacist will provide you the manufacturer’s patient information leaflet (Medication Guide). If you have any questions, carefully read the information and consult your doctor or pharmacist.

The dangers of taking naltrexone and bupropion together should be discussed with your doctor.

Why is this medication prescribed?

Adults who are obese or who are overweight and have health issues related to their weight can take the combination of naltrexone and bupropion to lose weight and subsequently prevent gaining it again, coupled with a reduced calorie diet and activity program. Opiate antagonists, which include naltrexone, are a group of drugs. Antidepressants, which include bupropion, are a class of drugs. To decrease appetite and assist in controlling cravings, these drugs act jointly on the hunger center and the reward system in the brain.

How should this medicine be used?

An oral extended-release (long-acting) pill containing naltrexone and bupropion is available. Usually, it is taken twice a day. When using this drug, avoid eating a meal heavy in fat. Take bupropion and naltrexone every day at roughly the same time. Ask your doctor or pharmacist to explain any instructions on your prescription label that you do not understand, and carefully follow their instructions. Naltrexone and bupropion must be taken exactly as prescribed. Never take it in quantities or frequencies other than those recommended by your doctor.

Avoid crushing, chewing, or splitting the extended-release pills; instead, swallow them whole.

Initially prescribed at a low dose, your doctor will likely gradually increase your dosage of the naltrexone and bupropion combination over the course of four weeks, not more than once. Your physician will assess your weight loss after 16 weeks of treatment. Your doctor could advise you to discontinue taking the medication combination of naltrexone and bupropion if you have not dropped a specific amount of weight because it is doubtful that you will continue to benefit from it.

Other uses for this medicine

Inquire with your doctor or pharmacist for more details if you believe this drug may be prescribed for other purposes.

What special precautions should I follow?

As for precautions, it is important to consult with a healthcare professional before taking naltrexone and bupropion, as they can have potential side effects and interactions with other medications. Some general precautions include:

• Allergies: Inform your doctor if you have any known allergies to naltrexone, bupropion, or any other medications.
• Medical conditions: Inform your doctor about any existing medical conditions, such as liver or kidney problems, seizure disorders, bipolar disorder, eating disorders, or a history of substance abuse.
• Medication interactions: Naltrexone and bupropion may interact with other medications, including other antidepressants, opioids, and certain seizure medications. Inform your doctor about all the medications, supplements, and herbal products you are taking.
• Pregnancy and breastfeeding: These medications may have potential risks during pregnancy and breastfeeding. Consult your doctor if you are pregnant, planning to become pregnant, or breastfeeding.
• Side effects: Be aware of the potential side effects associated with naltrexone and bupropion. Common side effects may include nausea, headache, insomnia, dry mouth, constipation, and dizziness. However, individual experiences may vary.

Always follow your healthcare professional’s guidance and instructions regarding the use of naltrexone, bupropion, or any other medications.

What special dietary instructions should I follow?

Dietary instructions for Naltrexone and Bupropion:

• There are no specific dietary restrictions associated with these medications. However, it is generally recommended to follow a healthy and balanced diet while taking them.
• To support your weight loss goals, focus on consuming a variety of nutrient-rich foods, including fruits, vegetables, whole grains, lean proteins, and healthy fats.
• Limit your intake of processed foods, sugary beverages, and high-calorie snacks.
• It’s important to stay hydrated by drinking an adequate amount of water throughout the day.
• If you have any specific dietary concerns or conditions, such as diabetes, consult with a registered dietitian or your healthcare provider for personalized dietary advice.

What should I do if I forget a dose?

If you forget to take a dose of naltrexone and bupropion, it is generally recommended to take it as soon as you remember. However, if it is close to the time for your next scheduled dose, it is advisable to skip the missed dose and continue with your regular dosing schedule. Taking a double dose to make up for a missed one is not recommended, as it may increase the risk of side effects.

What side effects can this medication cause?

Naltrexone and bupropion, both as individual medications and when used together in combination therapy (such as Contrave), can have side effects. It’s important to note that not everyone will experience these side effects, and the severity and frequency can vary from person to person. Common side effects associated with naltrexone and bupropion may include:

• Nausea
• Headache
• Upset stomach or abdominal pain
• Decreased appetite
• Diarrhea or constipation
• Difficulty sleeping
• Anxiety or nervousness
• Muscle or joint pain
• Dry mouth
• Insomnia (difficulty sleeping)
• Nausea or vomiting
• Dizziness or lightheadedness
• Increased sweating
• Tremors or shaking
• Agitation or anxiety
• Constipation
• Changes in appetite or weight

It’s important to be aware of the potential side effects and report any persistent or bothersome symptoms to your healthcare professional. They can provide guidance and may adjust the medication or dosage if necessary.

It’s worth noting that naltrexone and bupropion can have additional rare but serious side effects. These may include severe allergic reactions, liver problems, changes in mood or behavior, seizures, or increased blood pressure. Contact your healthcare professional immediately if you experience any severe or concerning symptoms.

This is not an exhaustive list of side effects, and other uncommon or rare side effects may occur. Always refer to the medication’s package insert or consult your healthcare professional for comprehensive information on side effects associated with naltrexone, bupropion, or their combination therapy.

What should I know about storage and disposal of this medication?

• Naltrexone and bupropion should be stored at room temperature, away from excessive heat, moisture, and direct sunlight.
• Follow the specific storage instructions provided by your healthcare professional or the medication’s packaging.
• Keep these medications out of reach of children and pets.
• Do not use naltrexone or bupropion after the expiration date indicated on the packaging.

In case of emergency/overdose

• If you suspect an overdose or experience severe symptoms, call emergency services (such as 911 in the United States) immediately.
• Contact your local poison control center or seek immediate medical attention if you believe you have taken more than the prescribed dose of naltrexone or bupropion.
• Be prepared to provide information about the medication, dosage, and the situation to healthcare professionals or emergency responders.

What other information should I know?

• Inform all healthcare professionals involved in your care about the medications you are taking, including naltrexone, bupropion, or any other prescription, over-the-counter medications, supplements, or herbal products.
• Attend regular follow-up appointments with your healthcare professional to monitor your progress, discuss any concerns or side effects, and make any necessary adjustments to your treatment plan.
• Do not stop or change the dosage of naltrexone or bupropion without consulting your healthcare professional.
• Inform your healthcare professional about any new or worsening symptoms, including changes in mood, behavior, or any unusual or concerning side effects.
• Carry an identification card or wear a medical alert bracelet indicating that you are taking naltrexone and bupropion, particularly if you have a history of medical conditions or allergies that healthcare providers should be aware of in case of an emergency.

Always consult your healthcare professional or pharmacist for comprehensive and personalized information about the storage, disposal, and emergency procedures specific to your prescribed medication regimen.