Question 1

Can I cut or crush Contrave tablets?

Accepted Answer

No. The FDA label says Contrave tablets should not be cut, chewed or crushed. They are extended-release tablets, so breaking them changes how the medicine is released. The Medication Guide says to tell your healthcare provider if you cannot swallow the tablets whole.

Question 2

Why does the label warn about high-fat meals?

Accepted Answer

The label says Contrave should not be taken with a high-fat meal because that produces a significant increase in how much bupropion and naltrexone reach the bloodstream. Avoiding high-fat meals is listed in the label among the steps that reduce the risk of seizure.

Question 3

What is the highest dose of Contrave?

Accepted Answer

Two tablets in the morning and two in the evening — 32 mg of naltrexone and 360 mg of bupropion a day. The label says total daily doses greater than that are not recommended, and the Medication Guide says not to take more than two tablets at the same time or more than four tablets in one day.

Question 4

How long before it is clear whether Contrave is working?

Accepted Answer

The label says to evaluate response after 12 weeks at the maintenance dose. If a patient has not lost at least 5% of starting body weight, it says to discontinue Contrave, because it is unlikely that continued treatment will produce and sustain clinically meaningful weight loss.

Question 5

Does kidney or liver disease change the dose?

Accepted Answer

Yes. In moderate or severe renal impairment the label caps the maximum daily dose at two tablets — one each morning and evening — and says Contrave is not recommended in end-stage renal disease. In moderate hepatic impairment the same two-tablet cap applies, and Contrave is not recommended in severe hepatic impairment.

Question 6

Do other medicines change my Contrave dose?

Accepted Answer

Some do. The label says the maximum daily dose is two tablets during concomitant use of CYP2B6 inhibitors such as ticlopidine or clopidogrel, because these raise bupropion exposure. It also says at least 14 days should pass between stopping a monoamine oxidase inhibitor and starting Contrave, and between stopping Contrave and starting an MAOI.

Contrave dosage — the four-week step up

Your step-up schedule

Starting dose vs maximum dose

Weight loss at each dose

When your doctor might change your dose

Reduced kidney or liver function

Taking clopidogrel or ticlopidine

Twelve weeks at the full dose

Common questions

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