Contrave and Birth Control Drug Interactions: Safe or Not?

Contrave is a prescription medication used for chronic weight management, combining naltrexone and bupropion to aid in weight loss. However, Contrave and birth control drug interactions are possible and may reduce the effectiveness of the pill, impacting birth control pill effectiveness.

Understanding how Contrave drug interactions occur and the specific drugs involved – especially hormonal birth control drugs – is crucial to ensuring safety and efficacy.

Key Takeaways

• Contrave and birth control drug interactions are not well-documented, but hormonal changes may alter drug efficacy and metabolism.
• Taking Contrave with certain medications may increase the risk of high blood pressure, seizure disorder, or suicidal thoughts in some patients.
• Always talk with your doctor before starting Contrave treatment to avoid severe allergic reactions and other complications.

Understanding Contrave and Its Mechanism of Action

Contrave is an extended-release tablet that combines naltrexone hydrochloride and bupropion hydrochloride. It is prescribed for a subset of individuals with a high initial body mass index who need additional support beyond a reduced-calorie diet and exercise.

Naltrexone bupropion affects brain pathways involved in appetite regulation and physical or psychological dependence, helping compatible individuals achieve clinically meaningful weight loss.

What is Contrave used for?

Contrave is a prescription medication specifically designed for weight loss and management in overweight or obese individuals. It combines two active ingredients, naltrexone and bupropion, which work synergistically in the brain to help control appetite.

When used alongside a reduced-calorie diet and increased physical activity, Contrave can significantly aid in weight loss and help maintain it over time.

How does Contrave work (mechanism of action)?

Contrave’s exact mechanism of action is not fully understood, but it is believed to target specific areas of the brain, such as the hypothalamus and dopamine pathways. The hypothalamus plays a crucial role in regulating appetite by sending signals that influence hunger and satiety. Dopamine, a neurotransmitter associated with pleasure and reward, is also involved.

Contrave may work by increasing dopamine levels and acting on the hypothalamus to reduce appetite, thereby helping individuals manage their weight more effectively.

Effectiveness of Contrave

Effectiveness for weight loss and weight management

Contrave has demonstrated significant effectiveness for weight loss and weight management in clinical trials involving individuals who are overweight or obese. Participants who took Contrave, in combination with a reduced-calorie diet and increased physical activity, experienced more substantial weight loss compared to those who received a placebo.

This combination approach not only helps in shedding pounds but also in maintaining weight loss over the long term, making Contrave a valuable tool in a comprehensive weight management plan.

How long does it take to work?

In clinical studies, most individuals who took Contrave began to notice weight loss within the first few weeks of treatment. The extent of weight loss varied among participants, but on average, those on Contrave lost approximately 5-10% of their initial body weight over the course of a year.

It’s important to understand that Contrave is not a quick fix; it is intended to be part of a long-term weight loss strategy that includes a healthy diet and regular exercise. This holistic approach ensures sustainable weight management and overall health improvement.

Contrave and Birth Control Drug Interactions

There is limited evidence suggesting that taking Contrave directly affects the efficacy of birth control.

However, hormonal contraceptives undergo metabolism in the liver, and Contrave interactions could theoretically alter hormone levels, leading to reduced contraceptive effectiveness. It is important to manage missed doses and consider the potential need for backup methods to maintain contraceptive reliability.

Bupropion hydrochloride, one of the active ingredients, is known to induce certain liver enzymes, potentially affecting the breakdown of estrogen and progestogen. This means that oral contraceptives might not work as effectively in some individuals.

Similarly, changes in metabolism may lead to an increased risk of breakthrough bleeding or contraceptive failure. Reduced contraceptive effectiveness can increase the risk of unplanned pregnancy, so it is crucial to consult healthcare providers to mitigate these risks.

Talk with your doctor if you are using hormonal birth control while taking Contrave to determine the best course of action.

Other Contrave Drug Interactions

Beyond birth control, Contrave interacts with several other drugs that can impact its safety and effectiveness. Since Contrave tablets contain both naltrexone hydrochloride and bupropion hydrochloride, their interaction profiles can be complex.

Patients should be aware of these potential risks when taking Contrave alongside other medications.

Antidepressant Drugs

One of the active ingredients in Contrave tablets, bupropion hydrochloride, is commonly used to treat depression and is found in antidepressant drugs like Wellbutrin SR. However, combining Contrave treatment with other antidepressant drugs—such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs)—may increase the risk of side effects, including suicidal thoughts and behaviors.

Additionally, excessive levels of serotonin in the brain may lead to serotonin syndrome, a potentially life-threatening condition characterized by confusion, agitation, rapid heartbeat, and severe sweating. Patients with major depressive disorder should talk with their doctor before starting Contrave to ensure their current medications do not pose a risk.

Opioid Medications

Since Contrave treatment contains naltrexone hydrochloride, which is commonly used in opioid withdrawal therapy, it blocks opioid receptors. This makes taking Contrave unsafe for individuals who are physically dependent on opioids. If an opioid-dependent patient takes Contrave, they may experience opioid withdrawal symptoms such as nausea, vomiting, diarrhea, muscle pain, and increased anxiety.

Additionally, opioid withdrawal triggered by Contrave tablets can be severe and increase the risk of serious injury or even be life-threatening. Anyone currently taking prescription opioids for pain management or opioid use disorder should avoid taking Contrave and talk with their doctor about alternative options.

Drugs Affecting Blood Pressure

Contrave treatment has been linked to an increase in blood pressure, making it risky for individuals who are already taking high blood pressure medications. Severely high blood pressure (also known as hypertensive crisis) can occur if Contrave interacts with certain other drugs used to manage hypertension, such as beta-blockers, ACE inhibitors, or calcium channel blockers. This interaction may cause dizziness, heart palpitations, or an increased risk of cardiovascular events.

It’s important to note that alcohol is a drug. As such, Contrave and alcohol drug interactions can affect blood pressure.

Patients with a history of high blood pressure should be monitored closely when starting Contrave treatment. Their healthcare provider may need to adjust their medication regimen. If you are currently taking any high blood pressure medications, talk with your doctor before taking Contrave.

Monoamine Oxidase Inhibitor (MAOI) Drugs

Patients who are taking monoamine oxidase inhibitors (MAOIs), such as phenelzine, tranylcypromine, or isocarboxazid, should not take Contrave tablets. MAOIs are used to treat depression and some anxiety disorders, but they can interact dangerously with bupropion hydrochloride, leading to severely high blood pressure and potentially fatal hypertensive reactions. The effects of MAOIs can persist even after stopping the medication, which is why it is critical to wait at least 14 days after discontinuing MAOIs before starting Contrave treatment.

Patients who need to switch from an MAOI to Contrave should talk with their doctor to avoid serious interactions.

Over-the-Counter Drugs and Certain Medications

Many over-the-counter drugs contain ingredients that may increase the risk of high blood pressure, risk of seizures, or adverse reactions when combined with Contrave. For example, common cold and flu medications often contain decongestants like pseudoephedrine, which can raise blood pressure and trigger hypertensive reactions in patients already susceptible to cardiovascular issues. Additionally, taking Contrave with over-the-counter pain relievers such as ibuprofen or naproxen may affect kidney function and contribute to an increased risk of serious complications.

Certain prescription drugs used to quit smoking, such as varenicline (Chantix), may also interact with Contrave tablets, leading to an increased risk of psychiatric side effects, including suicidal thoughts and mood changes. Patients who are trying to quit smoking should consult their doctor before combining Contrave treatment with other smoking cessation aids.

Since Contrave interacts with a variety of other drugs, it is essential to review all medications—including over-the-counter drugs, supplements, and herbal remedies—with a healthcare professional before starting Contrave. Proper monitoring can help prevent serious allergic reactions, risk of seizures, and life-threatening complications.

Contrave Drug Interactions and Safety Considerations

Drug or Condition	Interaction with Contrave	Recommendation
Birth Control Pills	Possible reduced effectiveness due to altered metabolism	Talk with your doctor; consider alternative contraception
Antidepressant Drugs	Increased risk of suicidal thoughts and serotonin syndrome	Consult a healthcare professional before starting Contrave
Opioid Medications	May trigger severe opioid withdrawal symptoms	Avoid Contrave if dependent on opioids; seek alternative treatments
High Blood Pressure Medications	Risk of hypertensive crisis and cardiovascular events	Monitor blood pressure closely; adjust medications as needed
Monoamine Oxidase Inhibitors (MAOIs)	Dangerous blood pressure spikes; avoid for 14 days post-MAOI use	Do not take with Contrave; wait at least 14 days after stopping MAOIs
Over-the-Counter Drugs	Potential for increased blood pressure and adverse reactions	Consult your doctor before using OTC drugs with Contrave
Alcohol Consumption	May elevate blood pressure and increase risk of adverse effects	Limit alcohol intake; discuss risks with your healthcare provider

Risks and Side Effects of Taking Contrave

Like all prescription medications, taking Contrave carries a risk of side effects. While some adverse effects are mild and manageable, others can be severe or even life-threatening.

Patients should be aware of these potential risks and talk with their doctor about any preexisting conditions that may increase the risk of complications.

Risk of Seizures

One of the most serious concerns associated with taking Contrave is the risk of seizures. Bupropion hydrochloride, one of its active ingredients, is known to lower the seizure threshold, meaning that it makes seizures more likely to occur. This risk is particularly elevated in individuals with a seizure disorder, a history of epilepsy, or those who are withdrawing from alcohol or sedatives.

Patients with conditions such as eating disorders, including anorexia nervosa and bulimia, also face an increased risk of seizures due to potential low blood sugar and electrolyte imbalances.

Additionally, Contrave interactions with other drugs—including certain antidepressant drugs, opioid dependence treatments, and prescription drugs for neurological conditions—can further increase the risk of seizures. Individuals should never suddenly stop drinking alcohol while taking Contrave, as alcohol withdrawal can also trigger seizures.

It is crucial to talk with your doctor if you have a history of seizures before starting Contrave treatment.

Hypertensive Reactions

Since Contrave treatment affects neurotransmitters involved in the body’s stress response, it can lead to hypertensive reactions, meaning sudden spikes in blood pressure. This effect is particularly concerning for individuals with high blood pressure or a history of cardiovascular disease.

Taking Contrave alongside other stimulants—such as caffeine, amphetamines, or decongestants found in over-the-counter drugs—can increase the risk of severely high blood pressure, heart palpitations, or even strokes.

Patients who drink alcohol regularly should also be cautious, as Contrave interacts with alcohol in a way that may further elevate blood pressure levels. If you have a history of high blood pressure, severely high blood pressure, or heart disease, it is essential to have your healthcare professional closely monitor for any cardiovascular side effects.

Serious Allergic Reaction

While uncommon, some patients may experience a serious allergic reaction to Contrave tablets, which can become a medical emergency.

Symptoms of an allergic reaction include:

• Skin rash, hives, or severe itching
• Swelling of the face, tongue, or throat
• Difficulty breathing or swallowing
• Chest tightness or wheezing

A severe allergic reaction can escalate into anaphylaxis, a potentially fatal condition requiring immediate medical intervention. If you or someone you know experiences these symptoms, call emergency services or your local emergency number right away.

Talk with your doctor before starting Contrave if you have a history of allergies to medications, particularly bupropion hydrochloride or naltrexone hydrochloride.

Additional Serious Side Effects to Consider

Contrave side effects can also include the following:

1. Increased Risk of Suicidal Thoughts – As noted in the boxed warning alerts for doctors, patients, particularly those with major depressive disorder, may experience suicidal thoughts and behaviors. It is important to have a healthcare professional monitor patients for mood changes.
2. Liver Problems and Severe Hepatic Impairment – Contrave treatment can lead to severe hepatic impairment, particularly in individuals with preexisting liver disease. Symptoms such as jaundice, dark urine, or severe fatigue may indicate liver dysfunction and require immediate medical attention.
3. Adverse Reactions in Mental Health – Patients with bipolar disorder or schizophrenia may experience worsened psychiatric symptoms. Since bupropion hydrochloride is a stimulant-like antidepressant, it can sometimes trigger manic or psychotic episodes.
4. Interactions with Certain Medications – Contrave interacts with a range of other medications, including antidepressant drugs, opioid withdrawal treatments, over-the-counter stimulants, and high blood pressure medications. These interactions can increase the risk of adverse reactions, making it critical to review your medication list with your doctor.

 

When to Seek Immediate Medical Attention

If you experience any severe side effects, including persistent chest pain, suicidal thoughts, severe dizziness, or an accidental overdose, seek emergency medical care immediately by calling your local emergency number.

Your healthcare professional should also be notified of any concerning symptoms as soon as possible to determine whether starting Contrave remains safe for your condition.

Monitoring and Safety Precautions

Before starting Contrave, your healthcare professional will review your health history and current medications. Regular monitoring is necessary, especially for those at risk of high blood pressure, suicidal thoughts, or adverse reactions.

The boxed warning alerts doctors that Contrave treatment may increase the risk of suicidal thoughts and behaviors in some patients, requiring careful observation. Additionally, taking Contrave with high-fat meals can increase the risk of drug exposure, potentially leading to side effects.

Frequently Asked Questions (FAQ) About Contrave and Drug Interactions

When considering Contrave treatment, you’re probably wondering if Contraves is the right fit for your weight loss journey. It is important to understand its potential drug interactions, side effects, and effects on hormone levels.

Below are answers to common questions about taking Contrave, its impact on birth control, and its effectiveness in weight loss.

Always talk with your doctor before starting any new medication to avoid potential increased risk of adverse effects.

1. What medications should not be taken with Contrave?

Several medications should not be combined with Contrave tablets due to possible serious interactions. Monoamine oxidase inhibitors (MAOIs), such as phenelzine or tranylcypromine, can cause dangerously high blood pressure if taken with Contrave treatment, so patients must wait at least 14 days after stopping an MAOI before starting Contrave.

Opioid medications, including oxycodone, hydrocodone, and fentanyl, should also be avoided since naltrexone hydrochloride blocks opioid receptors, leading to opioid withdrawal symptoms in dependent individuals. Additionally, taking Contrave alongside other antidepressant drugs, over-the-counter drugs with stimulants, or high blood pressure medications may further increase the risk of severe hypertensive reactions or risk of seizures.

Patients should always provide a full medication list to their healthcare professional to ensure safety.

2. Does Contrave affect hormones?

While Contrave treatment does not directly alter hormone levels, its ingredients—bupropion hydrochloride and naltrexone hydrochloride—influence brain chemicals that regulate appetite, mood, and metabolism.

Some patients report changes in menstrual cycles, mood fluctuations, or increased cravings, which could be linked to indirect hormonal effects. Additionally, because Contrave interacts with liver enzymes responsible for breaking down many medications, including hormonal contraceptives, it could theoretically reduce the effectiveness of some birth control pills.

Talk with your doctor if you experience irregular cycles or are concerned about Contrave and birth control drug interactions.

3. What if I get pregnant on Contrave?

If you become pregnant while taking Contrave, you should stop the medication immediately and consult your healthcare professional. Contrave tablets have not been well studied in pregnant individuals, but there is concern that the medication could affect fetal development, mainly due to bupropion hydrochloride, which may slightly increase the risk of congenital heart defects in rare cases. Since weight loss is not recommended during pregnancy, Contrave treatment is generally discontinued if a patient becomes pregnant.

Additionally, bupropion hydrochloride and naltrexone hydrochloride may pass into breast milk, so nursing mothers should also avoid taking Contrave unless specifically advised by their doctor.

4. How quickly do you lose weight on Contrave?

The rate of weight loss on Contrave treatment varies by individual, but clinical studies have shown that patients typically lose 5-10% of their initial body mass index (BMI) within six months to a year when combining the medication with a reduced-calorie diet and increased physical activity. Some patients may see clinically meaningful weight loss as early as four to eight weeks, but results depend on factors such as metabolism, adherence to diet and exercise, and other health conditions.

Taking Contrave alone without lifestyle changes is less effective, and some patients may experience a plateau or require dose adjustments to optimize results. If weight loss does not occur after 12-16 weeks, doctors may reassess whether Contrave treatment is appropriate.

5. What cancels out the birth control pill?

Several factors can reduce the effectiveness of hormonal birth control, including Contrave interactions with liver enzymes that metabolize estrogen and progestogen. Managing missed doses is crucial to maintain contraceptive effectiveness. While taking Contrave does not directly cancel out birth control, the potential for altered metabolism means there could be a slight increased risk of contraceptive failure. This can increase the risk of unplanned pregnancy.

Additionally, certain over-the-counter drugs, prescription medications like antibiotics (e.g., rifampin), anti-seizure drugs, and herbal supplements such as St. John’s Wort may interfere with hormonal contraceptives. High-fat meals, severe diarrhea, or vomiting soon after taking a pill can also impair absorption, reducing its effectiveness.

Patients concerned about contraception while on Contrave treatment should talk with their doctor about additional protection methods, such as an IUD or barrier contraception.

If you have further questions about taking Contrave, its drug interactions, or the potential risk of side effects, always consult your healthcare professional for personalized guidance.

Conclusion

While Contrave and birth control drug interactions are not widely documented, potential metabolism changes may alter contraceptive effectiveness. Since Contrave treatment is designed to aid in chronic weight management, it works by influencing neurotransmitters that regulate appetite and energy expenditure. However, taking Contrave alongside other prescription drugs and over-the-counter medications requires careful evaluation due to the possible increased risk of high blood pressure, risk of seizures, and adverse reactions.

Because effective weight loss for certain individuals depends on maintaining a balanced metabolism, any interference with medication absorption or hormonal regulation could potentially impact results. If hormonal fluctuations affect appetite, mood, or metabolism, they may indirectly influence weight loss progress. To minimize Contrave interactions and optimize clinically meaningful weight loss, always talk with your doctor before starting Contrave treatment to ensure a safe and effective approach tailored to your individual health needs.