Celexa and Contrave Drug Interactions: What to Know
Celexa (citalopram) and Contrave (bupropion-naltrexone) are medications used for different purposes—Celexa to treat depression and Contrave for chronic weight management for compatible individuals.
However, Celexa and Contrave drug interactions can occur if these two medications are taken together, affecting safety and efficacy. Understanding these risks is essential before combining these medications.
Key Takeaways
- Celexa and Contrave drug interactions can increase the risk of serious adverse reactions such as seizures and high blood pressure.
- Taking Contrave with Celexa may require dose adjustment to minimize the risk of seizures and other side effects.
- Patients with bipolar disorder, a seizure disorder, eating disorders, or other risk factors should consult their doctor before taking these medications together.
Understanding Celexa and Contrave Drug Interactions
Celexa (citalopram) is a selective serotonin reuptake inhibitor (SSRI) commonly prescribed to treat depression and other mood disorders. It works by increasing serotonin levels in the brain, improving mood regulation and emotional stability. Contrave, on the other hand, is a weight loss medication that combines naltrexone and bupropion to influence appetite and cravings by acting on the brain’s reward system. Naltrexone is an opioid antagonist used to treat alcohol and opioid dependence, while bupropion is an atypical antidepressant that affects dopamine and norepinephrine levels. Contrave helps promote weight loss in certain individuals.
When Celexa and Contrave are taken together, their interaction can have unintended effects due to the way both medications alter neurotransmitter activity. Bupropion, a key component of Contrave, inhibits the reuptake of dopamine and norepinephrine, while Celexa primarily affects serotonin. The combination can create an imbalance in neurotransmitter regulation, increasing the likelihood of adverse reactions such as serotonin syndrome, nervous system overstimulation, and mood instability.
One of the most significant concerns with this combination is the lower seizure threshold caused by bupropion. Since Celexa may also contribute to mild excitatory effects in the nervous system, the concurrent use of these drugs increases the risk of seizures, particularly in individuals with a history of seizure disorder, bipolar disorder, or brain trauma.
Dr. Matthew Olesiak, MD, Chief Medical Director of SANE MD, states:
“Bupropion, a key ingredient in Contrave, is known to reduce seizure threshold. When combined with an SSRI like Celexa, the risk of seizures may further increase, especially in patients with preexisting risk factors.”
In addition to seizure risk, the interaction between Celexa and Contrave can contribute to serotonin syndrome, a potentially life-threatening condition characterized by confusion, rapid heart rate, high blood pressure, sweating, muscle stiffness, and agitation. This occurs when excessive serotonin accumulates in the nervous system, often as a result of combining multiple drugs that influence serotonin levels.
Celexa and Contrave Drug Interaction Summary
| Category | Details |
|---|---|
| Primary Medications | – Celexa (Citalopram): SSRI antidepressant increasing serotonin levels – Contrave: Weight loss drug (naltrexone + bupropion) acting on dopamine/norepinephrine |
| Main Interaction Concerns | – Increased seizure risk due to bupropion – Risk of serotonin syndrome – Blood pressure elevation – CNS overstimulation |
| High-Risk Groups | – Individuals with: – Seizure disorders – Bipolar disorder – Brain injuries – Eating disorders |
| Neurological Side Effects | – Dizziness or vertigo – Confusion or poor concentration – Tremors or twitching – Insomnia or restlessness – Blurred vision |
| Cardiovascular Risks | – High blood pressure – Severe headaches – Chest pain or palpitations – Shortness of breath |
| Opioid Interaction Risks | – Naltrexone blocks opioid receptors – May cause withdrawal if taken with opioids – Risk of overdose after stopping Contrave and resuming opioids |
| Suicidal Thoughts Risk | – Both drugs can increase suicidal ideation, especially in those <25 – Watch for sudden mood changes, aggression, or withdrawal |
| Serious Allergic Reactions | – Rash or hives – Dark urine (possible liver issue) – Chest pain or difficulty breathing |
Increased Risk of Seizures and CNS Toxicity
Taking Contrave with Celexa can significantly increase the risk of seizures, especially for individuals who have a seizure disorder, bipolar disorder, a history of traumatic brain injury, or a brain tumor. According to research published in Pharmacy & Therapeutics Journal, Bupropion, one of the main components of Contrave, is known to lower seizure threshold, making seizures more likely when combined with other medications that impact the central nervous system (CNS), such as Celexa.
Additionally, naltrexone and bupropion both influence neurotransmitter activity in the brain, which can contribute to CNS toxicity when taken with Celexa. This may lead to symptoms such as:
- Dizziness or vertigo
- Confusion or difficulty concentrating
- Tremors or muscle twitching
- Increased nervous system stimulation, leading to restlessness or insomnia
- Headaches and blurred vision
Because these side effects can affect cognitive function, patients should avoid activities requiring mental alertness, such as driving or operating heavy machinery, until they fully understand how the combination of medications affects them.
Dr. Olesiak notes: “Patients taking both Celexa and Contrave should be cautious of potential neurological side effects, including dizziness and tremors, which may impair motor function and decision-making.”
In individuals predisposed to seizures, even small changes in dosage or missed doses can trigger an episode. The FDA emphasizes the importance of following a healthcare provider’s guidance on dose adjustments to minimize the risk of seizures.
Blood Pressure and Cardiovascular Concerns
Both Celexa and Contrave can impact blood pressure, but taking Contrave increases the likelihood of developing high blood pressure or severely high blood pressure, particularly in individuals who have preexisting cardiovascular conditions. Bupropion, a stimulant-like drug, can elevate blood pressure, while naltrexone can also contribute to fluctuations in heart rate and blood pressure or heart function.
Patients who already have hypertension, heart disease, or a history of stroke are at an even higher risk of developing hypertensive reactions, which may present as:
- Severe headaches
- Dizziness and vision changes
- Chest pain or palpitations
- Shortness of breath
For individuals on both Celexa and Contrave, frequent monitoring of blood pressure is essential to prevent dangerous spikes.
Dr. Olesiak advises: “Because bupropion can cause an increase in blood pressure, patients taking Contrave should regularly monitor their readings, especially if they are also on SSRIs like Celexa.”
If a patient develops severely high blood pressure or experiences chest pain, they should seek immediate medical attention. In some cases, a dose adjustment or alternative treatment may be necessary to lower the risk of cardiovascular complications.
Additional Risks and Considerations
Opioid Withdrawal & Accidental Overdose
Since naltrexone and bupropion block opioid receptors, individuals using opioid-based medications or struggling with opioid dependence must avoid taking Contrave. This is because naltrexone prevents opioids from binding to receptors, which can trigger opioid withdrawal symptoms if the individual is physically dependent.
Common symptoms of opioid withdrawal include:
- Severe nausea and vomiting
- Sweating and chills
- Increased heart rate and blood pressure
- Muscle aches and restlessness
Additionally, individuals who stop taking Contrave and later use opioids may have a reduced tolerance, making them susceptible to an accidental overdose, which could be fatal. Patients should tell their doctor if they are taking opioids before starting Contrave treatment.
Increased Risk of Suicidal Thoughts
As with most antidepressants, Celexa carries an FDA warning for suicidal thoughts in young adults, particularly during the initial weeks of treatment. Bupropion, while not a traditional SSRI, also alters brain chemistry, and its stimulating effects may increase the risk of anxiety, restlessness, or impulsivity. When used together, these drugs may elevate the likelihood of:
- Suicidal ideation
- Self-harm thoughts
- Severe mood swings or aggression
Patients (especially those under the age of 25) and their families should monitor for behavioral changes, including sudden agitation, social withdrawal, or unexplained mood shifts. Tell your doctor immediately if these symptoms occur.
Serious Allergic Reaction
Though uncommon, some individuals may experience a serious allergic reaction to Celexa, Contrave, or their combined effects.
Symptoms of a severe allergic reaction include:
- Skin rash or hives
- Dark urine, indicating possible liver issues
- Severe chest pain or difficulty breathing
If any of these symptoms occur, seek immediate medical attention to prevent serious complications. Tell your doctor about any history of allergies before taking these medications.
Understanding these side effects and safety guidelines can help you take these medications safely.
Safe Use Guidelines
To reduce the potential risks associated with Celexa and Contrave drug interactions, patients should follow these essential safety guidelines:
1. Tell Your Doctor About All Other Drugs and Over-the-Counter Drugs You Are Taking
Many other drugs, including over-the-counter drugs, herbal supplements, and prescription medications, can interact with Celexa and Contrave, potentially increasing the risk of adverse reactions.
Some medications that require special attention include:
- Other antidepressants (e.g., SSRIs, SNRIs, MAOIs)
- Antipsychotic medications (may further lower seizure threshold)
- Blood pressure medications (as Contrave may cause fluctuations in blood pressure)
- Opioid pain relievers, Codeine such as , (which Contrave blocks due to its naltrexone component)
- Over-the-counter drugs like decongestants or nonsteroidal anti-inflammatory drugs (NSAIDs), which may elevate blood pressure
Additionally, stimulants like Modafinil can also interact with Contrave.
Since some interactions may increase the risk of seizures, hypertensive reactions, or serotonin syndrome, it is critical to tell your doctor about all medications you are taking before starting Contrave treatment.
2. Avoid High-Fat Meals When Taking Contrave
Taking Contrave with high-fat meals can increase systemic exposure to bupropion, leading to a higher risk of adverse effects, including:
- Increased blood pressure or heart rate
- Nausea, dizziness, or agitation
- Lower seizure threshold, heightening the risk of seizures
To minimize these risks, Contrave tablets should be taken with a reduced-calorie diet, but without excessive dietary fat.
Patients should focus on balanced meals and avoid consuming high-fat meals around their dosing schedule.
3. Do Not Suddenly Stop Drinking Alcohol
Abruptly stopping alcohol consumption while taking Contrave or Celexa can increase the risk of withdrawal symptoms, including:
- Seizures (due to bupropion lowering seizure threshold)
- Severe agitation or anxiety
- Sleep disturbances and mood instability
However, if you’re not a regular drinker, you should avoid drinking alcohol while on either of these drugs. (Contrave and alcohol drug interactions can be particularly severe.)
Patients who regularly consume alcohol should discuss a safe reduction plan with their healthcare provider before starting Contrave treatment.
Tell your doctor if you have a history of heavy alcohol use, as you may require a dose adjustment or closer monitoring.
4. Swallow Contrave Tablets Whole—Do Not Crush, Chew, or Split Them
Contrave tablets are extended-release tablets, meaning the medication is designed to be released into the body gradually over time.
Crushing, chewing, or splitting the tablets can:
- Cause a sudden spike in drug levels, leading to adverse reactions
- Increase the risk of seizures, particularly in individuals predisposed to them
- Alter how the medication is absorbed, reducing effectiveness
Patients should swallow Contrave tablets whole with water and follow the prescribed dosing schedule. If a dose is missed, take the next scheduled dose rather than doubling up.
5. Follow the Prescribed Dose Range and Take Contrave in Divided Doses
To minimize the risk of hypertensive reactions, seizures, and other side effects, Contrave should be taken exactly as prescribed. Typically, Contrave is started at a lower dose and gradually increased to help the body adjust.
Taking too much too quickly can increase the risk of:
- Severely high blood pressure (Combining Contrave with Propranolol, a beta-blocker, can further affect blood pressure.
- Nervous system overstimulation (e.g., restlessness, jitteriness)
- Lower seizure threshold, increasing seizure risk
Patients should never exceed the recommended dose range or change their dosing schedule without consulting a healthcare provider.
6. Monitor for Trouble Sleeping, as Contrave Can Cause Insomnia
Contrave contains bupropion, a stimulant-like drug, which can cause trouble sleeping, particularly if taken too close to bedtime.
Patients who experience persistent insomnia should:
- Take Contrave earlier in the day to reduce its impact on sleep
- Avoid caffeine and other stimulants, which may worsen restlessness
- Discuss potential dose adjustments with their doctor if sleep disturbances become severe
If insomnia persists, tell your doctor, as alternative treatment strategies may be needed to ensure safe and effective chronic weight management without disrupting sleep quality.
FAQ: Celexa and Contrave Drug Interactions
When considering Celexa and Contrave drug interactions, it’s important to understand how these medications may interact with each other and with other drugs. Both Celexa (citalopram) and Contrave (naltrexone-bupropion) affect neurotransmitters, meaning their combination can lead to an increased risk of side effects, including seizures, high blood pressure, and serotonin syndrome.
Below are answers to some of the most common questions regarding their safe use.
1. Can you take Contrave while on antidepressants?
Taking Contrave while on antidepressants can be risky due to potential interactions between bupropion (a component of Contrave) and other antidepressants. Bupropion can increase serotonin and dopamine levels, which, when combined with SSRIs or SNRIs, may raise the risk of serotonin syndrome—a dangerous condition characterized by agitation, rapid heartbeat, and high fever.
Additionally, bupropion can lower the seizure threshold, making seizures more likely, especially if combined with medications that have similar effects. Patients currently on antidepressants should consult their doctor before starting Contrave, as a dose adjustment or alternative treatment may be necessary.
2. Can Celexa and buPROPion be taken together?
Celexa (citalopram) and bupropion are sometimes prescribed together, but this combination requires careful monitoring. While both medications are used to treat depression, they act on different neurotransmitters—Celexa primarily affects serotonin, while bupropion impacts dopamine and norepinephrine. Taking them together may increase the risk of seizures, especially in patients with seizure disorder, bipolar disorder, or other neurological conditions. There is also a potential for high blood pressure or mood instability.
If these medications are prescribed together, patients should be monitored for trouble sleeping, restlessness, and changes in blood pressure. Always tell your doctor about any side effects that arise.
3. What medications should not be taken with Contrave?
Several medications should not be taken with Contrave due to the risk of severe drug interactions.
These include:
- Opioid medications (e.g., oxycodone, morphine, fentanyl) – Contrave contains naltrexone, which blocks opioid receptors, potentially causing opioid withdrawal if taken together.
- Monoamine oxidase inhibitors (MAOIs) (e.g., phenelzine, selegiline) – These drugs can lead to dangerous blood pressure spikes and serotonin syndrome when combined with Contrave.
- Other drugs that lower seizure threshold (e.g., antipsychotics, steroids, certain antibiotics) – Combining them with Contrave may increase the risk of seizures.
- Stimulants and amphetamines (e.g., Adderall, Ritalin) – These can exacerbate Contrave’s effects on blood pressure and the central nervous system, increasing the likelihood of hypertension, anxiety, or heart issues.
Because Contrave contains bupropion and naltrexone, it’s crucial to tell your doctor about all other drugs and over-the-counter medications you’re taking.
4. What Cannot be taken with Celexa?
Several medications should not be taken with Celexa due to the risk of dangerous interactions.
These include:
- Other antidepressants, especially MAOIs – Combining Celexa with MAOIs or other SSRIs/SNRIs can lead to serotonin syndrome, a life-threatening condition.
- NSAIDs and blood thinners (e.g., aspirin, warfarin) – Celexa can increase the risk of bleeding, particularly in patients using blood thinners.
- Certain heart medications – Drugs that prolong the QT interval (e.g., amiodarone, sotalol) can increase the risk of irregular heart rhythms when taken with Celexa.
- St. John’s Wort – This herbal supplement can increase serotonin levels, heightening the risk of serotonin syndrome.
Patients should always tell their doctor about all medications and supplements they are taking before starting Celexa.
5. Can you take citalopram with Contrave?
Taking citalopram (Celexa) with Contrave can be dangerous due to their combined effects on neurotransmitters and blood pressure. Bupropion in Contrave lowers the seizure threshold, while citalopram can prolong the QT interval, increasing the risk of serious heart rhythm issues. Additionally, both drugs impact serotonin levels, which may increase the risk of serotonin syndrome if taken together.
Patients with a history of seizures, heart conditions, or high blood pressure should avoid taking these medications together unless advised by their doctor. If prescribed both, close monitoring of blood pressure, heart function, and neurological symptoms is essential to reduce the risk of serious side effects.
Conclusion
The Contrave interactions with Celexa pose risks that require careful monitoring. Individuals considering this combination should consult a healthcare professional to determine if a dose adjustment is needed or if alternative medications should be considered. Tell your doctor immediately if experiencing severe hepatic impairment, eye pain, or signs of an allergic reaction.
Understanding these interactions before starting Contrave treatment is crucial to ensuring a safe and effective treatment regimen for chronic weight management while minimizing the risk of seizures and high blood pressure.
References
Pharmacy & Therapeutics Journal
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:
- Talk with your doctor before starting Contrave, especially if you have high blood pressure, mental health conditions, or a history of seizure disorder.
- Avoid high-fat meals, which can increase the risk of gastrointestinal side effects.
- Limit alcohol consumption – drink alcohol sparingly or avoid it altogether while taking Contrave to prevent life-threatening interactions.
- 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
The Food and Drug Administration (FDA)
Contrave and Antibiotics Drug Interactions: What to Know
Contrave, a combination of bupropion and naltrexone, is prescribed to assist with weight loss in certain adults who are struggling with obesity or overweight conditions accompanied by related health issues. Understanding potential Contrave and antibiotics drug interactions is crucial for ensuring patient safety and therapeutic efficacy.
This article explores specific antibiotics known to interact with Contrave, the mechanisms behind these interactions, and essential considerations for patients and healthcare providers.
Key Takeaways:
- Specific Antibiotic Interactions: Certain antibiotics, such as clarithromycin, can interact with Contrave, potentially increasing the risk of side effects.
- Health Monitoring: Patients should monitor their blood pressure and blood sugar levels while on Contrave, especially when taking other medications.
- Consult Healthcare Providers: It’s imperative to inform your doctor about all medications you’re taking to manage potential drug interactions effectively.
Understanding Contrave and Its Components
Contrave is a prescription medication designed to assist with weight loss in compatible adults with obesity or those who are overweight and have at least one weight-related health condition, such as high blood pressure, type 2 diabetes, or high cholesterol.
Take Contrave as part of a reduced-calorie diet and exercise plan to maximize results. How does Contrave work for weight loss?
Contrave contains two active ingredients that work together to affect the brain’s appetite control and reward system:
- Bupropion – This medication is classified as an atypical antidepressant and is also used to treat depression and bipolar disorder in some cases. Bupropion inhibits the reuptake of norepinephrine and dopamine, two neurotransmitters involved in regulating mood, energy levels, and hunger. By increasing the availability of these neurotransmitters, bupropion helps reduce food cravings and can contribute to appetite suppression. However, this mechanism may also increase the risk of suicidal thoughts, which is why Contrave carries a boxed warning alerting doctors to this possibility, particularly in younger patients.
- Naltrexone – Commonly used to help people with opioid withdrawal and alcohol dependence, naltrexone works as an opioid antagonist. It blocks opioid receptors in the brain, reducing the pleasure associated with eating highly palatable foods. This action helps limit binge-eating behaviors and promotes better portion control.
It is important to note that individuals who suddenly stop drinking alcohol while taking Contrave may face an increased risk of seizures. This is particularly relevant for those with alcohol use disorder, as abruptly ceasing alcohol consumption can lead to severe withdrawal symptoms.
Therefore, healthcare providers may advise against taking Contrave during this period. Patients who have suddenly stopped drinking alcohol should inform their healthcare provider, as this can influence the decision to prescribe Contrave due to the heightened risk of seizures.
According to the FDA, Contrave’s combination of these two ingredients alters the brain’s hunger and reward responses, making it easier for individuals to adhere to dietary changes necessary for weight loss (FDA).
While effective, Contrave is not suitable for everyone. Individuals with seizure disorder, severely high blood pressure, or a history of certain drug interactions should avoid taking it, as these conditions may increase the risk of serious side effects, including irregular heartbeat and chest pain. Additionally, high-fat meals should be avoided while taking Contrave, as they can increase the risk of side effects by altering the absorption rate of the medication.
Patients should always tell their doctor about any medications they are currently taking, including over-the-counter drugs and other medicines, to minimize possible interactions that could compromise safety or effectiveness.
Antibiotics and Contrave Interactions
Certain antibiotics may interact with Contrave, potentially increasing the risk of side effects or diminishing the drug’s effectiveness. If you are prescribed antibiotics while taking Contrave, it is crucial to inform your doctor. They may recommend alternative antibiotics or adjust your Contrave dosage to minimize interactions.
For example, antibiotics like clarithromycin can affect liver function, which may be compounded by naltrexone in Contrave. Additionally, linezolid, an antibiotic with monoamine oxidase inhibitor (MAOI) properties, can interact with bupropion, increasing the risk of hypertensive reactions.
Open communication with your healthcare provider ensures that any necessary adjustments are made to maintain the safety and efficacy of your treatment plan.
Note: While clarithromycin and linezolid are identified as antibiotics that may interact with Contrave, specific interactions with other antibiotics are not well-documented. (Drugs.com) Therefore, it’s essential to consult your healthcare provider regarding any antibiotics prescribed during Contrave treatment.
Understanding Contrave and Drug Interactions
Contrave is a prescription medication that combines two active ingredients, bupropion and naltrexone, to aid in weight loss and weight management. As with any medication, understanding how Contrave interacts with other drugs is crucial.
Drug interactions can increase the risk of side effects, reduce the effectiveness of Contrave, or even lead to serious health problems. This includes interactions with prescription medications, over-the-counter (OTC) drugs, vitamins, and supplements. For instance, certain drug interactions may affect how Contrave is metabolized in the body, potentially leading to increased side effects or diminished therapeutic effects.
Thus, it’s crucial to inform your healthcare provider about all the medications and supplements you are taking to effectively manage these interactions.
Health History and Conditions
Before starting Contrave, it’s vital to discuss your health history and any existing conditions with your doctor. Certain health conditions, such as high blood pressure, eating disorders, or a history of seizures, can influence how Contrave works or increase the risk of adverse effects.
For example, individuals with high blood pressure need careful monitoring as bupropion, one of the components of Contrave, can elevate blood pressure. Similarly, those with a history of eating disorders or seizures may face heightened risks when taking Contrave.
Your doctor will evaluate your health history to determine if Contrave is a safe and suitable option for you, ensuring that any potential risks are managed appropriately.
Medications that Interact with Contrave
Several medications can interact with Contrave, leading to increased risks of side effects or reduced effectiveness. Notable interactions include:
- Opioids: Combining Contrave with opioids like morphine, codeine, or fentanyl can lead to side effects such as nausea, vomiting, and dizziness. Naltrexone, a component of Contrave, blocks opioid receptors, which can precipitate withdrawal symptoms in individuals dependent on opioids.
- Monoamine Oxidase Inhibitors (MAOIs): Contrave can interact with MAOIs, which can cause serious side effects, including high blood pressure and seizures. Therefore, it is recommended that MAOIs be avoided for at least 14 days before and after Contrave.
- Certain Antidepressants: Taking Contrave with selective serotonin reuptake inhibitors (SSRIs) or other antidepressants, such as Effexor, Lexapro, Zoloft, Cymbalta, and Prozac, can increase the risk of side effects like nausea and dizziness. This is due to the combined effects on neurotransmitter levels in the brain.
- Beta-blockers: Contrave combined with beta-blockers can elevate the risk of high blood pressure and heart rate issues. This interaction necessitates careful monitoring and possible dosage adjustments. See our guide for more about how Contrave can increase blood pressure.
Always keep your healthcare provider informed about all the medications you are currently taking to avoid potential interactions and ensure the safe use of Contrave.
Monitoring and Precautions
Your doctor will monitor your progress and adjust your dosage as needed to ensure the safe and effective use of Contrave. It is essential that you adhere to your doctor’s instructions and attend regular follow-up appointments.
Additionally, be aware of the following precautions:
- Allergic Reactions: If you notice signs of an allergic reaction, such as hives, itching, or difficulty breathing, seek medical help right away. A serious allergic reaction can be severe and require prompt treatment.
- Serious Skin Reactions: Contrave can cause serious skin reactions, including Stevens-Johnson syndrome. Symptoms like blistering, peeling, or loosening of the skin necessitate immediate medical attention.
- Low Blood Sugar: Contrave can increase the risk of low blood sugar in individuals with diabetes. To prevent hypoglycemia, monitor your blood sugar levels regularly and adjust your treatment plan as needed.
- Bipolar Disorder: Contrave can increase the risk of manic episodes in people with bipolar disorder. If you have a history of bipolar disorder, inform your doctor before starting Contrave to manage this risk effectively.
- Opioid Withdrawal: Contrave can precipitate opioid withdrawal symptoms. If you are taking opioids, inform your doctor to ensure appropriate management and avoid withdrawal complications.
By understanding Contrave and its interactions with other medications, you can minimize the risk of side effects and ensure the safe and effective use of the medication.
To optimize your treatment plan, always inform your doctor about your health history, medications, and any concerns you may have.
Frequently Asked Questions (FAQ) About Contrave and Drug Interactions
Understanding how Contrave interacts with other medications is essential for ensuring both safety and effectiveness.
Below are answers to common questions regarding Contrave and potential drug interactions. If you have concerns about a specific medication, always consult your healthcare provider before making any changes to your treatment plan.
1. What medications should not be taken with Contrave?
Certain medications should be avoided while taking Contrave due to the risk of serious drug interactions. Monoamine oxidase inhibitors (MAOIs), such as phenelzine and tranylcypromine, should not be taken within 14 days of starting or stopping Contrave due to the risk of hypertensive reactions. Opioid-based medications, including oxycodone and morphine, should also be avoided since naltrexone blocks opioid receptors, potentially leading to withdrawal symptoms.
Additionally, medications that lower the seizure threshold, such as antipsychotics and corticosteroids, may increase the risk of seizures when taken with Contrave. Always tell your doctor about all other medications you are taking, including over-the-counter drugs, to prevent possible interactions.
2. Can I take azithromycin with Contrave?
Azithromycin, a commonly prescribed antibiotic, is not known to have any serious drug interactions with Contrave. However, some individuals may experience gastrointestinal side effects, such as nausea or upset stomach, which could be compounded by Contrave.
Additionally, since Contrave contains bupropion, which can increase blood pressure, patients who have high blood pressure or heart conditions should consult their healthcare provider before taking both medications together.
If you experience any unusual symptoms, such as dizziness, chest pain, or rapid heart rate, contact your doctor immediately.
3. Can you take ibuprofen while taking Contrave?
Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), is generally safe to use with Contrave, but some precautions should be considered. Both ibuprofen and Contrave have the potential to impact the liver, particularly in individuals with preexisting liver conditions or those who drink alcohol frequently.
Additionally, NSAIDs like ibuprofen can elevate blood pressure, so individuals with severely high blood pressure or a history of cardiovascular issues should use ibuprofen cautiously. If long-term pain management is needed, it is best to discuss other medicines or alternative treatment options with a healthcare provider.
4. Is it okay to take amoxicillin with bupropion?
Amoxicillin, a widely used antibiotic, does not have a life-threatening interaction with bupropion, one of Contrave’s active ingredients. However, both medications can cause gastrointestinal discomfort, and in rare cases, serious skin reactions, such as rashes or hives, may occur.
While there is no direct contraindication, patients with a history of a serious allergic reaction to either medication should proceed with caution.
If you experience symptoms such as skin rash, swelling, or flu-like symptoms, seek medical attention promptly.
Conclusion
Understanding how Contrave and antibiotics drug interactions can affect treatment outcomes is essential for ensuring safety and effectiveness. While most antibiotics do not significantly interact with Contrave, certain medications—such as clarithromycin and linezolid—can increase the risk of side effects like liver damage, elevated blood pressure, and seizures.
Patients should always tell their doctor about any other drugs they are taking, including over-the-counter drugs, to manage possible interactions effectively.
Additionally, those with health conditions such as high blood pressure, seizure disorder, or bipolar disorder should exercise caution when starting Contrave treatment. Taking Contrave safely requires dose adjustments in some cases, particularly when using medications that may interact with Contrave or affect its metabolism.
By following your healthcare provider’s guidance, monitoring for potential side effects, and staying informed about certain drug interactions, patients can minimize risks and optimize the benefits of Contrave as part of their weight loss journey.
