Contrave for Weight Loss: How Naltrexone-Bupropion Works, Side Effects, and Online Options

Last updated: August 13, 2026

Contrave is an FDA-approved oral medication that combines naltrexone and bupropion for chronic weight management. Adults researching prescription appetite support often want clear answers on how Contrave works, who may qualify, common side effects, insurance considerations, and whether a licensed clinician can evaluate them through telehealth.

Looking for medical weight management support? Klarity Health connects you with over 2,000 licensed providers who can review your health history and discuss whether prescription options such as Contrave may fit your care plan. Coverage varies by plan. See if you may qualify → · Browse conditions

What Is Contrave?

Contrave is the brand name for extended-release naltrexone hydrochloride and bupropion hydrochloride tablets. The U.S. Food and Drug Administration approved Contrave as a prescription medicine for long-term weight management, used together with a reduced-calorie diet and increased physical activity.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), naltrexone-bupropion (Contrave) sits among the FDA-approved medicines for overweight and obesity, alongside options such as orlistat, phentermine-topiramate, liraglutide, semaglutide, and tirzepatide.

Mayo Clinic lists bupropion-naltrexone (Contrave) among six prescription weight-loss drugs approved for long-term use. You take Contrave by mouth; dosing is typically once or twice daily as directed by a clinician, with a gradual titration schedule to improve tolerability.

Important label context from the manufacturer: the individual medicines naltrexone and bupropion are not approved for weight loss on their own in this combination product’s intended use, and Contrave is not approved to treat depression or opioid or alcohol dependence. See the brand overview at contrave.com.

How Contrave Works

Contrave targets brain pathways involved in hunger and reward-based eating rather than blocking fat absorption in the gut (the way orlistat works) or relying only on short-term stimulant appetite suppressants.

• Bupropion is also used as an antidepressant and smoking-cessation aid. In the Contrave combination, it contributes to reduced appetite and altered food-reward signaling.
• Naltrexone is an opioid receptor antagonist used in other settings for alcohol and opioid use disorders. In combination with bupropion, it may help blunt compensatory reward pathways that can undermine weight-loss efforts.

Together, the combination aims to reduce cravings and help you feel more in control around food while you follow nutrition and activity changes. Results vary. Prescription weight-loss medicines work best as part of a broader plan, not as a stand-alone fix.

Who May Qualify for Contrave?

Clinicians generally consider prescription weight-loss medicines for adults who have not lost enough weight with lifestyle changes alone and who meet BMI-based criteria. Per Mayo Clinic guidance on prescription weight-loss drugs:

• BMI of 30 or higher (obesity), or
• BMI of 27 or higher with a serious weight-related condition such as type 2 diabetes or high blood pressure

A licensed provider reviews your full history before prescribing: cardiovascular status, mental health, seizure risk, substance use history, other medicines, pregnancy plans, and prior weight-loss attempts. Contrave is not appropriate for everyone.

How Well Does Contrave Work?

Mayo Clinic notes that long-term prescription weight-loss drugs, used with lifestyle changes, produce greater average weight loss than lifestyle changes alone. Across approved long-term options, one year of treatment can mean roughly 3% to 18% more total body weight loss than lifestyle changes alone, depending on the medicine and the person. Losing and keeping off about 5% to 10% of body weight can improve blood pressure, blood sugar, and triglycerides for many people.

Your clinician may reassess after several months on a full dose. If you have not lost at least about 5% of body weight after 3 to 6 months at the target dose, they may discuss a different medicine or approach.

Contrave Side Effects and Safety

Common side effects of bupropion-naltrexone can include nausea, headache, constipation, and upset stomach. Contrave can raise blood pressure, so clinicians often check blood pressure regularly early in treatment. The medicine may also affect mood, thinking, or suicidal thoughts in some people; report new or worsening depression, anxiety, or unusual behavior promptly.

Do not start Contrave without a medical evaluation. Contraindications and cautions commonly include (discuss the full list with your clinician and pharmacist):

• Uncontrolled high blood pressure
• Seizure disorders or conditions that raise seizure risk
• Current use of other bupropion products
• Chronic opioid use or acute opioid withdrawal (naltrexone blocks opioids)
• Abrupt discontinuation of alcohol, benzodiazepines, barbiturates, or antiepileptic drugs
• Eating disorders such as anorexia or bulimia (bupropion-related seizure risk)
• Pregnancy, breastfeeding, or plans to become pregnant
• MAO inhibitor use within 14 days

This overview does not replace the full prescribing information or personalized medical advice.

Contrave vs Other Prescription Weight Loss Options

Choosing among medicines depends on your health profile, preferences (oral tablet vs injection), cost, and insurance formulary rules.

For a broader clinical map of FDA-approved options, see Klarity’s guide to prescription weight loss medication online and the NIDDK overview linked above.

Cost, Coupons, and Insurance Coverage

Weight-loss drugs can be expensive, and insurance does not always pay for them. Mayo Clinic advises patients to ask their insurer about coverage before starting therapy. Prior authorization, step therapy, BMI documentation, and lifestyle program requirements are common.

Manufacturer savings programs and pharmacy discount cards may lower cash price for eligible patients when insurance does not apply or when copays remain high. Program rules change; verify current terms on the official Contrave savings page and with your pharmacy. Coverage always varies by plan, employer, Medicare Advantage design, and state rules. Verify benefits before you book care or fill a prescription.

Can You Get Contrave Through Telehealth?

Licensed physicians, nurse practitioners, and physician assistants can evaluate adults for weight-management medicines, including Contrave, via telehealth when state law and clinical standards allow. A typical pathway looks like this:

1. Intake: medical history, medications, mental health screening, weight and blood pressure history, and goals
2. Clinical visit: video or approved virtual encounter with a licensed provider
3. Decision: discuss risks, benefits, alternatives (including GLP-1s and other orals), and monitoring
4. Prescription: if appropriate, an electronic prescription to your preferred pharmacy
5. Follow-up: dose titration checks, blood pressure and side-effect review, and progress reassessment

Contrave is not a controlled substance in the same Schedule IV class as phentermine, which can simplify some telehealth workflows compared with stimulant appetite suppressants. Your provider still follows clinical and legal requirements for safe prescribing.

Ready to talk with a clinician? Klarity Health’s online weight loss service connects you with licensed providers for evaluation and ongoing management when medically appropriate. You can also explore online prescription visits when you need broader medication support.

Frequently Asked Questions

Is Contrave an appetite suppressant?

Clinicians often describe Contrave as helping reduce appetite and food cravings by acting on central nervous system pathways involved in hunger and reward. It is not the same as short-term stimulant appetite suppressants such as phentermine alone.

How long do you take Contrave?

If you tolerate the medicine, lose enough weight to improve health markers, and your clinician agrees, long-term use is possible. If response is inadequate after several months at a full dose, your clinician may change the plan.

Does insurance cover Contrave?

Sometimes. Many commercial plans and some Medicare Advantage designs may cover anti-obesity medicines with prior authorization; others exclude weight-loss drugs entirely. Always verify your pharmacy benefit. Klarity Health does not guarantee coverage.

Can I take Contrave with depression medication?

Only under clinician guidance. Bupropion is itself an antidepressant, and combining products that contain bupropion or that raise seizure risk can be dangerous. Never combine or stop psychiatric medicines without medical advice.

Is Contrave better than Wegovy or Zepbound?

There is no single “best” medicine for every person. Injectables such as semaglutide and tirzepatide often produce larger average weight loss in clinical programs, while Contrave offers an oral option that may suit people who prefer tablets, cannot use certain injectables, or have a clinical profile that favors naltrexone-bupropion. Your provider matches the option to your history and goals.

Related Care Options

• Online weight loss treatment
• Online doctor prescriptions
• Online anxiety treatment (mood and anxiety history often matter when reviewing bupropion-containing regimens)
• Online depression treatment
• Condition guides

Next Steps with Klarity Health

If you are considering Contrave or another prescription weight-loss medicine, start with a licensed clinical evaluation rather than self-directed dosing or unverified online sources. Klarity Health’s network of over 2,000 licensed providers can help you review eligibility, discuss alternatives, and coordinate prescriptions when appropriate.

Check if your plan may cover a weight management visit → · Explore conditions

Disclaimer: This article is for educational purposes only and is not medical advice. Contrave and other prescription medicines require evaluation by a licensed clinician. Coverage varies by insurance plan and pharmacy benefit. Verify benefits and discuss risks, benefits, and alternatives with your healthcare provider before starting any medication.