From the Research
Contrave (bupropion and naltrexone) is generally considered safe for patients with Glucose-6-phosphate dehydrogenase (G6PD) deficiency. Neither bupropion nor naltrexone has been specifically identified as medications that trigger hemolytic anemia in G6PD-deficient individuals, as noted in a comprehensive review of medications and G6PD deficiency 1. Unlike medications such as certain antibiotics, antimalarials, and sulfonamides that are known to cause oxidative stress and hemolysis in G6PD deficiency, Contrave works through different mechanisms affecting dopamine/norepinephrine reuptake and opioid receptors.
The most recent and highest quality study on this topic, published in 2023, provides an expanded clinical pharmacogenetics implementation consortium guideline for medication use in the context of G6PD genotype, which can help inform decisions about medication safety in patients with G6PD deficiency 2. However, this study does not specifically mention Contrave as a medication that should be avoided in patients with G6PD deficiency.
Some key points to consider when prescribing Contrave to patients with G6PD deficiency include:
- Informing the healthcare provider about the patient's G6PD deficiency before starting Contrave
- Monitoring for unusual symptoms such as fatigue, jaundice, or dark urine that might indicate hemolysis
- Weighing the benefits of Contrave for weight loss against any potential risks based on the patient's complete medical history and other medications they may be taking
- Being aware of the potential for individual responses to vary, as noted in studies on G6PD deficiency and hemolytic anemia 3, 4.
Overall, the available evidence suggests that Contrave can be safely used in patients with G6PD deficiency, but with careful monitoring and consideration of individual patient factors.