Naltrexone + Bupropion Weight Loss
Combination therapy — known by the brand name Contrave — prescribed and monitored by our physicians, using brand-name or compounded alternatives as clinically appropriate.
How This Combination Works
Craving & Reward Control
Naltrexone acts on the brain's reward pathway to reduce food cravings and the pull of highly palatable foods.
Help With Emotional Eating
Bupropion supports appetite regulation, mood, and energy, which is why this pairing suits stress and emotional eating patterns.
Physician-Prescribed & Monitored
We prescribe naltrexone/bupropion — brand-name or a compounded alternative — with structured follow-up and blood pressure monitoring.
What to Expect
Medical Evaluation
We review BMI, blood pressure, mood and mental health history, seizure risk, alcohol use, and any current or recent opioid use.
Four-Week Dose Escalation
Dosing starts at one tablet daily and steps up weekly over about four weeks to the maintenance dose, which limits nausea and headaches.Ongoing Follow-Up
Monthly visits track weight, blood pressure, mood, and tolerability, with dose adjustments and nutrition coaching along the way.Candidacy & Safety
You May Be a Good Candidate If
- BMI of 30 or higher, or 27 or higher with a weight-related condition such as type 2 diabetes, hypertension, or high cholesterol
- Cravings, snacking, or emotional eating are the main barriers to progress
- Prefers an oral medication over an injectable option
- Not using opioid medication and has no history of seizures
Safety & Monitoring
- Blood pressure and heart rate are checked before starting and at every visit
- Mood, sleep, and anxiety are screened at each follow-up
- No opioid pain medication while on treatment — tell all providers you take naltrexone
- Limit or avoid alcohol during treatment
- Not for use during pregnancy or breastfeeding
Denton Family Practice Clinic does not sell brand-name medication. Our providers evaluate, prescribe, and monitor naltrexone/bupropion therapy or an appropriate compounded alternative dispensed by a licensed pharmacy. Brand names are referenced for identification only.
Frequently Asked Questions
What is naltrexone/bupropion (Contrave)?
It is a sustained-release oral combination of naltrexone, used for craving control, and bupropion, an appetite- and mood-related agent. It is FDA-approved for chronic weight management. We prescribe and monitor this therapy — brand-name or a compounded alternative — we do not sell medication.
How much weight do people lose on it?
In clinical trials, patients who stayed on treatment lost roughly 5–9% of body weight at one year. Results are strongest when paired with structured nutrition and activity changes.
How long until it starts working?
Craving reduction is often noticed within the first few weeks as the dose is stepped up. Providers typically reassess at about 12 weeks; if you have not lost at least 5% of body weight, the plan is changed.
What are the common side effects?
Nausea, constipation, headache, dizziness, insomnia, and dry mouth are the most common. They are usually worst during dose escalation and settle over time.
Who should not take it?
It is not appropriate with a seizure disorder, uncontrolled hypertension, current opioid use or opioid dependence, eating disorders such as bulimia or anorexia, abrupt alcohol or sedative withdrawal, or MAO inhibitor use, or during pregnancy.
Does it cause mood changes?
Bupropion-containing products carry a warning about suicidal thoughts and behaviors, particularly in younger adults. e screen mental health history before prescribing and monitor mood at every follow-up. Report any new or worsening mood symptoms immediately.
Can I take pain medication while on it?
Naltrexone blocks opioid pain medication, so opioids should not be used during treatment. Tell every provider you are on naltrexone, especially before surgery or an emergency.
Can I drink alcohol on it?
Alcohol should be limited or avoided. It increases seizure risk with bupropion and works against your weight-loss goals.
How does it compare with a GLP-1 medication?
GLP-1 therapies generally produce greater average weight loss, but naltrexone/bupropion is an oral, non-injectable option that is often a better fit for craving-driven or emotional eating, or when a GLP-1 is not tolerated, covered, or available.
What is a compounded alternative?
When brand-name therapy is unavailable or cost-prohibitive, your provider may prescribe the individual generic components or an appropriate compounded formulation from a licensed pharmacy, and will explain the differences before you start.
What happens if I stop?
Cravings tend to return and some weight regain is common without a maintenance plan, so we set nutrition, activity, and follow-up strategy in place before any planned stop.
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