From the Guidelines
Contrave contains 90 mg of bupropion XL (extended-release) per tablet, which is equivalent to the standard 150 mg dose of bupropion XL when prescribed alone, as indicated by the dosing information provided in the study 1. This means that two tablets of Contrave provide 180 mg of bupropion XL, which is comparable to the 300 mg dose of bupropion XL when used as a standalone medication. The medication combines bupropion XL with 8 mg of naltrexone per tablet, creating a dual-mechanism medication primarily used for weight management. The dosing schedule for Contrave typically involves a gradual titration, starting with one tablet in the morning for the first week, then adding a second tablet in the evening for week two, followed by two tablets in the morning and one in the evening for week three, and finally two tablets twice daily from week four onward, as outlined in the study 1. This gradual increase helps minimize side effects like nausea, headache, and insomnia that can occur with bupropion. Some key points to consider when prescribing Contrave include:
- The bupropion component works by affecting dopamine and norepinephrine levels in the brain, while naltrexone blocks opioid receptors, together reducing hunger and food cravings more effectively than either medication alone.
- The medication should be avoided in patients with uncontrolled hypertension, seizure disorder, or those taking monoamine oxidase inhibitors, as noted in the study 1.
- Patients should be monitored for vital signs and observed for neuropsychiatric adverse effects, including suicidal thoughts and behaviors, especially in individuals younger than 24 years, as cautioned in the study 1.
- The long-term cardiovascular safety of naltrexone-bupropion ER remains unclear, and patients should be counseled on the potential risks and benefits, as discussed in the study 1. Additionally, a more recent study 1 provides further information on the medication, including its mechanism of action, dosing, and potential side effects, but the key information regarding the bupropion XL dose equivalent in Contrave remains consistent with the findings of the earlier study 1.
From the Research
Bupropion XL Dose Equivalent in Contrave
- The dose of bupropion in Contrave is 90 mg, which is a combination of naltrexone hydrochloride extended release and bupropion hydrochloride extended release 2.
- Bupropion XL (extended release) is administered once daily, and its efficacy was established in two of six well-designed placebo-controlled studies 3.
- The bioequivalence of bupropion formulations, including XL, suggests that the 90 mg dose in Contrave may be equivalent to the XL formulation 3.
- However, the exact dose equivalent of bupropion XL in Contrave is not explicitly stated in the provided studies.
- Studies have shown that Contrave, which contains 90 mg of bupropion, is effective for weight loss and improves cardiometabolic markers 4.
- Bupropion has been used as an antidepressant for over 20 years, and its unique pharmacology inhibiting the reuptake of noradrenaline and dopamine makes it a potential option for treating depression 5.
- The efficacy and safety of bupropion, including its extended-release formulation, have been established in various studies, but the specific dose equivalent in Contrave requires further clarification 3, 6, 5.