Does Contrave Increase Blood Pressure? What to Know

Contrave is a prescription medication used for weight management in certain individuals who struggle with obesity or overweight conditions. As with many weight loss drugs, there are concerns about potential side effects, including the possibility of increased blood pressure. Understanding how taking Contrave affects the cardiovascular system is essential for those considering it as part of their weight loss journey.

So…does Contrave increase blood pressure?

This article explores whether Contrave treatment can lead to high blood pressure, how the medication works, and what individuals should be aware of before starting it. It also highlights Contrave’s side effects, safety precautions, and the importance of discussing personal health history with a healthcare provider.

Key Takeaways

• Taking Contrave may cause increased blood pressure in some individuals, particularly those with pre-existing medical conditions affecting the heart or circulatory system.
• Before starting Contrave, patients should talk with their doctor to assess their risk of suicidal thoughts, cardiovascular risks, and potential drug interactions with other medications.
• If you experience chest pain, dizziness, or trouble breathing while taking Contrave, contact your local emergency number or local emergency services number immediately for medical assistance.

What Is Contrave?

Contrave is a prescription weight loss medication approved by the FDA for managing weight in compatible adults who are obese or overweight and have at least one weight-related medical condition, such as high blood pressure, type 2 diabetes, or high cholesterol. Unlike over-the-counter drugs, which offer general appetite suppression, Contrave is specifically formulated to target the brain’s reward and hunger systems.

It combines two active ingredients, bupropion hydrochloride and naltrexone hydrochloride, which work together to help individuals lose weight by reducing food cravings and regulating appetite. Contrave is not a standalone solution; it is intended to be used alongside a reduced-calorie diet and increased physical activity to maximize results.

Who Is Contrave Prescribed For?

Doctors typically prescribe Contrave to certain patients who meet one of the following criteria:

• A body mass index (BMI) of 30 or higher (classified as obesity)
• A BMI of 27 or higher accompanied by at least one related medical condition, such as high blood pressure, type 2 diabetes, or elevated cholesterol levels

However, taking Contrave is not suitable for everyone. Individuals with certain medical conditions or who take other medications should talk with their doctor before starting the medication.

How Contrave Works

Contrave extended-release tablets contain a combination of two drugs, each playing a unique role in weight management.

Bupropion Hydrochloride

Bupropion hydrochloride is an atypical antidepressant that is commonly used to treat depression, seasonal affective disorder, and smoking cessation. It works by increasing the levels of dopamine and norepinephrine in the brain, neurotransmitters that influence mood, energy levels, and food cravings.

In the context of Contrave treatment, bupropion hydrochloride helps to:

• Reduce appetite by altering hunger signals
• Decrease emotional and stress-related eating
• Improve energy levels, making physical activity easier
• Influence metabolism to support weight loss

However, because bupropion hydrochloride has stimulant-like properties, it can contribute to increased blood pressure and trouble sleeping in some patients. Individuals with high blood pressure or seizure disorder should be closely monitored when taking Contrave.

Naltrexone Hydrochloride

Naltrexone hydrochloride is primarily used to treat opioid and alcohol dependence by blocking opioid receptors in the brain. However, Contrave extended-release tablets serve a different function: they alter the brain’s reward system to reduce food cravings.

This means that naltrexone hydrochloride helps with:

• Limiting compulsive overeating behaviors
• Reducing the psychological reward associated with high-calorie foods
• Supporting long-term weight management by reinforcing healthier eating habits

A study published in Pharmacy and Therapeutics found that Contrave treatment helps individuals stick to a reduced-calorie diet and achieve sustainable weight loss by targeting both appetite control (via bupropion hydrochloride) and craving reduction (via naltrexone hydrochloride). However, it is not free of side effects—some users may experience nervousness, sadness, trouble sleeping, or gastrointestinal discomfort.

How Contrave Affects the Body

Together, these two components modify brain chemistry to support weight loss by reducing hunger and food cravings. However, because bupropion hydrochloride stimulates the central nervous system, taking Contrave can lead to:

• Increased blood pressure, particularly in individuals with existing high blood pressure or cardiovascular issues
• Changes in mental health conditions, including an increased risk of suicidal thoughts and behaviors
• Potential interactions with other drugs, including antidepressants and medications for seizure disorder

Dr. Matthew Olesiak, Chief Medical Director of SANE MD, explains:

“Contrave works by targeting both appetite control and cravings, but patients should be aware that it can have cardiovascular effects, including potential increases in blood pressure. It’s crucial to monitor any changes while on the medication and consult a healthcare provider if concerns arise.”

Does Contrave Increase Blood Pressure?

One of the primary concerns for individuals considering taking Contrave is whether it contributes to high blood pressure. The FDA reports that Contrave can increase blood pressure, especially in the first three months of treatment. Clinical studies suggest that bupropion hydrochloride, a stimulant-like compound, may cause increased blood pressure in some patients.

This effect varies based on individual health factors, such as a history of seizure disorder, eating disorders, or medical conditions like cardiovascular disease. Drug interactions with Contrave may also increase the risk of high blood pressure.

Factors That May Increase the Risk:

• A personal or family history of high blood pressure
• Use of other drugs that affect blood pressure
• Consuming high-fat meals, which can impact Contrave’s absorption
• Drink alcohol excessively while taking Contrave
• Pre-existing mental health conditions, including bipolar disorder

Monitoring Blood Pressure While Taking Contrave

If you have a history of high blood pressure, it’s essential to talk with your doctor before starting Contrave. Regular monitoring can help detect changes in blood pressure early. Signs to watch for include:

• Chest pain or palpitations
• Severe headaches
• Dizziness or consciousness confusion
• Feeling faint after moving from a sitting position
• Muscle cramps

Dr. Olesiak adds:

“For patients considering Contrave, it’s vital to monitor blood pressure changes and be mindful of cardiovascular health, especially if there’s a history of hypertension or heart disease.”

Side Effects of Contrave

As with all prescription drugs, side effects of Contrave can occur, ranging from mild to severe. Some individuals may experience temporary discomfort as their body adjusts to the medication, while others may develop more serious health concerns that require medical attention.

If you are taking Contrave, it is important to monitor for side effects and report any severe or unusual symptoms to your healthcare provider. Certain conditions, such as high blood pressure, mental health conditions, and seizure disorder, may increase the likelihood of adverse reactions.

Common Side Effects

Most individuals experience mild to moderate side effects of Contrave that often improve over time. These may include:

• Nervousness feeling sad – Some patients report mood changes, restlessness, or mild suicidal thoughts as a side effect of taking Contrave. Individuals with a history of bipolar disorder or mental health conditions should be particularly cautious.
• Sweating redness – Increased sweating, skin chills, or flushing may occur, especially during physical activity.
• Diarrhea difficulty – Some patients may experience digestive discomfort, including diarrhea, nausea, or bloating. These symptoms typically improve as the body adapts to the medication.
• Spasms – Muscle twitching or spasms can occur, especially when first starting Contrave.
• Trouble sleeping – Taking Contrave can lead to trouble sleeping, insomnia, or vivid dreams due to the stimulant-like effects of bupropion hydrochloride. Avoiding high-fat meals close to bedtime may help mitigate this issue.

While these symptoms are not typically dangerous, they can be bothersome. If they persist or worsen, talk with your doctor about possible adjustments to your medication regimen.

Serious Side Effects That Require Medical Attention

In some cases, Contrave’s side effects can be severe or even life-threatening. If you experience any of the following, seek medical emergency care immediately by contacting your local emergency number or local emergency services number.

• Severe allergic reaction – Serious allergic reaction symptoms include rash, hyperventilation, joint pain, facial or throat swelling, difficulty swallowing, and trouble breathing. A severe allergic reaction can be life-threatening and requires immediate medical attention.
• Consciousness, confusion, decreased awareness – If you experience consciousness confusion or decreased awareness, it may indicate neurological complications such as a reaction to the medication or an underlying mental health condition.
• Dark urine – Dark urine and yellowing of the skin or eyes may be signs of liver problems. If you notice these symptoms, seek medical emergency care immediately.
• Pain, shakiness, and combativeness – Severe pain, shakiness, aggressive behavior, and gastrointestinal distress may indicate a serious reaction to taking Contrave. These symptoms should be addressed by a healthcare provider as soon as possible.

Rare But Serious Side Effects

While less common, taking Contrave can also lead to the following rare but dangerous side effects:

• Risk of suicidal thoughts – Some patients experience an increased risk of suicidal thoughts and behaviors, particularly young adults or those with pre-existing mental health conditions. It is essential to monitor mood changes and seek help from a volunteer crisis counselor if needed.
• Chest pain – Any chest pain or tightness should be evaluated immediately, as it could indicate heart-related complications or high blood pressure side effects.
• An overdose occurs – If an overdose occurs, symptoms may include extreme confusion, trouble breathing, seizures, or unconsciousness. Contact your local emergency number immediately.

How to Minimize Side Effects of Contrave

To reduce the likelihood of experiencing side effects, consider the following precautions:

1. Talk with your doctor before starting Contrave, especially if you have high blood pressure, mental health conditions, or a history of seizure disorder.
2. Avoid high-fat meals, which can increase the risk of gastrointestinal side effects.
3. Limit alcohol consumption – drink alcohol sparingly or avoid it altogether while taking Contrave to prevent life-threatening interactions.
4. Be aware of drug interactions – Inform your doctor about any other drugs or over the counter drugs you are taking.

Taking Contrave may lead to suicidal thoughts and behaviors, particularly in young adults and individuals with mental health conditions. Those with a history of bipolar disorder or depression should be closely monitored for changes in mood or behavior.

If you or someone you know experiences suicidal thoughts, seek immediate support from a volunteer crisis counselor or call your local emergency services number.

Drug Interactions and Precautions

Before starting Contrave, it is essential to discuss your full health history with a healthcare provider, including any medical conditions, allergies, and current medications.

Taking Contrave while on certain other medications can lead to serious or even life-threatening interactions.

When discussing your health history, be sure to mention any:

• Prescription drugs or over-the-counter drugs
• Mental health conditions such as bipolar disorder or a history of suicidal thoughts
• High blood pressure, heart disease, or a history of stroke
• Seizure disorder or an experience with seizures
• Eating disorders, such as bulimia or anorexia
• Other drugs or supplements taken for weight loss, diabetes, or depression

Taking Contrave may not be safe for everyone, and your doctor may recommend an alternative weight loss drug based on your health history and risk factors.

Contrave May Interact With:

1. Other Drugs That Affect Serotonin Levels

Certain medications influence serotonin levels in the brain, which can increase the risk of suicidal thoughts when combined with taking Contrave.

This includes:

• Selective serotonin reuptake inhibitors (SSRIs) like Zoloft, Lexapro, Celexa, and Prozac used to treat depression
• Serotonin-norepinephrine reuptake inhibitors (SNRIs)
• Tricyclic antidepressants
• Monoamine oxidase inhibitors (MAOIs) – These must be stopped at least 14 days before starting Contrave
• Medications for mental health conditions or bipolar disorder
• Drugs used for migraine relief (e.g., triptans)

These combinations may increase the risk of serotonin syndrome, a serious condition causing consciousness confusion, sweating redness, rapid heart rate, and tremors.

Seek medical emergency assistance if you experience severe symptoms.

2. Medications That Lower Seizure Threshold

Taking Contrave may increase the risk of seizures, particularly if used alongside medications that lower seizure thresholds.

Patients with seizure disorder or a history of trouble sleeping should be especially cautious.

Drugs that can lower the seizure threshold include:

• Antipsychotics and mood stabilizers (e.g., lithium, olanzapine)
• Tramadol, Fentanyl, and other opioid pain relievers
• Theophylline (used for asthma and lung conditions)
• Stimulants, including some over-the-counter drugs for colds and allergies
• Other drugs that impact dopamine and norepinephrine levels

Drinking alcohol can also significantly lower seizure thresholds, increasing risks. It is best to avoid alcohol completely while taking Contrave.

3. Over-the-counter drugs That Affect Blood Pressure

Certain over-the-counter drugs can interact with Contrave treatment, especially those that impact blood pressure.

Be cautious with:

• Cold and flu medications containing decongestants (e.g., pseudoephedrine, phenylephrine)
• Pain relievers such as ibuprofen and naproxen, which may contribute to increased blood pressure
• Caffeine-based weight loss supplements, which can amplify stimulant effects
• Herbal supplements, such as St. John’s Wort, which may interfere with bupropion hydrochloride

If you have a history of high blood pressure, always talk with your doctor before taking any new medication, including over-the-counter drugs.

Additional Precautions When Taking Contrave

In addition to avoiding drug interactions, certain precautions should be taken to reduce the risk of complications while on Contrave treatment:

• Do not take Contrave with high-fat meals. Consuming high-fat meals can increase the absorption of the drug, potentially leading to more severe side effects of Contrave, including nausea and dizziness.
• Monitor blood pressure regularly. Because bupropion hydrochloride may cause increased blood pressure, individuals with high blood pressure or heart conditions should track their readings frequently.
• Avoid alcohol completely. Drinking alcohol while taking Contrave may increase the risk of seizures and serious allergic reactions.
• Inform your doctor if you are pregnant or breastfeeding. Contrave treatment is not recommended during pregnancy, and its components can pass into breast milk.

Who Should Avoid Taking Contrave?

Contrave treatment is not suitable for everyone. Individuals should talk with their doctor if they have:

• A history of bipolar disorder or mental health conditions
• Pre-existing high blood pressure or heart conditions
• Eating disorders such as bulimia or anorexia
• A history of seizures (seizure disorder)
• A tendency toward trouble sleeping

Additionally, those who are breastfeeding should avoid taking Contrave since its components can pass into breast milk.

Frequently Asked Questions (FAQ) About Contrave and Blood Pressure

If you are considering taking Contrave for weight management, you may have concerns about its effects on blood pressure, heart health, and potential side effects.

Below are answers to some of the most frequently asked questions to help you make an informed decision. If you have any underlying medical conditions, always talk with your doctor before starting a new medication.

1. Does Contrave Cause High Blood Pressure?

Yes, taking Contrave can increase blood pressure in some individuals, particularly those with a history of high blood pressure or cardiovascular disease. This is mainly due to bupropion hydrochloride, which can stimulate the nervous system and raise blood pressure and heart rate.

While the increase is usually mild, it can be more pronounced in individuals sensitive to stimulants or those taking other medications that affect the cardiovascular system.

If you have high blood pressure, talk with your doctor before starting Contrave and monitor your readings regularly. Seek medical attention if you experience symptoms such as chest pain, dizziness, or persistent headaches.

2. What Is the Downside of Contrave?

The biggest downside of Contrave is the potential for side effects, which can range from mild to severe. Common side effects of Contrave include nausea, trouble sleeping, dry mouth, and dizziness. More serious risks include increased blood pressure, mood changes, and an increased risk of suicidal thoughts and behaviors, especially in young adults with mental health conditions like bipolar disorder.

Additionally, taking Contrave may not be suitable for individuals with a history of seizure disorder, eating disorders, or high blood pressure. Because it affects brain chemistry, it can also interact with other drugs, requiring careful supervision by a healthcare provider.

3. Is Contrave Hard on Your Heart?

Contrave treatment may impact heart health, especially in individuals with pre-existing high blood pressure, heart disease, or irregular heart rhythms. Bupropion hydrochloride can increase blood pressure and heart rate, putting additional strain on the cardiovascular system.

While most people tolerate Contrave well, those with heart conditions should exercise caution and consult their doctor before starting this medication.

Symptoms such as chest pain, shortness of breath, or rapid heartbeat should be reported immediately, as they could indicate a serious reaction. Patients should also avoid drinking alcohol and eating high-fat meals, which can amplify potential cardiovascular risks.

4. How Much Does Bupropion Raise Blood Pressure?

The extent to which bupropion hydrochloride raises blood pressure varies from person to person. Studies suggest that it can lead to an increase of around 1-3 mmHg in some individuals, but the increase can be more significant in those with pre-existing high blood pressure.

The risk is higher when Contrave is combined with other drugs that also affect blood pressure, such as decongestants or stimulant medications. If you are taking Contrave, your healthcare provider may recommend regular blood pressure checks to ensure your blood pressure remains within a safe range.

If you notice symptoms such as persistent headaches, dizziness, or trouble breathing, seek medical attention immediately.

Final Thoughts: Is Contrave Safe for Blood Pressure?

Contrave is safe for most individuals when taken as prescribed and under medical supervision. However, those with pre-existing high blood pressure or cardiovascular concerns should exercise caution and talk with their doctor before using it.

If you notice any severe symptoms such as dark urine, severe allergic reaction, or chest pain, seek immediate medical emergency care.

For those struggling with weight and considering weight loss drugs, seeking free and confidential support from a healthcare provider can help them navigate treatment options safely.

Scientific References

Pharmacy and Therapeutics

The Food and Drug Administration (FDA)