What are the interactions between Contrave (bupropion and naltrexone) and Klonopin (clonazepam) when taken together?

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Last updated: April 10, 2025View editorial policy

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From the Research

Taking Contrave (naltrexone/bupropion) and Klonopin (clonazepam) together is generally not recommended without close medical supervision. These medications can interact in ways that may increase side effects, particularly those affecting the central nervous system. Contrave can cause dizziness, insomnia, and anxiety, while Klonopin, a benzodiazepine, causes sedation and can depress breathing. When combined, these medications may lead to excessive drowsiness, impaired coordination, confusion, or respiratory depression. Additionally, bupropion (in Contrave) may reduce the effectiveness of clonazepam through liver enzyme interactions.

Some key points to consider:

  • Bupropion has been associated with an increased risk of seizures, particularly at high doses or in combination with other medications that lower the seizure threshold 1, 2.
  • The combination of bupropion and clonazepam may increase the risk of adverse effects, including excessive sedation, respiratory depression, and seizures 3.
  • Alternative weight management strategies or anxiety treatments might be considered to avoid this potentially problematic combination.
  • If you're currently taking one of these medications and your doctor has prescribed the other, be sure to inform them about all medications you're taking. Never adjust dosages or stop either medication without medical guidance. Your doctor might need to monitor you more closely or adjust dosages if these medications must be used together.

It's also important to note that the risk of major adverse cardiovascular events (MACE) with the use of Contrave has been evaluated in several studies, and the available evidence does not indicate an increased risk of CV events or MACE following use of naltrexone/bupropion ER, naltrexone with bupropion, or the individual components 4. However, this does not necessarily mean that the combination of Contrave and Klonopin is safe, as the potential for adverse interactions and side effects still exists.

In terms of benzodiazepine use, it's worth noting that these medications can be associated with dependence and withdrawal symptoms, and their use should be carefully monitored and tapered as needed 5. The combination of Contrave and Klonopin may increase the risk of adverse effects, and alternative treatments should be considered to minimize this risk.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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