Contrave side effects: what to expect and how to cope

Are you thinking of asking your doctor about Contrave for weight loss? It can be a good option because it helps curb appetite and cravings, but there are potential side effects to consider.

In this article, we explore Contrave’s side effects, how long they last, and how to manage them. This way you can decide if Contrave is right for you and have a conversation with your weight loss specialist.

Need a weight loss program and thinking about medication? You have options. Find a provider on Klarity today to talk about whether Contrave, or another medication, is right for you.

Common Contrave side effects

Contrave can cause several common side effects. They’re typically mild and tend to go away as your body adjusts to the medication. Your provider will start you on a low dose and increase it gradually, which helps with the adjustment period. 

Below, we’ll cover the side effects participants experienced in clinical trials and the percentage of participants that experienced each. This way, you have a better idea of what to expect for side effects and how common they actually are.

Nausea 

Approximately 32.5% of participants in clinical trials experience nausea compared to 6.7% of those taking placebo. Nausea tends to be mild and typically subsides within a few weeks. If you experience nausea, it will likely improve as your body gets used to Contrave and you work up to your maintenance dose.

You may be able to reduce nausea by eating smaller meals. Also, try eating a bland diet and avoiding fried or spicy foods. It’s recommended to take Contrave with food and avoid high-fat meals to reduce side effects like nausea. Your healthcare provider may also recommend nausea treatments or medication if needed.

Reddit user Ardel17 says, “I have found that taking [Contrave] with food helps. Dry toast and saltines helped as well. I really only had nausea bad the first couple days. It tapered off and reappeared every week when I upped the dose and then tapered off again. It should go away eventually but if it doesn’t you should talk to your doctor.”

Constipation

Around 19.2% of clinical trial participants reported constipation as a side effect of Contrave. You can help alleviate constipation by increasing your fiber intake. But don’t increase the amount of fiber you eat too quickly — a gradual approach helps avoid the bloating and diarrhea that a sudden increase in fiber can cause. Staying hydrated and exercising regularly can also help.

Reddit users who take Contrave say constipation tends to start around week 2 and can take weeks or months to resolve. Talk to your healthcare provider if you experience constipation while taking Contrave. They may recommend over-the-counter (OTC) medications to treat it. 

Headache 

Headaches were reported by 17.6% of participants in clinical trials. You can manage headaches with hydration, a consistent sleep schedule, and regular exercise. OTC pain relievers may also offer relief.

Experiences with headaches while taking Contrave vary from person to person. One Reddit user says, “My headache experience has been mild. I sometimes wake up with a light/mild headache in the middle of the night which is extremely unusual for me.” While others say headaches were the reason they stopped taking Contrave. 

If you experience headaches with Contrave use, let your healthcare provider know. They’ll help you manage your side effects or suggest trying another medication. 

Vomiting 

10.7% of Contrave clinical trial participants experienced vomiting. Vomiting can come with nausea, so managing your nausea symptoms may help curb it.

If addressing your nausea doesn’t work, try OTC acid reducers and adjust your diet to reduce fatty foods. If you vomit after taking Contrave, tell your healthcare provider. They can guide you on dosage and decide if you should take another dose after throwing up.

Dizziness 

Dizziness was reported by 9.9% of clinical trial participants. If you feel dizzy, move slowly and, if possible, sit down to prevent falling. Eating regularly and staying hydrated can also help with dizziness.

Trouble sleeping

Insomnia occurs when you can’t sleep at night, even when you’re tired. It affected 9.2% of Contrave study participants. Practice good sleep hygiene to help with insomnia symptoms. This means having good sleep habits and creating an environment conducive to sleep. 

Some ways to improve sleep hygiene include following a regular sleep schedule, avoiding stimulants before bedtime, exercising, and sleeping in a cool, dark room. It’s also helpful to implement relaxation techniques before bedtime, like breathing exercises or meditation.

One Reddit user mentioned that the sleep problems subsided after getting used to the medication, saying, “At first, it didn’t seem to make much of a difference as the dosage was so low, but over time with higher dosing I got less and less sleep (of the little I was getting.) Once the adjustment process was over, I went back to my baseline.”

Dry mouth

Approximately 8.1% of participants in clinical studies for Contrave experience dry mouth. To combat this, sip water throughout the day and chew sugar-free gum. Also, avoid substances like nicotine and caffeine to help manage dry mouth symptoms. 

If dry mouth persists, maintain good dental hygiene and schedule regular dental check-ups. Good dental hygiene and talking to your dentist can help address and prevent associated dental issues.

Diarrhea 

Diarrhea was reported by 7.1% of clinical trial participants as a Contrave side effect. It’s less common than constipation, but diarrhea can still be uncomfortable. Manage it by staying hydrated and eating a balanced diet. If this doesn’t help, speak to your provider about taking an OTC diarrhea medication.

It’s possible that you’re someone who just doesn’t tolerate Contrave’s side effects well. If that’s the case, speak to your provider so you can find a weight loss solution that works better for you. But, if you can tolerate the side effects, you might be wondering how long you can expect them to last.

How long do Contrave side effects last?

Most Contrave side effects last for a few weeks. Symptoms should improve as your body adapts to the medication. If the side effects persist or interfere with daily life, speak with your healthcare provider. They may adjust your dosage, switch medications, or suggest additional treatments to ease your symptoms. 

Both Reddit users and WebMD Contrave reviewers confirm that Contrave side effects can last for weeks. But, many of these reports also say the side effects subside and treatment goes well after that. Based on patient reviews, you may have to endure side effects in the first few weeks. After that, you may find Contrave an effective part of your medical weight loss program. 

More serious side effects of Contrave to know about

You may experience serious side effects on Contrave. While rare, report these to your provider immediately, as some may require emergency medical care. 

Adverse reactions

Contrave can cause several adverse reactions, including hypertension, fast heart rate, seizures, liver problems, and allergic reactions. The risk of seizures is higher for individuals with a history of seizures or those taking medications that lower the seizure threshold. 

Boxed warning

Contrave has a boxed warning for suicidal behaviors and ideation. A boxed warning is the most serious warning issued by the U.S. Food and Drug Administration (FDA) for medications. The risk is higher for young adults and for patients with major depressive disorder. 

A boxed warning can sound a bit scary, but the numbers can help put it in perspective. In the studies, suicidal thoughts and ideation were rare with only 1 out of 3,239 patients reporting these symptoms. For comparison, a higher percentage of participants taking a placebo reported these symptoms (3 out of 1,515). In other words, only 0.3% of participants actually taking Contrave experienced this side effect. 

Regardless, Report suicidal behaviors or ideation to your healthcare provider immediately. 

Who shouldn’t take Contrave

Contrave is a prescription weight loss pill for people who have obesity or are clinically overweight with a weight-related medical condition. It isn’t right for everyone. Certain medical conditions can increase the risk of side effects and adverse reactions. Avoid Contrave if you have the following conditions:

• Uncontrolled hypertension: If you have high blood pressure that isn’t well-managed, Contrave isn’t recommended due to the potential for worsening the condition.
• Seizure disorders: If you have a seizure disorder, or history of seizures, you shouldn’t take Contrave, as it can increase your likelihood of seizures.
• Eating disorders: You shouldn’t take Contrave if you have bulimia or anorexia nervosa because it can increase the risk of seizures. Both bulimia and anorexia nervosa can cause seizures due to behaviors associated with these disorders like malnutrition, dehydration, and refeeding syndrome.
• Alcohol or drug withdrawal: Don’t take Contrave if you’re undergoing withdrawal from opiates, opiate agonists, or partial agonists. It’s also not recommended for people experiencing withdrawal symptoms from alcohol.
• Pregnancy: Contrave isn’t recommended during pregnancy as the associated weight loss may be harmful to fetal health.
• Allergies: Don’t take Contrave if you’re allergic to its active ingredients, naltrexone and bupropion (brand name: Wellbutrin).

Contrave can also interact with certain medications. It isn’t recommended if you take any of the following:

• Monoamine oxidase inhibitors (MAOIs)
• Opioid analgesics
• Drugs metabolized by CYP2D6, including tricyclic antidepressants, selective serotonin-reuptake inhibitors (SSRIs), beta-blockers, and antipsychotics
• Digoxin
• CYP2B6 inhibitors and inducers, including ritonavir, lopinavir, and efavirenz
• Drugs that lower seizure threshold, including systemic corticosteroids and theophylline
• Dopaminergic drugs, such as levadopa and amantadine
• Alcohol

Key takeaway

Contrave is a prescription pill for medically-supervised weight loss. Its common side effects include nausea, constipation, headache, vomiting, dizziness, trouble sleeping, dry mouth, and diarrhea. These typically subside after the first few weeks. Discuss persistent or severe side effects with your healthcare provider.

While rare, serious adverse reactions can occur with Contrave, such as seizures, increased blood pressure, and allergic reactions. It also includes a boxed warning for suicidal thoughts and ideation.

Contrave isn’t for everyone. Certain medical conditions and medications can increase the risk of adverse reactions and side effects. Always communicate with your healthcare provider to manage Contrave side effects and achieve the best possible results.

Talk to a provider about the right weight loss treatment in 24 hours or less

Losing weight and keeping it off can be tough. But, medical weight loss can help you achieve meaningful and lasting results. Klarity makes it easy to speak with a medical weight loss provider — find a provider and have an appointment in 24 hours or less. 

Sources

Clin Obes, Naltrexone/Bupropion extended release-induced weight loss is independent of nausea in subjects without diabetes, Hong K, Herrmann K, Dybala C, Halseth AE, Lam H, Foreyt JP, Oct. 2016 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5129540/

DailyMed, Contrave Extended Release, https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=485ff360-32c8-11df-928b-0002a5d5c51b#section-6.1

Pharmacy & Therapeutics, Naltrexone/Bupropion ER (Contrave): Newly Approved Treatment Option for Chronic Weight Management in Obese Adults, Sherman MM, Ungureanu S, Rey JA., Mar. 2016, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4771085/

Reddit, r/Contrave, https://www.reddit.com/r/Contrave/

Reddit r/loseit, Anyone use Contrave?, https://www.reddit.com/r/loseit/

WebMD, User Reviews for Contrave Oral, https://reviews.webmd.com/drugs/drugreview-166975-contrave-oral

The information provided in this article is for educational purposes only and should not be construed as medical advice. Always seek the guidance of a qualified healthcare professional with any questions or concerns you have regarding your health.

How we reviewed this article: This article goes through rigorous fact-checking by a team of medical reviewers. Reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the author.