Can You Take Gabapentin and Contrave Together? Risks & Warnings

Contrave (a combination of bupropion and naltrexone) is a prescription weight-loss drug used to help compatible individuals with obesity or weight-related medical conditions. Gabapentin, on the other hand, is commonly prescribed to treat seizures and nerve pain. While both medications have their respective uses, there are possible Contrave and Gabapentin drug interactions when taken together.

Patients should also be aware that Contrave may cause severe allergic reactions. If any symptoms of a severe allergic reaction occur, they should stop taking Contrave and seek immediate medical help.

Patients considering taking Contrave alongside gabapentin should be aware of the risks, side effects, and necessary precautions to avoid severe health complications.

Key Takeaways

• Contrave and Gabapentin Drug Interactions: Combining these medications may increase the risk of seizures, dizziness, and other serious side effects.
• Potential Health Risks: Patients with high blood pressure, liver damage, or a history of eating disorders should consult a doctor before taking Contrave.
• Monitoring and Adjustments: Dose adjustment may be required, especially for patients with preexisting conditions or those taking other medications.

Understanding Contrave and Gabapentin

What is Contrave?

Contrave is a prescription weight loss medication designed to aid certain individuals struggling with obesity or weight-related medical conditions.

Contrave is prescribed for adults with an initial body mass index (BMI) of 30 or greater, or those with a BMI of 27 or more if they have additional weight-related health issues.

It contains two active ingredients, bupropion and naltrexone, which work synergistically to help control appetite and reduce food cravings.

How Bupropion Works

Bupropion is an atypical antidepressant used to treat depression and aid smoking cessation. It influences the levels of dopamine and norepinephrine in the brain, which can help improve mood, reduce cravings, and increase energy levels. As a stimulant-like antidepressant, bupropion may also enhance motivation and alertness, factors that can contribute to a more active lifestyle during a weight loss regimen.

However, bupropion has been associated with an increased risk of seizures, especially at high doses or in individuals with a history of seizure disorder, eating disorders, or excessive alcohol consumption. Because of this, it is crucial for patients taking Contrave to follow prescribed dosage instructions carefully.

How Naltrexone Works

Naltrexone is primarily used for opioid withdrawal and alcohol dependence treatment. It works by blocking opioid receptors in the brain, reducing the pleasurable effects of alcohol and opioids. In Contrave, naltrexone is believed to modify reward pathways associated with food consumption, helping individuals curb cravings for high-calorie foods.

Naltrexone also affects appetite regulation by interacting with the hypothalamus, the part of the brain responsible for hunger and satiety. Decreasing the brain’s reward response to food helps reinforce long-term eating behavior changes for compatible individuals.

How Contrave Supports Weight Loss Compared to Other Weight Loss Drugs

By combining bupropion and naltrexone, Contrave helps manage appetite, cravings, and emotional eating. However, its effectiveness depends on adherence to a reduced-calorie diet and physical activity. Clinical trial data has shown that patients taking Contrave lose more weight compared to those in the placebo group, though side effects such as nausea, dizziness, and insomnia are common.

Additionally, Contrave drug interactions are common, including medications for high blood pressure, heart disease, and seizures, necessitating caution for individuals with preexisting health conditions. Because of the presence of bupropion, individuals with bipolar disorder should also consult their doctor before starting Contrave to assess the risk of mood disturbances.

Contrave and Gabapentin Drug Interactions: Risks & Effects

Medication Overview

Category	Contrave	Gabapentin	Potential Interaction
Medication Type	Weight loss drug containing bupropion & naltrexone	Anticonvulsant used for seizures, nerve pain, and anxiety	Increased risk of neurological side effects
Primary Use	Aids weight loss by controlling appetite	Treats seizures, nerve pain, and anxiety	Can cause overlapping effects on the nervous system
Seizure Risk	Bupropion lowers seizure threshold	Helps prevent seizures but sudden withdrawal may trigger them	Higher seizure risk, especially in those with neurological disorders
CNS Effects	May cause restlessness, insomnia, or agitation	Can cause drowsiness and dizziness	May result in confusion, cognitive impairment, and slowed reflexes
Liver & Kidney Impact	Metabolized in the liver, affects enzyme activity	Excreted through the kidneys, caution in renal impairment	Possible drug accumulation, increasing toxicity risk
Mood & Mental Health Risks	May contribute to mood swings, suicidal thoughts	Linked to depression, suicidal ideation	Combined use may worsen mental health symptoms
Dizziness & Motor Impairment	Increases alertness but can cause anxiety	May cause dizziness, slowed reflexes	Risk of falls, impaired motor coordination
Drug Absorption & Metabolism	Affected by high-fat meals and liver enzymes	Absorption reduced by antacids	Timing of doses and food intake may affect drug effectiveness
Alcohol & Sedative Interactions	Should not be taken with alcohol or sedatives	Increases sedative effects when combined with alcohol	High risk of excessive sedation and respiratory depression
Who Should Avoid?	Those with seizure disorders, eating disorders, or uncontrolled hypertension	Patients with kidney disease, history of substance misuse	Individuals with existing neurological or metabolic conditions should consult a doctor

What is Gabapentin?

Gabapentin is an anticonvulsant medication primarily prescribed to treat seizures and nerve pain. It is also used for treating insomnia, bipolar disorder, and anxiety, as it has sedative effects that can help calm an overactive nervous system. Although it is not classified as a controlled substance, it has the potential for misuse due to its calming and pain-relieving properties.

How Gabapentin Works

Gabapentin affects the brain by altering calcium channel activity in nerve cells, helping to stabilize electrical signals and prevent seizures. While it does not interact with the brain’s major neurotransmitters in the same way as traditional psychiatric medications, it has been found to reduce nerve excitability, making it useful for treating conditions like neuropathic pain and anxiety.

Gabapentin also enhances the release of gamma-aminobutyric acid (GABA), a neurotransmitter that promotes relaxation and reduces nerve pain. Because of this, it is sometimes prescribed off-label to treat insomnia and anxiety disorders.

Common Uses of Gabapentin

• Seizure control: Often used in combination with other medications to prevent seizures in patients with epilepsy or other seizure disorders.
• Neuropathic pain relief: Frequently prescribed for nerve pain caused by diabetes, shingles, or spinal cord injuries.
• Bipolar disorder and mood stabilization: While not a first-line treatment, some doctors prescribe gabapentin off-label to help treat depression and bipolar disorder, particularly when mood instability is a concern.
• Anxiety and sleep disorders: Gabapentin’s sedative effects make it beneficial for individuals experiencing insomnia, stress, or anxiety.

Risks and Side Effects

Although gabapentin is widely used and generally considered safe, it can affect brain function and lead to side effects such as:

• Dizziness and drowsiness
• Nausea and vomiting
• Skin rash
• Memory problems and difficulty concentrating
• Suicidal thoughts (a rare but serious risk that requires monitoring). If you experience any concerning symptoms, contact the Suicide and Crisis Lifeline.

Because gabapentin can increase the risk of central nervous system depression, it should be used cautiously alongside other drugs that cause sedation, such as opioids, benzodiazepines, or alcohol. Patients should also be aware of possible interactions with over-the-counter medications and discuss all other medications they are taking with their healthcare provider.

Gabapentin is not recommended for individuals with liver damage or significant liver problems, as it is metabolized in the kidneys and requires careful dose adjustment in those with kidney disease. Additionally, abrupt discontinuation of gabapentin can increase the risk of withdrawal symptoms, including anxiety, insomnia, and, in severe cases, seizures.

Possible Interactions Between Contrave and Gabapentin

When taken together, Contrave and gabapentin can result in several possible interactions that may increase health risks. Since both medications affect brain activity, the central nervous system (CNS), mood, and organ function, their combination requires careful monitoring.

While Contrave is primarily prescribed for weight loss, its active ingredient bupropion is known to increase the risk of seizures and alter mood. Similarly, gabapentin, used to treat seizures and nerve pain, impacts nerve signaling and can contribute to drowsiness, cognitive impairment, and dizziness.

Because of these overlapping effects, patients should be aware of how Contrave interacts with gabapentin and the potential for serious side effects, including seizures, mood disturbances, and liver damage. Clinical trials have been conducted to evaluate the safety and efficacy of Contrave and Gabapentin, highlighting the importance of controlled studies in understanding their interactions.

Below is a breakdown of the most significant concerns when combining these two medications.

Increased Risk of Seizures in Patients with Seizure Disorder

One of the most serious risks of Contrave and gabapentin drug interactions is an increased risk of seizures.

• Bupropion, an ingredient in Contrave, is known to lower the seizure threshold, meaning that it makes the brain more prone to experiencing seizure activity.
• Gabapentin is an anticonvulsant, often used to treat seizures, but it also alters nerve activity and neurotransmitter function. In some cases, gabapentin withdrawal or abrupt dose changes can trigger seizures in individuals without a prior seizure disorder.
• When taking Contrave and gabapentin together, there may be a higher risk of seizures, especially in patients with preexisting neurological conditions, bipolar disorder, eating disorders, or those who suddenly stop drinking alcohol.
• Increased risk is also noted in patients who take other medications that affect the brain’s electrical activity, such as nicotine replacement therapies, opioid withdrawal treatments, or mood stabilizers.

To minimize this risk, patients should consult their healthcare provider about potential dose adjustments, particularly if they have a history of seizure disorder or liver damage or are using over-the-counter supplements that may further affect neurological stability.

Central Nervous System (CNS) Effects

Both Contrave and gabapentin influence the central nervous system, and taking them together may increase the risk of severe side effects such as:

• Dizziness
• Drowsiness
• Cognitive impairment (difficulty concentrating, confusion, and memory issues)
• Slower reflexes and motor impairment

Because of these effects, patients taking Contrave and gabapentin should avoid driving or operating heavy machinery, as the combination can affect coordination and mental alertness. Contrave and Oxycodone drug interactions can also occur. Basically, any drug that affects the central nervous system may interact with Contrave, and this should be discussed with your healthcare provider.

Additionally, these medications may intensify the effects of alcohol, leading to more significant sedation, increased dizziness, and a higher risk of falls or accidents. Patients should not drink alcohol while taking these medications to avoid compounding their CNS effects.

Liver and Kidney Health Risks

Patients with liver problems or kidney disease should use caution when taking Contrave and gabapentin together.

• Contrave interacts with liver enzymes, which play a key role in metabolizing bupropion and naltrexone.
• Gabapentin is primarily excreted through the kidneys, meaning patients with kidney impairment may experience a toxic buildup of the drug in their system.
• Liver damage or liver problems can slow drug metabolism, leading to higher concentrations of both Contrave and gabapentin in the bloodstream. This can increase the risk of serious side effects, such as nausea, dizziness, skin rash, and confusion.
• Patients should undergo regular lab tests to assess liver function, and doctors may recommend a dose adjustment to prevent dangerous drug accumulation.

Those with a history of high-fat meals should also be cautious, as consuming excessive fat while taking Contrave may increase the risk of adverse effects by altering drug absorption rates.

Mood and Mental Health Effects

Patients with depression, bipolar disorder, or anxiety should be aware that Contrave and gabapentin may contribute to mood changes, including:

• Suicidal thoughts (especially in young adults)
• Increased risk of depression
• Mood swings and irritability
• Anxiety or panic attacks

Since bupropion is an antidepressant, it affects dopamine and norepinephrine levels, which can increase the risk of agitation or emotional instability. Similarly, gabapentin has been linked to depression and suicidal thoughts, particularly in patients with underlying mental health conditions.

Young adults taking these medications should be closely monitored for changes in mood or behavior, and patients with a history of bipolar disorder should consult a doctor before starting Contrave to evaluate the risk of mood destabilization.

Additionally, those taking methylene blue (used for certain medical conditions) may experience possible interactions affecting serotonin levels, potentially leading to serious side effects such as confusion, rapid heart rate, and excessive sweating.

Interaction with Selective Serotonin Reuptake Inhibitors (SSRIs)

Contrave may interact with selective serotonin reuptake inhibitors (SSRIs), a class of antidepressants commonly prescribed to treat depression and anxiety. Examples of SSRIs include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and fluvoxamine (Luvox).

When taken together, Contrave and SSRIs can increase the risk of serotonin syndrome, a potentially life-threatening condition caused by excessive levels of serotonin in the body.

Symptoms of serotonin syndrome include agitation, confusion, rapid heart rate, changes in blood pressure, dilated pupils, loss of muscle coordination or twitching muscles, muscle rigidity, heavy sweating, diarrhea, headache, shivering or shaking, and goosebumps.

If you are taking Contrave and an SSRI, your doctor may need to monitor you closely for signs of serotonin syndrome to ensure your safety.

Interaction with Certain Beta-Blockers

Contrave may interact with certain beta-blockers, which are medications used to treat high blood pressure and other heart conditions. Examples of beta-blockers that may interact with Contrave include propranolol (Inderal), metoprolol (Lopressor), atenolol (Tenormin), and nadolol (Corgard). Combining Contrave with these beta-blockers can raise the risk of side effects such as low blood pressure, slow heart rate, fatigue, dizziness, and lightheadedness.

If you are taking Contrave and a beta-blocker, your doctor may need to monitor you closely for signs of these side effects. Regular check-ups and communication with your healthcare provider are essential for effectively managing your blood pressure and overall health.

Interaction with Supplements

Contrave may interact with certain supplements, including St. John’s Wort, ginseng, guarana, and yerba mate. These supplements can increase the risk of side effects from Contrave, such as increased heart rate, high blood pressure, anxiety, and insomnia.

If you are taking Contrave and any supplements, it is crucial to inform your doctor or pharmacist. They can help you understand the potential interactions and adjust your treatment plan accordingly to ensure your safety and well-being.

Interaction with Food

Contrave may interact with certain foods, particularly high-fat foods and grapefruit or grapefruit juice. Consuming high-fat foods while taking Contrave can increase the level of the drug in your body, raising the risk of side effects. Similarly, grapefruit and grapefruit juice can also elevate the levels of Contrave in your system, leading to an increased likelihood of adverse effects.

To minimize these risks, it is advisable to follow your healthcare provider’s dietary recommendations and avoid high-fat meals and grapefruit products while taking Contrave.

Interaction with Vaccines

Currently, there are no reports of Contrave interacting with vaccines. However, it is always a good practice to inform your doctor or pharmacist about all the medications and supplements you are taking before receiving a vaccine.

This ensures that your healthcare provider can make informed decisions about your treatment and vaccination plan, minimizing the risk of any potential interactions.

Interaction with Lab Tests

Bupropion, one of the active ingredients in Contrave, may cause a false-positive result for amphetamines on a urine drug test. A false-positive means the test shows a positive result for a drug that is not actually present. Before having a urine drug test for amphetamines, be sure to tell your doctor that you are taking Contrave.

This information can help prevent misinterpretation of your test results and ensure accurate diagnosis and treatment.

Risks and Warnings

Who Should Avoid This Combination?

Patients with the following health conditions may be at higher risk when taking both medications:

• Seizure disorder
• Eating disorders (as bupropion increases seizure risk)
• Severely high blood pressure
• Liver damage or liver problems
• Bipolar disorder
• Heart disease or a history of heart attack

Interactions with Other Medications

Patients taking Contrave should inform their healthcare provider about all other medications, including over-the-counter drugs and supplements.

Some possible interactions include:

• Monoamine oxidase inhibitors (MAOIs): Combining these with bupropion can lead to dangerously high blood pressure.
• Methylene blue: May interact with Contrave, leading to serotonin syndrome.
• Nicotine replacement therapies: May increase the risk of seizures.
• Other drugs that affect liver function, increasing toxicity risks.

Common Side Effects

Side Effects of Contrave

Contrave side effects may include:

• Nausea
• Dizziness
• Insomnia
• High blood pressure
• Increased risk of seizures
• Suicidal thoughts

Side Effects of Gabapentin

Patients taking gabapentin may experience:

• Drowsiness
• Skin rash
• Dizziness
• Other side effects affecting coordination
• Increased risk of suicidal ideation

Stopping the Medication

Patients should not stop taking either Contrave or gabapentin suddenly. Doing so may lead to withdrawal symptoms, including seizures, nausea, and suicidal thoughts.

A healthcare provider should oversee the treatment transition to prevent adverse effects.

Frequently Asked Questions (FAQ)

When taking Contrave, bupropion, gabapentin, and naltrexone, it is important to understand their potential drug interactions, side effects, and how they can impact treatment.

Below are comprehensive answers to commonly asked questions regarding these medications and their safety.

1. Can I take bupropion and gabapentin together?

Bupropion and gabapentin can be taken together, but this combination requires caution due to the potential increased risk of seizures. Bupropion, an active ingredient in Contrave, is known to lower the seizure threshold, making individuals more susceptible to seizure activity, particularly those with a history of eating disorders, bipolar disorder, or excessive alcohol consumption.

Gabapentin, while used to treat seizures, can also affect nerve signaling and brain activity in a way that may increase the risk of neurological side effects when combined with bupropion. These effects include dizziness, confusion, drowsiness, and cognitive impairment, which can interfere with daily activities.

Anyone considering using these medications together should consult their doctor for proper dose adjustment and risk assessment.

2. What medications should not be taken with Contrave?

Several medications should not be taken with Contrave, as they can lead to severe interactions or reduce their effectiveness. Monoamine oxidase inhibitors (MAOIs), such as phenelzine and isocarboxazid, should be avoided, as they can cause dangerously high blood pressure when combined with bupropion. Opioid-containing medications should also not be used, as naltrexone in Contrave blocks opioid effects and can trigger sudden opioid withdrawal symptoms.

Certain antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), may interact with Contrave and increase the risk of serotonin syndrome and suicidal thoughts, especially in young adults.

Additionally, blood pressure medications and other drugs that affect the central nervous system, such as seizure medications, require careful consideration to avoid increased risk of side effects. For example, Contrave and Losartan drug interactions can seriously impact blood pressure.

To prevent potential complications, patients should inform their healthcare provider about all other medications they are taking, including over-the-counter drugs. They should also consult their healthcare provider about other weight loss drugs that may be suitable alternatives to Contrave.

3. Can naltrexone and gabapentin be used together?

Naltrexone and gabapentin can be used together, but patients should be closely monitored for potential side effects. Naltrexone, an opioid antagonist, does not have a direct interaction with gabapentin, but their combined use may increase the risk of dizziness, drowsiness, and cognitive impairment.

Individuals with a history of liver damage should use caution, as both medications can affect liver metabolism, potentially leading to toxicity or reduced drug clearance.

Additionally, naltrexone’s effect on the brain’s reward system may impact the mood-stabilizing properties of gabapentin, which is sometimes used off-label for anxiety and bipolar disorder. Patients taking both medications should follow their prescribed dosages carefully and report any unusual symptoms to their healthcare provider.

4. What cannot be mixed with gabapentin?

Gabapentin should not be combined with alcohol, opioids, sedatives, benzodiazepines, or certain over-the-counter medications, as these combinations can lead to dangerous central nervous system depression. Alcohol intensifies the sedative effects of gabapentin, increasing the likelihood of drowsiness, dizziness, and cognitive impairment, which may impair coordination and reaction time.

Opioids such as oxycodone and hydrocodone should also be avoided, as their interaction with gabapentin can result in respiratory depression and potentially fatal overdose. Sedatives and benzodiazepines, including lorazepam and diazepam, may amplify gabapentin’s effects, making users excessively drowsy or confused.

Over-the-counter antihistamines like diphenhydramine can further contribute to sedation, leading to an increased risk of falls and accidents. Patients should also be aware that taking antacids within two hours of gabapentin can reduce its effectiveness by interfering with absorption.

5. Does naltrexone interact with gabapentin?

Naltrexone does not have a direct pharmacological interaction with gabapentin, but both medications can cause similar side effects, such as dizziness, drowsiness, and nausea. Individuals taking both drugs should be cautious when performing tasks that require alertness, as cognitive impairment may occur.

In rare cases, naltrexone has been associated with mood changes, including depression and suicidal thoughts, which may be exacerbated by gabapentin in certain individuals. This is particularly relevant for patients with a history of bipolar disorder, anxiety, or severe depression.

Those taking both medications should notify their doctor if they experience worsening mood symptoms, unusual fatigue, or excessive sedation.

If you have any further questions regarding Contrave, gabapentin, naltrexone, or bupropion, consult your healthcare provider for personalized guidance.

Final Thoughts

Patients considering taking Contrave alongside gabapentin should consult their healthcare provider to assess the risks and possible interactions. Given the increased risk of seizures, dizziness, and liver damage, close monitoring is essential.

Always follow the medication guide, undergo necessary lab tests, and stay informed about potential side effects.