Contrave: An Upcoming Diet Drug

Posted: Jul 15 in Weight Loss Medication by

weight loss medicationContrave, otherwise known as NB32, is finally getting the opportunity to help individuals lose weight in the United States. The diet drug was rejected by the U.S. Food and Drug Administration (FDA) when it was first introduced in 2011 due to lack of solid data about heart risk. However, it is getting a second chance, as it successfully went through a preliminary stage in June 2014, and is expected to gain final approval in September 2014.

Contrave is a combination of commonly prescribed drugs Wellbutrin (bupropion hydrochloride) and naltrexone.  Wellbutrin, a frequently used antidepressant has a side effect of decreased appetite.  When combined with the addiction medication naltrexone the appetite suppression quality of Wellbutrin is intensified.

Ethan Lazarus, M.D., medical director of the Clinical Nutrition Center in Denver, said that this combination was chosen because both Wellbutrin and naltrexone are used often for fighting addiction, curbing cravings, and has an off-label use of helping people to lose weight. In fact, many people who take Wellbutrin for depression end up losing weight as a result, even though that result was not originally intended. When these two drugs are combined, it makes for a very powerful and unique weight loss medicine.

Obesity rates in the United States have increased significantly in recent years, causing a greater need for effective obesity medicines. While these drugs are not meant to replace a healthy diet and exercise regimen, they help people curb their cravings, increase their metabolism and boost their energy levels while they make changes to the behaviors that led to their struggle with weight in the first place.

In 2012, two new obesity drugs were approved by the FDA, Belviq and Qsymia, which were the first new obesity drugs in 13 years. However, the acceptance of these two drugs has been slow, and the makers of Contrave hope they have more success.

Marketing the Benefits of Contrave

There are a few reasons why Contrave might just be the next best diet drug on the market. The first is, of course, learning from other previously marketed diet drugs, particularly the ones that had lackluster sales, like Belviq and Qsymia.

In addition, Contrave has a partnership with Takeda Pharmaceuticals to help with its marketing efforts. Takeda has extensive experience in promoting medications to the diabetic community who may well benefit from Contrave.  Because Contrave is not a controlled substance like Belviq and Qsymia, doctors will be allowed to provide samples to patients straight from their office.

Perhaps most important, Contrave was finally accepted by the FDA because of improved safety data, which revealed very few side effects. The primary side effects include mood alterations and risks for those with liver, kidney or cardiovascular disease, all which are not uncommon among diet drugs in the U.S.

In the end, Contrave provides enough weight loss to significantly improve many obesity related diseases and in combination with a medical weight loss program it is expected to help many people gain control of their weight.  Obesity medicine specialist believe it looks very promising for the future of obesity medicine.


8 Responses to “Contrave: An Upcoming Diet Drug”
  • Sabrina says:

    Can you get this without a prescription?

  • nancy says:

    you can ask your dr for a sample if they have them. i recently started on it and asked my dr for it..he had never prescribed it before so he researched it first. be prepared though, its very expensive and i doubt I covered by prescription insurance. discount drug cars can help, if you find the right one. i paid 148.00 with a prescription discount card that saved me about 23.00. That was for 70 tablets. Im on day 2 and I can see so far that it may help.

    • Dr. Lazarus says:

      Nancy – we do have some samples left, but the sample program was canceled and once we are done with the current batch, they won’t send any more. However, Orexigen recently started selling Contrave directly to some clinics – we are fortunate to be one of them. We sell to our patients, and our cost to patients is $109. No insurance, no coupons. That is for 120 tablets, not 70. With the coupon at the pharmacy, it should be no more than $100-$125. They overcharged you and didn’t apply the coupon correctly, in my opinion. Sometimes we will also use the two generics – Generic Wellbutrin XL 300 + Generic Naltrexone 50 mg, for patients where the $109 is too expensive.

  • Barbara Gaskins says:

    I take Paxil and Xanax. Is it safe to take contrave with this medication

    • Dr. Lazarus says:

      Generally speaking, yes, I think this would be okay. This question, however, is significantly more complex for two reasons. First, the bupropion in the Contrave can potentiate (make stronger) the Paxil. Second, of the SSRI class of medications, Paxil is notorious for causing more weight gain than any of the other SSRI. I would recommend setting up a visit with the prescribing physician and if medically appropriate, choosing an alternative to Paxil (paroxetine). Depending on why it is prescribed, more weight neutral options could include es-citalopram, or perhaps duloxetine. Unfortunately, weaning off and stopping paroxetine is also difficult. I have had better luck moving to duloxetine (SSRI / SNRI). Again, I cannot give individualized medical advice in a blog – please set up a consultation with a skilled obesity medicine physician, or the prescribing doctor, to consider alternatives.

  • Anna Lucia says:

    Does this boost metabolism? You said here it does help with that.

    • Dr. Lazarus says:

      Contrave probably does NOT help with metabolism – more in the craving / appetite center. It is possible that phentermine has a small effect on metabolism, but again, the main mechanism of action is thought to be in the appetite center as well. Thx for the comment 🙂

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