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Contrave Review: Pros, Cons, Safety, and More

Written by Melissa Mitri, MS, RD

Published on April 5, 2021

Our Expert Rating:

2.0

About This Rating
The average rating of this product is calculated based on the evaluation of the following factors:
  • Support for Claims:2.0
  • Ingredient Safety:1.0
  • Value for the Price:2.0
  • Brand Transparency:3.0

Contrave is an FDA-approved prescription weight-loss medication. I would not recommend it due to potentially serious side effects and a lack of research to confirm its safety.

Contrave Review: Pros, Cons, Safety, and More

Pros

  • Modest weight loss in some people
  • Prescription-based and FDA approved

Cons

  • Black box warning and risk of serious side effects
  • Ingredients are not approved for weight loss
  • Can interact with other medications

What Is Contrave?

Contrave is a prescription weight-loss pill approved by the FDA. It is approved for use in adults only.

To qualify for a prescription, you need to meet certain criteria. Specifically, your BMI needs to be 30 or higher or 27 or higher with at least one weight-related medical condition.

Examples of weight-related conditions are high blood pressure, high cholesterol, or type 2 diabetes.

The claims are that Contrave can help you to lose weight and keep it off by reducing hunger and cravings.

It is said to do this by working on 2 areas in your brain – the hunger center and the reward system.

It is recommended to follow a reduced-calorie diet and exercise plan in addition to taking Contrave for best results.

Contrave contains 2 main ingredients – Naltrexone and Bupropion. While both of these ingredients are FDA-approved for the treatment of other conditions, neither is approved for treating obesity.

While Contrave has led to weight loss in some clinical trials, there are many safety concerns. My biggest concern is that it includes a black box label warning from the FDA.

A black box warning calls attention to potentially serious or life-threatening risks from taking the medication. Therefore, weighing the pros and cons before taking Contrave is very important.

Evaluation of Ingredients

Contrave contains 2 main ingredients – Naltrexone and Bupropion. Both of these have been on the market individually for over 30 years.

1. Naltrexone – 8mg

Naltrexone is an anti-addiction medication approved to treat alcohol and opioid dependence.

It is unclear how Naltrexone may cause weight loss, but it may act on the reward centers of the brain to reduce cravings and the desire to use food as a reward.

Clinical trials have shown combining Naltrexone and Bupropion may lead to a 5% weight loss over a one-year period in some people.

While this may sound promising, these results are actually not very impressive for that amount of time.

2. Bupropion (Wellbutrin) – 90mg

Bupropion is a medication typically taken to treat depression or to quit smoking.

It is unclear how Bupropion may enhance weight loss, but my thoughts are that if it is used to treat depression, it may improve mood and decrease emotional eating.

If it is used to help break the habit of smoking, it may have the ability to help break unhealthy eating habits as well. However, none of this has yet been proven.

One small 24-week study showed those taking Contrave experienced an additional 5% weight loss compared to the placebo group.

However, this study was partially funded by a pharmaceutical company, which adds an element of bias.

If the company funding the research has a financial incentive to steer towards certain results, the results could be skewed.

Verdict on Claimed Benefits

Below is our summary of the available evidence for the claimed benefits of Contrave based on the available research:

  • Reduces hungerLimited Evidence
  • Controls cravingsLimited Evidence

Side Effects, Safety, and Dosage

Each Contrave pill contains 8mg of Naltrexone and 90mg of Bupropion.

The dosage of Contrave begins with one pill every morning the first week and then gradually increases every week until week 4:

  • Week 1: 1 pill with breakfast
  • Week 2: 1 pill with breakfast and dinner
  • Week 3: 2 pills with breakfast and 1 pill with dinner
  • Week 4: 2 pills with breakfast and 2 pills with dinner

If you have certain medical conditions such as liver or kidney disease, the dosage recommendations may be lower.

There are many possible side effects from taking Contrave. Additionally, it comes with a black box warning to indicate that serious side effects are possible.

Potential side effects include:

  • Nausea
  • Fatigue
  • Headache
  • Dizziness
  • Fatigue
  • Anxiety
  • Confusion
  • Trouble sleeping
  • Depression
  • Mania
  • Seizures
  • Eye problems such as pain, swelling, or sudden vision changes
  • Heart problems (research still ongoing)
  • Black box warning: Suicidal thoughts and actions

If you have the following conditions, it’s recommended not to take Contrave:

  • Anorexia or bulimia
  • Uncontrolled high blood pressure
  • History of seizures
  • Opioid, drug, or alcohol dependence
  • If you are already taking Bupropion or Naltrexone

These are pretty significant and potentially dangerous side effects. Due to this, I would not consider Contrave a recommended weight loss medication.

Cost

The cost for Contrave ranges from $60–$250 per month depending on the dose and amount of insurance coverage. It is available by prescription only.

If insurance doesn’t cover, the manufacturer offers a Contrave Savings Card and a discount on home delivery.

This is a fairly expensive cost for a weight loss medication since it is not completely covered by insurance.

How It Compares

Contrave is one of 4 prescription weight-loss medications currently approved by the FDA.

FDA approval doesn’t always mean that a product is completely safe.

Unfortunately, there have been other weight-loss medications in the past that have been approved, only to be later removed from the market due to safety concerns.

These side effects are often only discovered after observing people taking them for a while.

Contrave comes with more serious side effects than some others on the market. It is the only one that comes with a risk of suicidal thoughts or actions.

It’s also different from other weight-loss aids in that it contains ingredients that are often given to treat other conditions.

This can increase the risk of medication interactions when compared to other FDA-approved options.

The Bottom Line

While some people may lose weight on Contrave, the results are not significant enough to outweigh the potential safety risks.

The mechanism behind how it seemingly works is not clear, and its safety profile has not been determined.

Therefore, I would not feel comfortable recommending Contrave.

A Word from Our RD

While a prescription weight loss medication may seem safer, that’s not always the case.

As a registered dietitian, I have tracked the research for weight loss medications. Many are recalled from the market due to safety concerns, even with FDA approval.

You can achieve the same level of weight loss through a calorie deficit, regular exercise, and managing daily stresses.

If you’re an emotional eater or are experiencing frequent cravings, getting to the root of the problem is key. Finding healthier coping mechanisms will bring you results without the potential side effects.

If you are thinking about exploring Contrave or any other weight loss medication, I would suggest outweighing the benefits versus risks with your doctor.

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