What does the evidence show about Contrave (bupropion + naltrexone)'s effects?

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.

What safety findings are reported for Contrave (bupropion + naltrexone)?

Contrave (bupropion + naltrexone) has a med risk profile in the database. Med (seizure risk with bupropion; BP/HR; contraindicated in uncontrolled HTN or seizures) Legal status: Rx.

Rankings / Metabolic Health

Contrave (bupropion + naltrexone)

Metabolic Health · Combination

Tier B

Reviewed by Read Off Label · Last reviewed Jul 11, 2026 · How we grade

dopamineopioidprescription

6.4 / 10

Tier B

Ev 8 Bn 5 Sf 5

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.

Studied, labeled, or reported-use context: Titrated to 32 mg naltrexone / 360 mg bupropion daily — Rx; not individualized guidance.

Citation correction in progress

1 PubMed link was found to be unrelated to this entry and removed from public output. The remaining sources are shown below, but this row's claims and score still need a full source-by-source revalidation.

What the evidence says

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

Studied, labeled, or reported dose & route

Titrated to 32 mg naltrexone / 360 mg bupropion daily

This records doses and routes described in studies, approved labeling, clinical practice, or documented use. It is not individualized guidance and does not establish safety; context changes with indication, formulation, health history, monitoring, and other medicines.

Citations

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Common questions

What does the evidence show about Contrave (bupropion + naltrexone)'s effects?: 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.
What safety findings are reported for Contrave (bupropion + naltrexone)?: Contrave (bupropion + naltrexone) has a med risk profile in the database. Med (seizure risk with bupropion; BP/HR; contraindicated in uncontrolled HTN or seizures) Legal status: Rx.
What doses or routes are reported for Contrave (bupropion + naltrexone)?: Titrated to 32 mg naltrexone / 360 mg bupropion daily This is context from studies, approved labeling, clinical practice, or documented use; it is not individualized guidance and does not establish safety.
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.