What is the starting dose of Contrave (naltrexone-bupropion)?

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Last updated: April 10, 2025View editorial policy

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From the Guidelines

The starting dose of Contrave is one tablet (naltrexone 8 mg/bupropion 90 mg) taken once daily in the morning for the first week, as recommended by the most recent guidelines 1. This initial low dose allows your body to adjust to the medication while minimizing side effects like nausea, headache, and insomnia.

Key Points to Consider

  • After the first week, the dose increases to one tablet twice daily (morning and evening) for week 2.
  • In week 3, the dose increases to two tablets in the morning and one in the evening.
  • By week 4, you reach the target maintenance dose of two tablets twice daily (total of four tablets per day).

Importance of Gradual Titration

This gradual titration schedule is important because it helps reduce the risk of adverse effects while allowing the medication to reach therapeutic levels.

Administration Instructions

Contrave should be taken with food and swallowed whole, not crushed or chewed, as this could affect how the medication is released in your body.

Monitoring and Adjustment

If you experience significant side effects during dose escalation, your healthcare provider may recommend staying at a lower dose longer before increasing, as indicated in the study 1.

From the Research

Contrave Start Dose

  • The start dose for Contrave, which is a combination of naltrexone and bupropion, is not explicitly stated in the provided studies.
  • However, according to the study 2, the combination of naltrexone 32 mg and bupropion 360 mg acts on the mesolimbic reward pathway and the hypothalamic hunger system, and is approved for chronic weight management in adults with obesity or overweight and ≥1 weight-related comorbidity.
  • The study 3 mentions that there are currently five approved medications for the chronic management of obesity, including naltrexone/bupropion, but does not provide information on the start dose.
  • Another study 4 compares the cost-effectiveness of different antiobesity medications, including naltrexone-bupropion, but does not provide information on the start dose.
  • The study 5 discusses the use of weight loss medications, including naltrexone/bupropion, in the treatment of obesity and hypertension, but does not provide information on the start dose.
  • The study 6 reviews the currently available and anticipated medications for chronic weight management, but does not provide information on the start dose of Contrave.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Review of pharmacotherapy options for the management of obesity.

Journal of the American Association of Nurse Practitioners, 2016

Research

Drugs for Treating Obesity.

Handbook of experimental pharmacology, 2022

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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