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CONTRAVE (NALTREXONE HCL/BUPROPION HCL)
- Weight loss management for obese patient (bmi >= 30)
- Wt loss mgmt, pt with bmi 27-29 & wt-related comorbidity
8 mg-90 mg tablet,extended release
- 2 tablets by oral route 2 times per day in the morning and evening
Weight loss management for obese patient (bmi >= 30)
- 2 tablets by oral route 2 times per day in the morning and evening
- 1 tablet by oral route once daily in the morning
- 2 tablets by oral route in the morning and 1 tablet in the evening
- 1 tablet by oral route 2 times per day in the morning and evening
Wt loss mgmt, pt with bmi 27-29 & wt-related comorbidity
- 2 tablets by oral route 2 times per day in the morning and evening
- 1 tablet by oral route once daily in the morning
- 2 tablets by oral route in the morning and 1 tablet in the evening
- 1 tablet by oral route 2 times per day in the morning and evening
- Abstral
- acetaminophen-codeine
- Actiq
- Alfenta
- alfentanil
- Ascomp With Codeine
- Astramorph-pf
- Avinza
- Azilect
- belladonna alkaloids-opium
- Belladonna-opium
- bromphen-pseudoephed-codeine
- brompheniramine-PE-codeine
- Buprenex
- buprenorphine
- buprenorphine-naloxone
- Butalbital Compound W/codeine
- Butalbital Compound-codeine
- butalbital-acetaminop-caf-cod
- butorphanol tartrate
- Butrans
- Capcof
- Capital With Codeine
- carisoprodol-ASA-codeine
- Cheratussin Ac
- Cheratussin Dac
- chlorcyclizine-codeine
- chlorphen-pseudoephed-codeine
- chlorpheniramine-codeine
- chlorpheniramine-hydrocodone
- chlorpheniramine-PE-codeine
- clrcycliz-pseudoephed-codeine
- codeine sulfate
- codeine-butalbital-ASA-caff
- codeine-guaifenesin
- codeine-pyrilamine
- Conzip
- cpm-pseudoephed-hydrocodone
- Demerol
- Demerol (pf)
- Depodur (pf)
- dexbrompheniramine-PSE-codeine
- dexchlorphen-phenyleph-codeine
- dihydrocodeine-aspirin-caff
- Dilaudid
- Dilaudid (pf)
- Dilaudid-hp (pf)
- diphenoxylate-atropine
- Diskets
- Dolophine
- Duragesic
- Duramorph (pf)
- Eldepryl
- Endocet
- Endodan
- Exalgo Er
- fentanyl
- fentanyl citrate
- fentanyl citrate (PF)
- Fentora
- Fioricet With Codeine
- Fiorinal-codeine #3
- Guaiatussin Ac
- Guaifenesin Ac
- Guaifenesin Dac
- Guiatuss Ac
- Hycet
- hydrocodone bitartrate
- Hydrocodone Compound
- hydrocodone-acetaminophen
- hydrocodone-homatropine
- hydrocodone-ibuprofen
- Hydromet
- hydromorphone
- hydromorphone (PF)
- Ibudone
- ibuprofen-oxycodone
- Iophen C-nr
- isocarboxazid
- Kadian
- Lazanda
- linezolid
- Lomotil
- Lortab Elixir
- Lortuss Ex
- M-clear Wc
- M-end Max D
- M-end Pe
- Mar-cof Bp
- Mar-cof Cg
- Marplan
- Matulane
- meperidine
- meperidine (PF)
- Meperitab
- methadone
- Methadone Intensol
- Methadose
- methylene blue (antidote)
- morphine
- morphine (PF)
- morphine concentrate
- morphine liposomal (PF)
- Ms Contin
- nalbuphine
- Nardil
- Norco
- Opana
- Opana Er
- opium tincture
- Oxecta
- oxycodone
- oxycodone-acetaminophen
- oxycodone-aspirin
- Oxycontin
- oxymorphone
- paregoric
- Parnate
- pentazocine lactate
- pentazocine-naloxone
- Percocet
- Percodan
- phenelzine
- Phenylhistine
- Phenylhistine Dh
- Poly-tussin
- Poly-tussin Ac
- Poly-tussin D
- Primlev
- Pro-clear Ac
- Pro-clear Caps
- Pro-red Ac (w/ Dexchlorphenir)
- procarbazine
- Promethazine Vc-codeine
- promethazine-codeine
- promethazine-phenyleph-codeine
- pseudoephedrine-codeine-GG
- pseudoephedrine-hydrocodone
- rasagiline
- Relcof C
- remifentanil
- Reprexain
- Rezira
- Roxicet
- Rydex
- selegiline HCl
- Statuss Green (codeine)
- Sublimaze (pf)
- Suboxone
- Subsys
- Sufenta
- sufentanil citrate
- Synalgos-dc
- Synapryn
- Talwin
- tramadol
- tramadol-acetaminophen
- tramadol-glucosamine
- tranylcypromine
- Trymine Cg
- Tusnel C
- Tussicaps
- Tussigon
- Tussionex Pennkinetic Er
- Tylenol-codeine #3
- Tylenol-codeine #4
- Ultiva
- Ultracet
- Ultram
- Ultram Er
- Vicodin
- Vicodin Es
- Vicodin Hp
- Vicoprofen
- Virtussin Ac
- Vituz
- Xartemis Xr
- Xodol 10/300
- Xodol 5/300
- Xodol 7.5/300
- Z-tuss Ac
- Z-tuss E
- Zamicet
- Zelapar
- Zodryl Ac 25
- Zodryl Ac 30
- Zodryl Ac 35
- Zodryl Ac 40
- Zodryl Ac 50
- Zodryl Ac 60
- Zodryl Ac 80
- Zodryl Dac 25
- Zodryl Dac 30
- Zodryl Dac 35
- Zodryl Dac 40
- Zodryl Dac 50
- Zodryl Dac 60
- Zodryl Dac 80
- Zodryl Dec 25
- Zodryl Dec 30
- Zodryl Dec 35
- Zodryl Dec 40
- Zodryl Dec 50
- Zodryl Dec 60
- Zodryl Dec 80
- Zohydro Er
- Zubsolv
- Zutripro
- Zyvox
Contraindicated
- atomoxetine
- Brintellix
- Datscan
- ioflupane I 123
- isoniazid-rifamp-pyrazinamide
- Rifadin
- Rifamate
- rifampin
- rifampin-isoniazid
- Rifater
- Soltamox
- Strattera
- tamoxifen
- vortioxetine
Severe
Moderate
- A-hydrocort
- A-methapred
- Abilify
- Abilify Discmelt
- Abilify Maintena
- acarbose
- Actoplus Met
- Actoplus Met Xr
- Actos
- Adasuve
- alogliptin-metformin
- alogliptin-pioglitazone
- Amaryl
- aminophylline
- amitriptyline
- amitriptyline-chlordiazepoxide
- amoxapine
- Anafranil
- Anucort-hc
- Anusol-hc
- Apidra
- Apidra Solostar
- aripiprazole
- Aristospan Intra-articular
- Aristospan Intralesional
- betamethasone acet & sod phos
- Brisdelle
- budesonide
- Celestone Soluspan
- Celexa
- chlorpromazine
- citalopram
- clomipramine
- clozapine
- Clozaril
- Colocort
- Compazine
- Compro
- Cortef
- Cortenema
- Cortifoam
- cortisone
- Cymbalta
- Depo-medrol
- desipramine
- desvenlafaxine
- desvenlafaxine fumarate
- desvenlafaxine succinate
- dexamethasone
- Dexamethasone Intensol
- dexamethasone sodium phos (PF)
- dexamethasone sodium phosphate
- Dexpak 10 Day
- Dexpak 13 Day
- Dexpak 6 Day
- Diabeta
- doxepin
- droperidol
- Duetact
- duloxetine
- Effexor Xr
- Elixophyllin
- Entocort Ec
- escitalopram oxalate
- Ez Use Joint-tunnel-trigger
- Fazaclo
- Fetzima
- First-duke's
- First-mary's Mouthwash
- Flo-pred
- fludrocortisone
- fluoxetine
- fluphenazine decanoate
- fluphenazine HCl
- fluvoxamine
- Fortamet
- Geodon
- glimepiride
- glipizide
- glipizide-metformin
- Glucophage
- Glucophage Xr
- Glucotrol
- Glucotrol Xl
- Glucovance
- Glumetza
- glyburide
- glyburide micronized
- glyburide-metformin
- Glynase
- Glyset
- Grx Hicort 25
- Haldol
- Haldol Decanoate
- haloperidol
- haloperidol decanoate
- haloperidol lactate
- Hemril-30
- Humalog
- Humalog Kwikpen
- Humalog Mix 50-50
- Humalog Mix 50-50 Kwikpen
- Humalog Mix 75-25
- Humalog Mix 75-25 Kwikpen
- Humulin 70/30
- Humulin N
- Humulin N Kwikpen
- Humulin R
- Humulin R U-500 "Concentrated"
- hydrocortisone
- hydrocortisone acetate
- hydrocortisone sod succ (PF)
- hydrocortisone sod succinate
- imipramine HCl
- imipramine pamoate
- insulin asp prt-insulin aspart
- insulin aspart
- insulin detemir
- insulin glargine
- insulin glulisine
- insulin lispro
- insulin lispro protam-lispro
- insulin NPH and regular human
- insulin regular hum U-500 conc
- insulin regular human
- Invega
- Invega Sustenna
- Janumet
- Janumet Xr
- Jentadueto
- Kaletra
- Kazano
- Kenalog
- Khedezla
- Kombiglyze Xr
- Lantus
- Lantus Solostar
- Latuda
- Levemir
- Levemir Flexpen
- levomilnacipran
- Lexapro
- linagliptin-metformin
- lopinavir-ritonavir
- loxapine
- loxapine succinate
- Loxitane
- lurasidone
- Luvox Cr
- maprotiline
- Medrol
- Medrol (pak)
- metformin
- methylprednisolone
- methylprednisolone acetate
- methylprednisolone sod suc(PF)
- methylprednisolone sodium succ
- methylprednisolone-bupivacaine
- miglitol
- Millipred
- Millipred Dp
- milnacipran
- mirtazapine
- nateglinide
- nefazodone
- Norpramin
- nortriptyline
- Norvir
- Norvir Soft Gelatin
- Novolin 70/30
- Novolin N
- Novolin R
- Novolog
- Novolog Flexpen
- Novolog Mix 70-30
- Novolog Mix 70-30 Flexpen
- Novolog Penfill
- NPH insulin human recomb
- nystatin-hydrocortisone-diphen
- nystatin-TCN-HC-diphenhydramin
- olanzapine
- olanzapine pamoate
- olanzapine-fluoxetine
- Oleptro Er
- Orapred
- Orapred Odt
- Oseni
- paliperidone
- paliperidone palmitate
- Pamelor
- paroxetine HCl
- paroxetine mesylate
- Paxil
- Paxil Cr
- Pediapred
- perphenazine
- perphenazine-amitriptyline
- Pexeva
- Phenadoz
- Phenergan
- Physicians Ez Use M-pred
- pioglitazone
- pioglitazone-glimepiride
- pioglitazone-metformin
- Prandimet
- Prandin
- Precose
- prednisolone
- prednisolone acetate
- prednisolone sodium phosphate
- prednisone
- Prednisone Intensol
- Pristiq
- prochlorperazine
- prochlorperazine Edisylate
- prochlorperazine maleate
- Proctocort
- promethazine
- Promethazine Vc
- promethazine-DM
- promethazine-phenylephrine
- Promethegan
- protriptyline
- Prozac
- Prozac Weekly
- quetiapine
- Rayos
- Rectacort-hc
- Remeron
- Remeron Soltab
- repaglinide
- repaglinide-metformin
- Riomet
- Risperdal
- Risperdal Consta
- Risperdal M-tab
- risperidone
- risperidone microspheres
- ritonavir
- Sarafem
- Savella
- saxagliptin-metformin
- Seroquel
- Seroquel Xr
- sertraline
- Silenor
- sitagliptin-metformin
- Solu-cortef
- Solu-cortef (pf)
- Solu-medrol
- Solu-medrol (pf)
- Starlix
- Surmontil
- Symbyax
- tetrabenazine
- Theo-24
- Theochron
- theophylline
- theophylline in dextrose 5 %
- thioridazine
- thiothixene
- Tofranil
- Tofranil-pm
- tolazamide
- tolbutamide
- trazodone
- triamcinolone acetonide
- triamcinolone hexacetonide
- triamcinolone-lidocaine
- trifluoperazine
- trimipramine
- Uceris
- venlafaxine
- Veripred 20
- Versacloz
- Viibryd
- vilazodone
- Vivactil
- Xenazine
- ziprasidone HCl
- ziprasidone mesylate
- Zoloft
- Zyprexa
- Zyprexa Relprevv
- Zyprexa Zydis
- Anorexia nervosa
- Bulimia nervosa
- Lower seizure threshold
- Opioid dependence
- Opioid use last 4 hours in narcotic-dependent patient
- Opioid withdrawal symptoms
- Pregnancy
- Seizure disorder
- Seizure due to abrupt benzodiazepine withdrawal
- Seizure due to alcohol withdrawal
Contraindicated
- Alcoholism
- Angle-closure glaucoma
- Arteriovenous malformation
- Central nervous system neoplasm
- Cerebral metastases
- Cerebrovascular accident
- Chronic kidney disease stage 3A (moderate) GFR 45-59
- Chronic kidney disease stage 3B (moderate) GFR 30-44
- Chronic kidney disease stage 4 (severe) GFR 15-29 ml/min
- Chronic kidney disease stage 5 (failure) GFr<15 ml/min
- Hostility
- Mood changes
- Sedative drug dependence
- Severe hepatic disease
- Stimulant drug dependence
- Suicidal ideation
Severe
Moderate
- Acute myocardial infarction
- Bipolar disorder
- Hypertension
- Hypoglycemic disorder
- Kidney disease with likely reduction in GFR
- Psychotic disorder
- Weight loss
CONTRAVE (NALTREXONE HCL/BUPROPION HCL)
- Weight loss management for obese patient (bmi >= 30)
- Wt loss mgmt, pt with bmi 27-29 & wt-related comorbidity
- None
- Constipation
- Diarrhea
- Dizziness
- Dream disorder
- Headache disorder
- Insomnia
- Nausea
- Vomiting
- Xerostomia
More Frequent
Severe
Less Severe
- Hypertension
- Influenza
- Urticaria
- Acute abdominal pain
- Arthralgias
- Drowsy
- Drug-induced hot flash
- Dysgeusia
- Fatigue
- Hyperhidrosis
- Irritability
- Menstrual disorder
- Myalgias
- Nervousness
- Palpitations
- Pruritus of skin
- Skin rash
- Symptoms of anxiety
- Tinnitus
- Tremor
- Urinary tract infection
- Viral gastroenteritis
Less Frequent
Severe
Less Severe
Rare / Very Rare
Severe
- Abnormal hepatic function tests
- Acute myocardial infarction
- Akathisia
- Anaphylaxis
- Angioedema
- Bloody stools
- Cholecystitis
- Dehydration
- Drug-induced psychosis
- Dyspnea
- Erythema multiforme
- Hepatitis
- Homicidal ideation
- Hypersensitivity drug reaction
- Manic disorder
- Opioid withdrawal symptoms
- Pneumonia
- Pyelonephritis
- Secondary angle-closure glaucoma
- Seizure disorder
- Stevens-johnson syndrome
- Suicidal
- Suicidal ideation
Less Severe
- Abnormal vaginal bleeding
- Aggressive behavior
- Agitation
- Alopecia
- Behavioral disorders
- Disturbance of attention
- Erectile dysfunction
- Eructation
- Fever
- General weakness
- Hostility
- Hypoglycemic disorder
- Hypomania
- Jaw pain
- Lethargy
- Lip swelling
- Memory impairment
- Motion sickness
- Panic disorder
- Polydipsia
- Tachycardia
- Tension
- Urinary urgency
- Vertigo
- Vulvovaginal dryness
Contraindicated
None
Severe Precaution
Bupropion
Possible increased suicidal ideation and attempt with underlying major depression. No safety and efficacy established.
- 1 Day – 18 Years
- Possible increased suicidal ideation and attempt with underlying major depression. No safety and efficacy established.
Management or Monitoring Precaution
Naltrexone
No safety and efficacy established in pediatrics. Post-marketing reports of suicide in adults.
- 1 Day – 18 Years
- No safety and efficacy established in pediatrics. Post-marketing reports of suicide in adults.
Bupropion/naltrexone
- Severity Level:
X
- Additional Notes: Weight loss not indicated in pregnancy
Contraindicated
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Precaution Exists
Bupropion/naltrexone
Limited human data avail for bupropion; monitor infant for adv effects
| General | Excretion Potential | Effect on Infant | Notes |
| Evaluate use carefully | Excreted | Not known; no or inclusive data | Limited human data avail for bupropion; monitor infant for adv effects |
No Known Risk
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Contraindicated
None
Precaution Exists
Bupropion
Hepatic-Lower doses are generally recommended in elderly. Bupropion is extensively metabolized to active metabolites, and the elderly may accumulate drug. Renal-Possible accumulation of active metabolites. Consider lower dose for GFR<90 mL/min and monitoring renal function. Neuro/Psych-Consider bupropion CNS side effects of dizziness, insomnia, somnolence and memory loss when using in the elderly.
| Organ / System | HEP | REN | CARD | ENDO | NEURO / PSYCH | PULM |
| Increased Risk / Adverse Effects | Y | Y | N | Y | N | N |
BEERS: N HEDIS: N STOPP: N
No Known Risk
None
- This medication is a combination of bupropion and naltrexone. Bupropion is an antidepressant used to treat a variety of conditions, including depression and other mental/mood disorders. It can also be prescribed to help with smoking cessation or weight loss.<br /><br />Antidepressants can help prevent suicidal thoughts/attempts and provide other important benefits. However, studies have shown that a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. Therefore, it is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition.<br /><br /> Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed. If you are using naltrexone/bupropion to lose weight, stop taking this medication and tell your doctor right away if you have any of the symptoms listed above. Tell your doctor right away if you have any of these symptoms after stopping treatment.
| Weight loss management for obese patient (bmi >= 30) | |
| E66 | Overweight and obesity |
| E66.0 | Obesity due to excess calories |
| E66.01 | Morbid (severe) obesity due to excess calories |
| E66.09 | Other obesity due to excess calories |
| E66.1 | Drug-induced obesity |
| E66.2 | Morbid (severe) obesity with alveolar hypoventilation |
| E66.8 | Other obesity |
| E66.9 | Obesity, unspecified |
| Z68.3 | Body mass index (BMi) 30-39, adult |
| Z68.30 | Body mass index (BMi) 30.0-30.9, adult |
| Z68.31 | Body mass index (BMi) 31.0-31.9, adult |
| Z68.32 | Body mass index (BMi) 32.0-32.9, adult |
| Z68.33 | Body mass index (BMi) 33.0-33.9, adult |
| Z68.34 | Body mass index (BMi) 34.0-34.9, adult |
| Z68.35 | Body mass index (BMi) 35.0-35.9, adult |
| Z68.36 | Body mass index (BMi) 36.0-36.9, adult |
| Z68.37 | Body mass index (BMi) 37.0-37.9, adult |
| Z68.38 | Body mass index (BMi) 38.0-38.9, adult |
| Z68.39 | Body mass index (BMi) 39.0-39.9, adult |
| Z68.4 | Body mass index (BMi) 40 or greater, adult |
| Z68.41 | Body mass index (BMi) 40.0-44.9, adult |
| Z68.42 | Body mass index (BMi) 45.0-49.9, adult |
| Z68.43 | Body mass index (BMi) 50.0-59.9, adult |
| Z68.44 | Body mass index (BMi) 60.0-69.9, adult |
| Z68.45 | Body mass index (BMi) 70 or greater, adult |
| Wt loss mgmt, pt with bmi 27-29 & wt-related comorbidity | |
| E66.3 | Overweight |
| Z68.27 | Body mass index (BMi) 27.0-27.9, adult |
| Z68.28 | Body mass index (BMi) 28.0-28.9, adult |
| Z68.29 | Body mass index (BMi) 29.0-29.9, adult |
| 0-9 | A-Z |
|---|---|
| E66 | Overweight and obesity |
| E66.0 | Obesity due to excess calories |
| E66.01 | Morbid (severe) obesity due to excess calories |
| E66.09 | Other obesity due to excess calories |
| E66.1 | Drug-induced obesity |
| E66.2 | Morbid (severe) obesity with alveolar hypoventilation |
| E66.3 | Overweight |
| E66.8 | Other obesity |
| E66.9 | Obesity, unspecified |
| Z68.27 | Body mass index (BMi) 27.0-27.9, adult |
| Z68.28 | Body mass index (BMi) 28.0-28.9, adult |
| Z68.29 | Body mass index (BMi) 29.0-29.9, adult |
| Z68.3 | Body mass index (BMi) 30-39, adult |
| Z68.30 | Body mass index (BMi) 30.0-30.9, adult |
| Z68.31 | Body mass index (BMi) 31.0-31.9, adult |
| Z68.32 | Body mass index (BMi) 32.0-32.9, adult |
| Z68.33 | Body mass index (BMi) 33.0-33.9, adult |
| Z68.34 | Body mass index (BMi) 34.0-34.9, adult |
| Z68.35 | Body mass index (BMi) 35.0-35.9, adult |
| Z68.36 | Body mass index (BMi) 36.0-36.9, adult |
| Z68.37 | Body mass index (BMi) 37.0-37.9, adult |
| Z68.38 | Body mass index (BMi) 38.0-38.9, adult |
| Z68.39 | Body mass index (BMi) 39.0-39.9, adult |
| Z68.4 | Body mass index (BMi) 40 or greater, adult |
| Z68.41 | Body mass index (BMi) 40.0-44.9, adult |
| Z68.42 | Body mass index (BMi) 45.0-49.9, adult |
| Z68.43 | Body mass index (BMi) 50.0-59.9, adult |
| Z68.44 | Body mass index (BMi) 60.0-69.9, adult |
| Z68.45 | Body mass index (BMi) 70 or greater, adult |
Formulary Reference Tool