Contrave and Vyvanse Together: Drug Interactions Explained

When combining Contrave and Vyvanse together: drug interactions can occur. This is a concern, particularly because of their impact on blood pressure, serotonin syndrome, and other health risks.

Understanding how both medications influence the central nervous system is crucial for safety. This article explores the risks of taking Contrave and Vyvanse together.

Key Takeaways

• Taking Vyvanse with Contrave can increase the risk of high blood pressure, serotonin syndrome, and other complications.
• Both drugs affect mental health conditions and may interact with certain medications like selective serotonin reuptake inhibitors and tricyclic antidepressants.
• Always tell your doctor about any other medications, nutritional supplements, or over-the-counter drugs before combining these prescriptions.

What is Contrave?

Contrave is a weight loss drug that combines bupropion hydrochloride and naltrexone, two active ingredients that work together to support weight management.

It is primarily prescribed for compatible individuals with obesity or those who are overweight with additional health conditions such as high blood pressure, type 2 diabetes, or high cholesterol.

Contrave is intended to be used alongside a low-calorie diet and regular exercise to promote sustainable weight loss.

How Contrave Works

Contrave’s dual-action formula influences the central nervous system, specifically targeting areas of the brain that regulate cravings, appetite, and reward responses to food.

• Bupropion hydrochloride is an antidepressant that affects dopamine and norepinephrine levels. Originally developed to treat depression, it is also used in smoking cessation treatments due to its ability to reduce cravings. In Contrave, it helps control food-related urges and emotional eating.
• Naltrexone is an opioid antagonist that blocks opioid receptors in the brain. It is typically used in addiction treatment to reduce the effects of opioids and alcohol. In Contrave, naltrexone reduces the brain’s reward response to food, making overeating less satisfying.

Potential Risks and Warnings

Contrave carries a boxed warning that alerts doctors about serious mental health effects due to bupropion hydrochloride. This medication has been linked to an increased risk of suicidal thoughts in young adults, similar to other antidepressants.

Individuals with bipolar disorder may experience worsening mood symptoms, including mania or depression when taking Contrave. The drug may also interact with certain drugs used to treat mental health conditions, such as:

• Selective serotonin reuptake inhibitors (SSRIs)
• Tricyclic antidepressants
• Other medications for mood stabilization or psychiatric disorders

Additionally, Contrave should be used with caution in individuals with high blood pressure, as bupropion hydrochloride may lead to elevated blood pressure and increased heart rate. See our comprehensive guide on Contrave drug interactions.

Before starting this medication, patients should discuss their health history with a healthcare provider, especially if they have a history of heart disease, seizure disorder, or other medical conditions.

Since Contrave contains naltrexone, individuals taking opioid pain medications should avoid this drug, as it can block the effects of opioids and potentially cause withdrawal symptoms. Additionally, it can interact with other weight loss drugs. Check out our article on the drug interactions that may occur when taking Contrave and Mounjaro together.

Alcohol and Contrave

Patients taking Contrave should avoid drinking alcohol, as it may increase the risk of adverse effects, including dizziness, nausea, and mood instability. Individuals who drink alcohol regularly should consult their doctor or pharmacist before starting the medication.

By understanding how Contrave works and its potential drug interactions, patients can make informed decisions about their weight loss treatment and overall health conditions.

What is Vyvanse?

Vyvanse (lisdexamfetamine) is a prescription drug classified as a central nervous system (CNS) stimulant. It is primarily prescribed to treat ADHD (attention deficit hyperactivity disorder) in children ages 6 and older as well as adults.

Additionally, Vyvanse is FDA-approved for treating binge eating disorder (BED) in adults, helping reduce the number of binge episodes per week.

Vyvanse belongs to the amphetamine class of drugs, similar to Adderall XR, and contains dextroamphetamine sulfate, which influences dopamine and norepinephrine levels in the brain. These neurotransmitters play a key role in focus, impulse control, and motivation.

How Vyvanse Works

Vyvanse is a prodrug, meaning it remains inactive until it is metabolized in the body. Once taken, the body converts lisdexamfetamine into dextroamphetamine sulfate, which:

• Stimulates dopamine and norepinephrine activity in the brain, improving focus and attention in people with ADHD.
• Reduces compulsive binge eating behaviors in individuals with binge eating disorder by regulating impulsivity and appetite control.

Because Vyvanse requires metabolic activation, it has a smoother onset and longer duration compared to other stimulants like Adderall XR, leading to fewer spikes and crashes.

Common Side Effects of Vyvanse

Vyvanse can cause several side effects, particularly when taken in higher doses or without medical supervision.

Some of the most common include:

• Increased heart rate and elevated blood pressure, which can pose risks for individuals with heart disease or hypertension.
• Trouble sleeping (insomnia) due to its stimulant properties.
• Appetite suppression, which can lead to weight loss over time.
• Mood changes, including irritability, anxiety, or restlessness.

Because Vyvanse affects the central nervous system, patients taking the medication should regularly check their blood pressure and heart rate, especially if they have a history of certain medical conditions like bipolar disorder or seizure disorder.

Potential Drug Interactions with Vyvanse

Vyvanse may interact with certain drugs, including:

• Other medications for ADHD, such as Adderall XR, leading to excessive stimulation.
• Monoamine oxidase inhibitors (MAOIs), which can cause a hypertensive crisis if taken within 14 days of Vyvanse.
• Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants, which may increase the risk of serotonin syndrome.
• Over-the-counter decongestants and nutritional supplements that affect blood pressure or heart rate.

Vyvanse can also interact with certain medications used to treat depression, bipolar disorder, and seizure disorder, making it essential to discuss all prescription drugs and over-the-counter treatments with a healthcare provider before starting Vyvanse treatment.

Precautions and Warnings

Because Vyvanse is a stimulant, it has the potential for abuse, dependence, and addiction, especially in individuals with a history of substance use disorders.

Patients should take low doses as prescribed and avoid exceeding their recommended daily amount.

Additionally, Vyvanse should not be used by individuals with:

• Uncontrolled high blood pressure, due to the risk of increased blood pressure and elevated heart rate.
• A history of heart disease, as stimulants can lead to adverse effects on cardiovascular health.
• A history of psychosis or bipolar disorder, since Vyvanse may worsen symptoms of mania or hallucinations.

Alcohol and Vyvanse

Patients should avoid drinking alcohol while taking Vyvanse, as it may increase the risk of side effects such as dizziness, nausea, and impaired judgment. Alcohol can also interfere with Vyvanse’s metabolism, potentially leading to unpredictable drug effects.

Drug Interactions Between Contrave and Vyvanse

Taking Contrave and Vyvanse together can lead to potential drug interactions, particularly in how they affect blood pressure, serotonin syndrome, and stimulant-related side effects.

Because both drugs act on the central nervous system, they may amplify each other’s effects, increasing the likelihood of adverse effects and requiring close monitoring by a healthcare provider.

1. Increased Blood Pressure and Heart Risks

Both Contrave and Vyvanse can cause elevated blood pressure and an increased heart rate, making their combination risky, especially for individuals with heart disease, high blood pressure, or certain medical conditions affecting cardiovascular health.

• Vyvanse (lisdexamfetamine) is a stimulant that increases dopamine and norepinephrine, both of which can lead to higher blood pressure and increased heart rate.
• Contrave (bupropion and naltrexone) contains bupropion hydrochloride, which has stimulant-like properties and can also contribute to elevated blood pressure.

Combining these medications can lead to additive effects, significantly increasing the risk of hypertensive crisis—a dangerous and potentially life-threatening spike in blood pressure.

“When prescribing Vyvanse, especially alongside Contrave, we must consider its stimulant effects on the cardiovascular system. Individuals with a history of high blood pressure or heart concerns should be monitored closely.”
— Matthew Olesiak, MD, Chief Medical Director of SANE MD

Patients taking these drugs together should regularly monitor their blood pressure and heart rate, especially if they have a history of hypertension, arrhythmias, or other medical conditions affecting the heart.

2. Risk of Serotonin Syndrome

Serotonin syndrome is a serious and potentially life-threatening condition caused by excessive serotonin activity in the brain.

This syndrome can develop when multiple serotonergic drugs are taken together, increasing serotonin levels beyond safe limits.

• Contrave contains bupropion hydrochloride, which affects serotonin levels, particularly when combined with other serotonergic drugs, such as selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants.
• Vyvanse, though primarily affecting dopamine and norepinephrine, can also indirectly contribute to serotonin imbalance when combined with other prescription drugs that increase serotonin activity.

Taking these medications with monoamine oxidase inhibitors (MAOIs) or certain drugs that affect serotonin levels can increase the risk of serotonin syndrome, which may present with the following symptoms:

• Confusion or disorientation
• Rapid heartbeat (increased heart rate)
• Tremors or muscle rigidity
• High fever
• Seizures

If symptoms of serotonin syndrome occur, seek medical attention immediately by calling your local emergency number.

3. Potential for Mental Health Effects

Both Contrave and Vyvanse influence brain chemistry and may cause mood changes, particularly in individuals with bipolar disorder or other mental health conditions.

• Bupropion hydrochloride in Contrave is an antidepressant that may trigger mania, agitation, or mood instability in individuals with bipolar disorder.
• Vyvanse is a stimulant that may cause irritability, anxiety, or restlessness, especially when combined with other prescription drugs affecting mood.

People with a history of depression, anxiety, or bipolar disorder should use caution when taking these medications together, as they may exacerbate symptoms of mental health conditions.

“Because these medications act on neurotransmitters, it’s important to assess a patient’s health history before prescribing Vyvanse or Contrave together. Unexpected drug interactions can impact mood stability.”
— Matthew Olesiak, MD

4. Other Drug Interactions to Consider

Contrave and Vyvanse may interact with several certain drugs, including:

• Other medications for bipolar disorder, depression, or ADHD. Combining both ADHD medications (e.g., Vyvanse and Adderall XR) may lead to excessive stimulation and increased side effects. For example, Contrave and Lexapro drug interactions can be particularly troublesome.
• Over-the-counter pain relievers or cold medicines that affect blood pressure, particularly those containing pseudoephedrine.
• Nutritional supplements that influence neurotransmitter levels, such as St. John’s Wort or 5-HTP, which may increase the risk of serotonin syndrome.
• Other interactions with opioid medications, since Contrave contains naltrexone, which blocks opioid effects and may cause opioid withdrawal symptoms in those taking pain medications.

Before combining Contrave and Vyvanse, always tell your doctor about any certain medications, nutritional supplements, or over-the-counter drugs you are taking.

5. Alcohol and Drug Effects

Both Contrave and Vyvanse caution against drinking alcohol, as it may increase the risk of side effects such as:

• Dizziness and impaired judgment
• Increased heart rate
• Mood instability and agitation
• Higher blood pressure

Since bupropion hydrochloride in Contrave lowers the seizure threshold, combining it with alcohol can further increase the risk of seizures. See our complete guide to Contrave and alcohol drug interactions.

Similarly, Vyvanse treatment combined with alcohol may lead to unpredictable drug effects, including intensified stimulant effects or reduced alcohol tolerance.

It is best to avoid drinking alcohol while taking these medications. If alcohol consumption is unavoidable, consult a doctor or pharmacist to assess potential risks.

When to Seek Medical Attention

If you experience severe pain, a skin rash, or signs of serotonin syndrome, seek medical attention immediately. In case of an emergency, contact your local emergency number for urgent care.

Frequently Asked Questions (FAQ)

When considering Contrave and Vyvanse together, it’s important to understand how they interact and what risks they may pose.

Below are answers to common questions regarding their use, interactions, and safety considerations.

1. Can you take Contrave and Vyvanse?

Taking Contrave and Vyvanse together is not generally recommended without close medical supervision due to the risk of drug interactions affecting blood pressure, heart rate, and serotonin levels. Since both drugs act on the central nervous system, their combined stimulant effects can lead to elevated blood pressure, an increased heart rate, and a heightened risk of hypertensive crisis.

Additionally, bupropion hydrochloride in Contrave affects serotonin levels, which, when combined with Vyvanse, may contribute to serotonin syndrome, a potentially life-threatening condition.

If a healthcare provider determines that taking them together is necessary, regular monitoring of heart health, mental health symptoms, and side effects is essential to minimize risks.

2. Can you take bupropion and Vyvanse together?

Taking bupropion hydrochloride (the active ingredient in Contrave and Wellbutrin) with Vyvanse requires caution, as both medications influence brain chemistry and can have overlapping effects on dopamine and norepinephrine. This combination may increase the risk of anxiety, restlessness, insomnia, and elevated blood pressure, particularly in individuals sensitive to stimulants.

Another concern is the lowered seizure threshold associated with bupropion, which can be exacerbated by Vyvanse’s stimulant properties, leading to an increased risk of seizures. In some cases, doctors may prescribe both Vyvanse AND Contrave for conditions like depression and ADHD, but close monitoring is necessary to ensure safety.

Always consult a healthcare provider before combining these medications.

3. What medications should not be taken with Contrave?

Several prescription drugs and over-the-counter medications can interact with Contrave, potentially leading to serious health risks. Monoamine oxidase inhibitors (MAOIs), commonly used to treat depression, should be avoided due to the risk of a hypertensive crisis.

Opioid medications should also not be used, as naltrexone in Contrave blocks opioid effects and can trigger withdrawal symptoms in individuals dependent on opioids. Other medications that may require caution include selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants, which can increase the risk of serotonin syndrome.

Additionally, medications that affect blood pressure, such as certain stimulants and decongestants, should be discussed with a doctor or pharmacist before use.

4. What medications should you avoid while taking Vyvanse?

Vyvanse interacts with certain medications, potentially leading to increased side effects and health risks. Monoamine oxidase inhibitors (MAOIs) should not be taken within 14 days of Vyvanse, as they can cause a dangerous spike in blood pressure and lead to a hypertensive crisis. Other stimulants, such as Adderall XR or other ADHD medications, may amplify Vyvanse’s effects, increasing the risk of insomnia, heart palpitations, and anxiety.

Medications that influence serotonin levels, including SSRIs, tricyclic antidepressants, and serotonergic drugs, can increase the likelihood of serotonin syndrome when combined with Vyvanse. Over-the-counter medications, particularly those containing pseudoephedrine or other stimulants, should also be used cautiously, as they may further elevate blood pressure and heart rate.

Always inform a healthcare provider about any prescription drugs, nutritional supplements, or certain medications you are taking before starting Vyvanse.

5. Is Contrave or Vyvanse better?

Contrave and Vyvanse are prescribed for different conditions, so determining which is “better” depends on individual treatment goals. Contrave is primarily used as a weight loss drug, helping certain individuals manage obesity and binge eating disorder by reducing cravings and food-related rewards in the brain. Vyvanse, on the other hand, is a central nervous system stimulant designed to treat ADHD and binge eating disorder by improving focus, impulse control, and appetite regulation.

While both may assist with weight loss, they work through different mechanisms and carry distinct side effects. If weight loss is the primary goal, Contrave may be the better option, but if treating both ADHD and binge eating disorder is the priority, Vyvanse could be more suitable.

A healthcare provider can help determine the most appropriate medication based on individual health history, medical conditions, and treatment needs.

Final Thoughts

Taking Vyvanse treatment alongside Contrave should only be done under the supervision of a healthcare provider. Since both affect the central nervous system, they may pose an increased risk of side effects and drug interactions.

To ensure safety, always tell your doctor about any prescription drugs, medications, and other drugs you are taking.