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Contrave (Bupropion Plus Naltraxone) Buyer and Patient Handbook in Singapore

What is Contrave?

Contrave is a combination pill containing Bupropion and Naltrexone, approved for chronic weight management in adults with Obesity or overweight + weight-related comorbidities. It belongs to the class of centrally-acting appetite-suppressants. In Singapore, the product is regulated by HSA and carries the same safety standards as FDA-approved formulations. The tablet is available in a fixed-dose of 8 mg bupropion and 90 mg naltrexone.

Who Should Use Contrave?

• Adults ≥ 18 years with a body-mass index (BMI) ≥ 30 kg/m², or BMI ≥ 27 kg/m² with at least one obesity-related condition (e.g., Hypertension, dyslipidaemia, Type 2 Diabetes).
• Individuals who have not achieved sufficient weight loss through diet and exercise alone.
• Patients who can adhere to a structured lifestyle-modification programme alongside medication.

How Does It Work?

Contrave targets two brain pathways that influence eating behaviour. Bupropion stimulates pro-opiomelanocortin (POMC) neurons, which reduce appetite and increase energy expenditure. Naltrexone blocks an inhibitory feedback loop, enhancing the POMC signal. Think of it as releasing the brakes on a car’s accelerator while also giving the driver a slight “push” forward, resulting in decreased food intake and higher calorie burn. The formulation carries a low abuse potential, but patients with a history of seizure disorder should be cautious.

Why Choose Contrave?

• Dual-action: The combination provides greater weight-loss efficacy than either component alone.
• Evidence-based: Clinical trials demonstrate an average 5-10 % reduction in body weight after one year when paired with diet and exercise.
• Generic alternatives: Once available, generic versions may lower cost while delivering the same bioequivalence.
• Off-label use: Not recommended; any alternative indication should be discussed with a qualified health professional.

Dosage, Administration, Lifestyle and Dietary Recommendations

Recommended Dosage

• Initiate with one tablet (8/90 mg) daily for the first week.
• Increase to one tablet twice daily (morning and evening) from week 2 onward, as tolerated.
• Do not exceed two tablets per day.

How to Take

• Swallow the tablet whole with a full glass of water.
• Take each dose with food to minimise gastrointestinal discomfort.
• Maintain a consistent schedule (e.g., breakfast and dinner) for steady drug levels.

Missed Dose

• If you miss a dose and it is less than 6 hours until the next scheduled dose, skip the missed tablet.
• Do not double-dose to “make up” for the missed one.

Overdose

• Common symptoms include Nausea, Vomiting, rapid heart rate, and Seizures.
• Seek immediate medical attention or contact the Singapore Poison Centre (180-274-6688).

Special Populations

• Elderly (≥ 65 years): Start at the lowest dose and monitor for dizziness or blood-pressure changes.
• Renal or hepatic impairment: Dose adjustment may be required; consult a healthcare provider.
• Pregnancy & lactation: Contraindicated; avoid use.

Lifestyle & Diet

• Avoid excessive alcohol, as it can increase seizure risk.
• Limit intake of high-calorie, low-nutrient foods; aim for a calorie deficit of 500-750 kcal/day.
• Regular physical activity (≥ 150 min moderate aerobic exercise per week) amplifies weight-loss results.

Precautions and Warnings

• Do not use if you have uncontrolled hypertension, a seizure disorder, or a history of eating-disorder-related bingeing.
• Monitor blood pressure and heart rate monthly during the first three months.
• Sudden discontinuation may lead to weight regain; taper under supervision if cessation is needed.

Drug Interactions

Potential Side Effects

Common Side Effects

• Nausea
• Headache
• Dry mouth
• Constipation

Less Common Side Effects

• Insomnia
• Dizziness
• Tremor
• Increased blood pressure

Serious Side Effects

• Seizures - stop immediately and seek emergency care.
• Severe allergic reaction (rash, swelling, difficulty breathing) - call emergency services.
• Persistent High Blood Pressure - contact a healthcare professional promptly.

Who Should Avoid This Medication?

• Individuals with a current or past diagnosis of an eating disorder (e.g., Bulimia, Anorexia).
• Patients with uncontrolled hypertension (≥ 160/100 mmHg).
• Those taking opioid therapy for Chronic Pain.
• Anyone allergic to bupropion, naltrexone, or any excipients in the tablet.

Storage Instructions

• Store at 20-25 °C (68-77 °F) in a dry place away from direct sunlight.
• Keep the bottle tightly closed to protect from moisture.
• Keep out of reach of children and pets.

Contrave Alternatives

Frequently Asked Questions

How long does it take to see weight loss with Contrave?

Most users notice a modest reduction (≈ 2 kg) within the first 8 weeks, with continued loss up to 12 months when paired with diet and exercise.

Can I drink coffee while taking Contrave?

Yes, moderate caffeine intake (≤ 2 cups per day) is acceptable, but excessive caffeine may exacerbate insomnia.

Does Contrave affect blood sugar levels?

Bupropion can modestly improve glycaemic control, but regular monitoring is advised for patients with Diabetes.

I feel dizzy after the first few doses-what should I do?

Dizziness is a common early-stage effect; try taking the tablet with food and ensure adequate hydration. If symptoms persist beyond two weeks, seek medical advice.

Is Contrave safe for people over 65?

It can be used cautiously; start at one tablet daily and monitor blood pressure and mental status closely.

Can I use Contrave if I have mild liver disease?

Mild hepatic impairment usually does not require dose adjustment, but any liver condition warrants physician oversight.

What should I do if I miss a dose for several days?

Restart the titration schedule from the beginning (one tablet daily for a week) to minimise side-effects.

Does Contrave interact with over-the-counter supplements?

St. John’s wort and other serotonergic supplements may increase seizure risk; avoid them unless cleared by a healthcare professional.

Will I regain the weight after stopping Contrave?

Weight regain is common if lifestyle changes are not maintained; a gradual taper and continued diet/exercise can mitigate this.

How is Contrave supplied in Singapore?

It is available as a 30-tablet bottle of the fixed-dose 8 mg/90 mg formulation, dispensed by registered pharmacies.

Glossary

• BMI (Body-Mass Index): A ratio of weight (kg) to height squared (m²) used to classify obesity.
• POMC neurons: Brain cells that release peptides reducing appetite and increasing energy use.
• Bioequivalence: Pharmaceutical term indicating a generic drug has the same rate and extent of absorption as the brand product.

Disclaimer

The information provided here is for general educational purposes and reflects current knowledge about Contrave. It does not constitute medical advice, nor does it replace consultation with a qualified health professional. Off-label uses are not endorsed. Our platform offers access to licensed pharmacies; users remain responsible for ensuring the medication suits their health needs. Always discuss any concerns or potential interactions with a healthcare provider before starting or stopping any medication.