Contrave and Cymbalta Drug Interactions: What to Know

Combining medications can sometimes lead to unintended consequences, and Contrave and Cymbalta drug interactions are ones that require careful consideration. While both drugs are adequate for their intended purposes, they can also increase the risk of side effects when taken together.

Understanding how these medications interact and the precautions necessary for safe use is essential for anyone taking Contrave alongside Cymbalta.

Key Takeaways

• Taking Contrave with Cymbalta can increase the risk of side effects, including high blood pressure, serotonin syndrome, and liver problems.
• Both bupropion hydrochloride and naltrexone hydrochloride in Contrave tablets affect neurotransmitters, which may increase blood pressure and interact with certain beta blockers.
• Tell your doctor about other medications and medical conditions before starting Contrave treatment to minimize adverse effects.

Understanding Contrave and Cymbalta

Contrave and Cymbalta are prescribed for different conditions but share common pathways in the brain, potentially leading to certain drug interactions. Contrave is a weight loss drug that combines bupropion hydrochloride and naltrexone hydrochloride, while Cymbalta (duloxetine) is used to treat depression, anxiety, and nerve pain.

While both medications can be beneficial on their own, taking Contrave with Cymbalta can increase the risk of serious side effects. This combination may affect blood pressure, cause serotonin syndrome, and exacerbate mental health conditions.

According to Dr. Matthew Olesiak, Chief Medical Director at SANE MD, “Patients considering Contrave should discuss their health history and current prescriptions with their doctor or pharmacist to avoid potentially dangerous interactions. Medications that impact serotonin and norepinephrine levels, like Cymbalta, require special caution.”

Contrave and Cymbalta Interaction Risks

Risk Factor	Impact of Contrave	Impact of Cymbalta	Precautions
High Blood Pressure	Contains bupropion hydrochloride, which can increase blood pressure.	Acts as an SNRI, which can also elevate blood pressure.	Monitor blood pressure regularly; discuss alternative treatments with a doctor.
Seizure Risk	Lowers the seizure threshold, increasing the risk of seizures.	May contribute to lowering the seizure threshold.	Avoid use in individuals with seizure disorders; do not abruptly stop alcohol use.
Mental Health Changes	Affects mood and brain chemistry, potentially worsening mental health conditions.	Carries a warning for suicidal thoughts and behavioral changes.	Monitor for mood swings, depression, and suicidal thoughts; consult a doctor immediately if symptoms arise.
Liver Damage	Contains naltrexone hydrochloride, which can impact liver function.	Metabolized in the liver, potentially compounding liver damage.	Avoid excessive alcohol; regular liver function tests recommended.
Serotonin Syndrome	Influences neurotransmitter activity, increasing serotonin levels.	Increases serotonin activity, leading to a higher risk of serotonin syndrome.	Seek immediate medical help if symptoms like confusion, fever, or muscle stiffness occur.

How Contrave and Cymbalta Interact

When taking Contrave, it is essential to be aware of Contrave interactions with certain medications. The key mechanisms of interaction include:

• Blood Pressure Side Effects – Contrave may increase blood pressure due to bupropion hydrochloride, which can be compounded by Cymbalta’s impact on norepinephrine levels.
• Serotonin Syndrome Risk – Cymbalta increases serotonin activity, and Contrave can amplify this, leading to mental health changes or even a life-threatening condition called serotonin syndrome.
• Liver Problems – Naltrexone has the potential to cause liver issues, and when combined with DULoxetine, this risk may be heightened. Both medications metabolize in the liver, increasing the risk of liver damage, especially in patients with existing liver problems.

Risks of Taking Contrave and Cymbalta Together

Though Contrave can be used to treat depression, combining it with antidepressant medications can be dangerous. When two medications affect similar neurotransmitter pathways or physiological processes, the likelihood of adverse effects increases. Contrave and Cymbalta both impact blood pressure, neurological function, and liver metabolism, which makes their combined use potentially risky.

While some patients may tolerate both medications under careful supervision, taking Contrave for weight loss with Cymbalta mental health issues may increase the risk of serious complications, particularly in individuals with pre-existing health conditions. Some patients may also experience an allergic reaction to certain ingredients in either medication.

Understanding these risks is critical, especially for those with a history of high blood pressure, seizure disorders, mental health conditions, or liver problems.

Below are the primary concerns associated with this drug combination and what to watch for when starting Contrave treatment while also taking Cymbalta.

1. High Blood Pressure and Heart Concerns

One of the most pressing concerns about taking Contrave and Cymbalta together is their combined impact on blood pressure. Contrave contains bupropion hydrochloride, which can stimulate the nervous system and increase blood pressure. Cymbalta, a serotonin-norepinephrine reuptake inhibitor (SNRI), can also contribute to high blood pressure, creating a compounded effect.

For individuals with pre-existing high blood pressure, heart disease, or other health conditions related to cardiovascular health, this combination may increase the risk of dangerously high readings, leading to severely high blood pressure, stroke, or other cardiac events. Regular blood pressure monitoring is essential for those prescribed both medications.

2. Increased Risk of Seizures

Both bupropion hydrochloride in Contrave and Cymbalta have been associated with lowering the seizure threshold, meaning they make seizures more likely to occur. This is particularly dangerous for individuals with seizure disorders, eating disorders, or those at risk of low blood sugar, as fluctuations in glucose levels can further increase seizure susceptibility.

A dose adjustment or alternative medication may be necessary for individuals at increased risk of seizures. Patients should also avoid suddenly stopping drinking alcohol, as alcohol withdrawal can further heighten seizure risk.

3. Mental Health Changes and Suicidal Thoughts

Cymbalta carries a serious warning from the FDA regarding suicidal thoughts and behaviors, particularly in young adults under the age of 25. Since Contrave treatment also affects mood and brain chemistry, the combination can lead to mental health changes, including increased anxiety, depression, or suicidal thoughts.

This risk is particularly concerning for those with a history of bipolar disorder, depression, or other mental health conditions. Dr. Olesiak emphasizes, “Both Contrave and Cymbalta influence brain chemistry. Anyone experiencing mental health changes while on these medications should contact their healthcare provider immediately.”

Patients should be monitored closely for shifts in mood, agitation, or unusual behavior, particularly when starting Contrave or increasing the dose.

4. Liver Problems and Potential Damage

Since both Contrave and Cymbalta are metabolized in the liver, their combined use can increase the risk of liver damage, particularly in patients with liver problems or those who drink alcohol regularly.

The presence of naltrexone hydrochloride in Contrave is particularly concerning because it affects opioid receptors, which play a role in liver function.

Signs of liver damage include:

• Yellowing skin or eyes (jaundice)
• Dark urine
• Persistent nausea or vomiting
• Extreme fatigue

If any of these symptoms appear, tell your doctor immediately. Patients with pre-existing liver problems should consider alternative treatment options.

5. Serotonin Syndrome and Life-Threatening Risks

Serotonin syndrome is a potentially life-threatening condition that arises from an excessive accumulation of serotonin in the brain.

Since Cymbalta affects serotonin levels and Contrave also influences neurotransmitter activity, the combination may increase the risk of this dangerous reaction.

Symptoms of serotonin syndrome include:

• Confusion
• Rapid heart rate
• High fever
• Muscle stiffness
• Loss of coordination

If these symptoms occur, seek emergency medical care and call a local emergency number immediately. Avoiding alcohol and other medications that impact serotonin levels can help lower this risk.

Understanding these potential Contrave interactions can help patients make informed decisions about their treatment. Always consult a doctor or pharmacist before combining medications, and report any unusual side effects as soon as they appear.

Safety Measures When Taking Contrave and Cymbalta

When taking Contrave alongside Cymbalta, following safety measures can help reduce the risk of side effects and ensure the medications work as intended. Since both drugs influence neurotransmitters, blood pressure, and liver function, proper monitoring and precautions are essential.

For individuals with high blood pressure, seizure disorders, or mental health conditions, extra care is needed to prevent complications. Some other drugs, including certain beta blockers, over-the-counter drugs, and supplements, may interact with Contrave and Cymbalta, making medical guidance critical. Drug to treat ADHD can also be risky to take with Contrave. For example, taking Contrave and Vyvanse together can trigger drug interactions.

Below are important safety measures to follow while on these medications.

1. Tell Your Doctor About Other Medications

Many other medications can interact with Contrave and Cymbalta, altering their effectiveness or leading to harmful side effects. Certain drug interactions may require a dose adjustment or complete medication change to prevent issues such as increased blood pressure, risk of seizures, or liver damage.

Drugs that require special attention include:

• Monoamine oxidase inhibitors (MAOIs) – Can cause dangerously high serotonin levels, increasing the risk of serotonin syndrome.
• Certain beta blockers – May be less effective due to Contrave’s impact on the nervous system.
• Over-the-counter supplements and medications – Some over-the-counter drugs, herbal remedies, and vitamins can interfere with how these medications are processed in the body.

Before starting Contrave treatment, always tell your doctor about all medications you are taking, including prescription drugs, over-the-counter drugs, and supplements.

2. Avoid Drinking Alcohol and Over-the-Counter Drugs

Drinking alcohol while taking Contrave or Cymbalta can amplify adverse effects such as:

• Dizziness and drowsiness
• Impaired judgment and coordination
• Increased risk of liver problems
• Heightened risk of seizures

Since both medications affect the liver, excessive alcohol consumption may increase the risk of liver damage or interfere with the drug’s metabolism.

Additionally, over-the-counter drugs like pain relievers (such as ibuprofen and acetaminophen), antihistamines, or sleep aids can have unexpected interactions with Contrave and Cymbalta. Consulting a doctor or pharmacist before using any new medication is advised.

3. Monitor Blood Pressure Regularly

Both Contrave treatment and Cymbalta can increase blood pressure, making regular monitoring necessary. High blood pressure can increase the likelihood of heart-related complications, such as stroke or heart attack.

Patients who already have high blood pressure or severely high blood pressure should:

• Check their blood pressure regularly using a home monitor or at a pharmacy.
• Report significant increases to their healthcare provider.
• Discuss alternative treatments with their doctor if blood pressure becomes difficult to control.

Those taking certain beta blockers should be aware that Contrave may reduce their effectiveness, requiring a dose adjustment or a different blood pressure medication.

4. Do Not Suddenly Stop Drinking Alcohol

For individuals who regularly consume alcohol, suddenly stopping drinking alcohol can lead to withdrawal symptoms such as:

• Increased anxiety and agitation
• Seizures (especially in those at risk)
• Severe mood swings or mental health changes

Since both Contrave and Cymbalta affect the nervous system, abrupt changes in alcohol intake can make withdrawal symptoms more severe. Patients should work with their healthcare provider to reduce alcohol consumption gradually if necessary.

5. Be Aware of Vitamin and Lab Test Interactions

Certain vitamins and over-the-counter supplements may alter drug effects, requiring patients to consult their doctor before taking them.

Additionally, lab tests can yield false positive results due to the way these medications interact with the body.

Common concerns include:

• Vitamin interactions—Some supplements may interfere with Contrave’s interaction effects, making it less effective or increasing side effects.
• Even lab tests – Blood tests may show false positive results for certain conditions, misleading doctors about liver function, kidney health, or drug use.

Before undergoing any medical testing, always tell your doctor that you are taking Contrave and Cymbalta to avoid misinterpretation of results.

Who Should Avoid Taking Contrave with Cymbalta?

Because Contrave interacts with various medical conditions and other medications, some individuals should avoid taking these drugs together due to the potential for serious adverse effects. The combination of Contrave and Cymbalta can increase the risk of severe complications, particularly for those with pre-existing health conditions that affect the nervous system, cardiovascular system, or metabolic function.

Below are specific groups of people who should avoid taking Contrave while on Cymbalta:

1. Those with Bipolar Disorder or Other Mental Health Conditions

Individuals with bipolar disorder or other mental health conditions should avoid taking Contrave and Cymbalta together due to the potential for mental health changes, including increased mood swings, mania, or suicidal thoughts and behaviors.

Since bupropion hydrochloride in Contrave can act as a stimulant, it may trigger manic episodes in individuals with bipolar disorder, leading to worsened symptoms. Meanwhile, Cymbalta is an SNRI antidepressant, which can also affect mood regulation. The combination of these two medications may heighten mental health risks, making them unsuitable for individuals with psychiatric disorders.

2. Patients with Seizure Disorders

Both bupropion hydrochloride (found in Contrave) and Cymbalta can increase the risk of seizures by lowering the body’s seizure threshold. This makes the combination particularly dangerous for individuals with seizure disorders, a history of epilepsy, or other conditions that predispose them to seizures.

Additionally, people with eating disorders such as anorexia nervosa or bulimia should also avoid this combination, as nutritional deficiencies and extreme weight fluctuations can further lower seizure resistance. If seizure risk is a concern, doctors may recommend alternative weight loss drugs or antidepressants that do not interfere with neurological stability.

3. Individuals with Severely High Blood Pressure

Because Contrave treatment can increase blood pressure, individuals with severely high blood pressure or uncontrolled hypertension should avoid taking it, especially alongside Cymbalta. The stimulatory effects of bupropion hydrochloride in Contrave, combined with the impact of Cymbalta on norepinephrine levels, can lead to dangerously elevated blood pressure, putting patients at a higher risk of:

• Heart attack
• Stroke
• Other cardiovascular complications

Patients with pre-existing high blood pressure should consult their doctor before starting Contrave treatment and may need dose adjustment or alternative medications to avoid severe hypertension.

4. Pregnant or Breastfeeding Women

Taking Contrave while pregnant or breastfeeding is not recommended due to potential risks to the developing fetus or infant. Both bupropion hydrochloride and naltrexone hydrochloride can cross the placenta and may be passed into breast milk, leading to unintended effects on the baby’s development.

Potential risks include:

• Low birth weight
• Neurodevelopmental concerns
• Increased risk of congenital abnormalities

If a woman is pregnant or planning to become pregnant, a healthcare provider should be consulted to explore safer weight loss options or alternative treatments for mental health conditions.

5. People with Opioid Withdrawal Symptoms

Since Contrave contains naltrexone hydrochloride, it blocks opioid receptors, making it unsuitable for individuals currently using opioid medications or experiencing opioid withdrawal symptoms. Taking Contrave while on opioids can cause sudden opioid withdrawal, leading to severe symptoms such as:

• Intense nausea and vomiting
• Severe muscle pain and cramping
• Anxiety and restlessness
• Increased heart rate and blood pressure

Patients using opioid pain medications or undergoing treatment for opioid dependence should avoid Contrave unless their doctor specifically advises otherwise.

Frequently Asked Questions (FAQ)

When taking prescription medications, understanding potential drug interactions is essential for safety and effectiveness.

Below are answers to some of the most commonly asked questions regarding Contrave interactions with Cymbalta, antidepressants, and other medications.

Always consult a doctor or pharmacist before making any changes to your medication regimen.

1. Can you take Contrave while on antidepressants?

It depends on the specific antidepressant and your health history. Contrave contains bupropion hydrochloride, which affects neurotransmitters in a way similar to many antidepressants, increasing the risk of serotonin syndrome, high blood pressure, or worsening mental health conditions.

Certain antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) like Cymbalta, may require a dose adjustment or alternative treatment.

Always tell your doctor if you are taking an antidepressant before starting Contrave treatment to minimize the risk of serious side effects.

2. Can you take bupropion and Cymbalta together?

Taking both bupropion (the active ingredient in Contrave) and Cymbalta may increase the risk of seizures, high blood pressure, and serotonin syndrome. Both medications influence the central nervous system, and their combined use may heighten the chance of adverse effects, particularly in individuals with bipolar disorder, seizure disorders, or mental health conditions. In some cases, a doctor may prescribe them together with careful monitoring and possibly a dose adjustment.

If you are currently prescribed Cymbalta and are considering starting Contrave, consult a healthcare provider to assess the benefits and risks.

3. What medications should not be taken with Contrave?

Several other medications can interact with Contrave, leading to increased risk of side effects. Drugs that may require dose adjustment or complete avoidance include:

• Monoamine oxidase inhibitors (MAOIs) – Can cause dangerously high blood pressure and severe serotonin syndrome.
• Certain beta blockers – May not work as effectively due to Contrave’s interaction effects on the nervous system.
• Seizure medications – Since taking Contrave can lower the seizure threshold, drugs such as antiepileptics or other drugs that increase seizure risk should be used with caution.
• Opioid medications – Since naltrexone hydrochloride in Contrave blocks opioid receptors, it can lead to sudden opioid withdrawal if taken with opioid-based pain relievers. The drug interactions between Contrave and Codeine can be especially severe.

See our completed guide for more Contrave drug interactions.

Patients should tell their doctor about all prescription, over-the-counter drugs, and vitamin interactions before using Contrave.

4. What should you not mix with Cymbalta?

Cymbalta has several contraindications and drug interactions that may increase the risk of severe side effects. Avoid taking Cymbalta with:

• Other antidepressants, including MAOIs, SSRIs, and SNRIs, as they can cause serotonin syndrome.
• Opioid pain relievers, as they may intensify drowsiness and cause mental health changes.
• Certain beta blockers, as they may interfere with Cymbalta’s effects on blood pressure.
• Alcohol, as it can increase liver problems and amplify drowsiness or dizziness.
• Over-the-counter drugs and supplements like St. John’s Wort, which may increase the risk of serotonin-related complications.

You should also be careful of taking Contrave and birth control pills together, as they may alter the effectiveness of the contraceptive.

To ensure safe use, tell your doctor about all other medications and medical conditions before starting Cymbalta.

5. Can you take Contrave while on Cymbalta?

Taking Contrave and Cymbalta together is not generally recommended unless closely supervised by a doctor. Both drugs affect neurotransmitters, and their combined use may increase the risk of high blood pressure, serotonin syndrome, seizures, and mental health changes. Patients with a history of bipolar disorder, liver problems, or severely high blood pressure should avoid this combination.

If your doctor prescribes both, they may adjust the dose and require frequent monitoring to reduce potential complications. Always consult a doctor or pharmacist before starting Contrave treatment while taking Cymbalta.

Final Thoughts

Before starting Contrave treatment, it is essential to consider other factors such as medical conditions, current other drugs, and health factors.

Since Contrave interactions with Cymbalta may increase the risk of serious side effects, tell your doctor about all prescriptions and over-the-counter products you use.

Patients can use these medications more safely by being aware of potential adverse effects, making necessary dose adjustments, and monitoring blood pressure. When taking Contrave with other medications, always consult a doctor or pharmacist for personalized guidance.