Contrave (bupropion + naltrexone)
Metabolic Health · Combination
Tier B
Bottom line
Read Off Label grades Contrave (bupropion + naltrexone) as B (6.4/10) based on strong evidence, med benefit magnitude, and a med-risk safety profile.
COR-I trial: ~6.
Typical use: Titrated to 32 mg naltrexone / 360 mg bupropion daily — Rx.
What this is
COR-I trial: ~6.1% weight loss vs 1.3% placebo. Also mildly helpful for food cravings and mood. LIGHT cardiovascular trial terminated early due to sponsor data dispute — CV safety uncertain.
Mechanism
Bupropion: NE/dopamine reuptake inhibitor stimulates POMC neurons in hypothalamus; naltrexone: opioid antagonist that blocks autoinhibitory feedback on POMC — combination produces sustained appetite suppression
Dose & route
Titrated to 32 mg naltrexone / 360 mg bupropion daily
Citations
- https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60888-4/fulltext
- https://pubmed.ncbi.nlm.nih.gov/23804960/
- https://www.nejm.org/doi/full/10.1056/NEJMoa1607141
- https://pubmed.ncbi.nlm.nih.gov/39762910/
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Common questions
- Does Contrave (bupropion + naltrexone) work?
- Read Off Label rates the evidence for Contrave (bupropion + naltrexone) as Strong and the benefit magnitude as med, producing an overall grade of B (6.4/10). COR-I trial: ~6.
- Is Contrave (bupropion + naltrexone) safe?
- Contrave (bupropion + naltrexone) has a med risk profile in published human data. Legal status: Rx. This is not medical advice — see the disclaimer.
- What is the typical dose for Contrave (bupropion + naltrexone)?
- Titrated to 32 mg naltrexone / 360 mg bupropion daily
- How does Contrave (bupropion + naltrexone) work?
- Bupropion: NE/dopamine reuptake inhibitor stimulates POMC neurons in hypothalamus; naltrexone: opioid antagonist that blocks autoinhibitory feedback on POMC — combination produces sustained appetite suppression
This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.