If you’ve tried diets and still struggle with cravings, you’ve probably heard of the combo naltrexone bupropion. It’s sold under the name Contrave in many countries and is the only prescription weight‑loss pill that mixes an opioid blocker (naltrexone) with an antidepressant (bupropion). The idea is simple: curb appetite while boosting mood, so you’re less likely to over‑eat.
Naltrexone blocks the brain’s reward signals that make you feel good after eating high‑calorie foods. Bupropion, on the other hand, lifts dopamine and norepinephrine levels, which helps control hunger and gives a mild energy boost. When combined, they target the hypothalamus and the reward center at the same time, leading to reduced cravings and lower calorie intake.
The medication is approved for adults with a body‑mass index (BMI) of 30 or higher, or a BMI of 27 plus who also have weight‑related conditions like high blood pressure, type 2 diabetes, or sleep apnea. It’s not a magic bullet—you still need to eat healthier and stay active. If you have a history of seizures, eating disorders, or are on certain antidepressants, talk to your doctor first.
Most people start at a low dose and work up to a full dose over four weeks. The usual schedule looks like this:
Take the pills with food to reduce stomach upset, and try to keep the timing consistent each day.
Most users report mild issues that go away after a couple of weeks. Common ones include nausea, headache, dry mouth, constipation, and trouble sleeping. A small number of people feel dizziness or a rapid heartbeat. Because bupropion can raise seizure risk, the drug isn’t recommended for anyone with a seizure disorder or who’s abruptly stopping alcohol or benzodiazepines.
If you notice severe mood changes, thoughts of self‑harm, or allergic reactions like rash or swelling, stop the medication and call your healthcare provider right away.
Think of naltrexone bupropion as a boost, not a replacement for lifestyle changes. Pair the medication with a balanced diet—focus on protein, fiber, and healthy fats—and aim for at least 150 minutes of moderate activity each week. Keep a food journal to spot hidden triggers and stay accountable.
Stay hydrated, get enough sleep, and manage stress; all of these affect hunger hormones. If you miss a dose, take it as soon as you remember unless it’s already close to the next scheduled dose—then just skip the missed one.
Regular follow‑ups with your doctor are key. They’ll check weight loss progress, blood pressure, and any side effects every four to six weeks. If you’re not losing at least 3 % of your body weight after 12 weeks on the full dose, your doctor might suggest stopping or trying a different approach.
Bottom line: naltrexone bupropion can be a helpful tool for the right patients, but it works best when you combine it with healthy eating, movement, and consistent medical supervision.
Clear 2025 guide to Contrave (Mysimba): how it works, who it’s for, dosing, side effects, safety checks, UK availability, costs, and how it compares to Wegovy and Orlistat.
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