Contrave for weight loss: results, side effects and cost

Contrave is a prescription pill that combines naltrexone and bupropion to help adults lose weight and keep it off, alongside a reduced-calorie diet and more activity. In its main 56-week trial, people on the full dose lost 5.4% of their body weight on average, against 1.3% on placebo, and as of October 27, 2026 the maker sells it for $99 a month through its mail-order program.

It works differently from GLP-1 medications such as Wegovy or Foundayo, costs less than most of them, and loses less weight on average in trials. Below is what the label says about results, side effects and who shouldn’t take it, then how it compares with phentermine and the GLP-1 pills.

The boxed warning comes first

Contrave carries a boxed warning for suicidal thoughts and behaviors. One of its two ingredients, bupropion, is also sold as an antidepressant, and antidepressants raised the risk of suicidal thinking and behavior in children, teens and young adults in short-term trials. The label says to watch anyone starting Contrave closely for worsening mood or new suicidal thoughts, at any age, and asks families and caregivers to keep in touch with the prescriber. Contrave isn’t approved for anyone under 18.

In the weight-loss trials themselves, which ran up to 56 weeks, no suicides or suicide attempts were reported. Suicidal thoughts were reported by 1 of 3,239 people on Contrave (0.03%) and 3 of 1,515 on placebo (0.20%). Tell your clinician about any history of depression or other mental health conditions before you start.

What Contrave is and who it’s for

Contrave, approved by the FDA in 2014 and sold by Currax Pharmaceuticals, is an extended-release tablet with 8 mg of naltrexone and 90 mg of bupropion. Naltrexone blocks opioid receptors, and bupropion is a weak blocker of dopamine and norepinephrine reuptake. The label says the pair seems to act on two brain areas that govern eating, the hypothalamus (appetite) and the reward system, though the exact way it causes weight loss isn’t fully understood.

It’s approved, with diet and exercise, for long-term weight management in adults with obesity or overweight in the presence of at least one weight-related condition. Its trials enrolled people with a BMI of 30 or more, or 27 or more with high blood pressure or high cholesterol. Its effect on heart attacks and strokes hasn’t been established.

DailyMed lists no DEA schedule for Contrave, so it isn’t a controlled substance. That matters online: the special DEA telemedicine rules that apply to phentermine don’t apply to it.

How to take Contrave

You build up to the full dose over four weeks to limit nausea.

The full dose is 32 mg of naltrexone and 360 mg of bupropion a day, and the label advises against going higher. Swallow the tablets whole, without cutting, chewing or crushing them. The trials gave Contrave with meals, but the label warns against taking it with a high-fat meal, which sharply raises the levels of both drugs and with them the seizure risk.

The label also sets a stopping rule: check your progress after 12 weeks at the full dose, and stop if you haven’t lost at least 5% of your starting weight, because you’re unlikely to reach meaningful weight loss by continuing. People with moderate or severe kidney problems, or moderate liver problems, have a lower maximum of one tablet twice a day.

Contrave for weight loss: what the trials found

Four 56-week trials tested Contrave in 4,536 people. In each, everyone also got diet and activity advice.

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About one person in five on Contrave in COR-I lost 10% or more (21%, against 7% on placebo). Nearly half of everyone left the trials before week 56 (46% on Contrave, 45% on placebo), most of them within the first 12 weeks.

Contrave side effects

These were the most common side effects across the placebo-controlled trials, at the full dose.

Side effects led 24% of people on Contrave to stop, against 12% on placebo, most often for nausea (6.3%), headache (1.7%) and vomiting (1.1%).

The label’s other warnings are worth knowing before you start:

• Seizures. Bupropion can cause seizures, and the risk rises with dose. Seizures occurred in about 0.1% of people on Contrave in the trials, against none on placebo.
• Blood pressure and heart rate. Both can rise, especially in the first three months. Heart rate ran 1.7 beats a minute higher than placebo at week 52.
• Opioids. Naltrexone blocks opioid pain medicines. Trying to overcome that block with large opioid doses can cause a fatal overdose, and after stopping Contrave you may be more sensitive to opioids, even at lower doses.
• Liver. Hepatitis and liver problems have been reported with naltrexone.

Who shouldn’t take Contrave

The label rules Contrave out if you have uncontrolled high blood pressure, a seizure disorder or history of seizures, anorexia or bulimia, or chronic use of opioids (including methadone and buprenorphine). It also rules it out with any other bupropion product, with an MAOI antidepressant taken within the past 14 days, and while abruptly stopping alcohol, benzodiazepines, barbiturates or antiseizure drugs.

What Contrave costs

Currax publishes its prices on its savings page, read October 27, 2026:

• CurAccess home delivery: $99 a month with free shipping, through its partner mail-order pharmacy, whether or not you have insurance. If your plan covers Contrave, you may pay less. Medicare Part D, Medicaid and TRICARE members can use it, but the fill is processed as a cash purchase.
• Savings card at a retail pharmacy: with private insurance that covers Contrave, as little as $0. Without coverage, the card offers a cash price of $199 for 120 tablets, which is one month at the full dose. Medicaid members can’t use the card.

At $99 a month, a year of Contrave comes to $1,188 for the medication. The FDA-approved GLP-1 pills cost more: the Wegovy pill is $149 to $299 a month at NovoCare by dose, and Foundayo is $149 to $299 at LillyDirect, where the $299 price at 14.5 mg and 17.2 mg needs a refill within 45 days (both read October 27, 2026).

Contrave vs phentermine

Both are pills, and both are older and cheaper than the GLP-1s, but the rules around them differ.

The phentermine label says the extra weight loss over placebo in its short trials was “only a fraction of a pound a week,” and that tolerance to its appetite effect usually develops within a few weeks. Because it’s a controlled substance, online prescribing relies on a temporary DEA rule that runs through December 31, 2026 (Federal Register). Contrave isn’t covered by that rule because it isn’t controlled. Our guide to phentermine online covers the rules and Qsymia, the long-term phentermine and topiramate capsule.

Contrave vs GLP-1 medications

These results come from separate trials with different people and lengths, so they aren’t a head-to-head comparison.

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Trial figures come from the Qsymia, Foundayo and Wegovy labels. GLP-1 labels carry a different boxed warning, for thyroid C-cell tumors, and aren’t for people with a personal or family history of medullary thyroid carcinoma or MEN 2. Contrave’s label has no such warning, which is one reason a clinician might consider it when a GLP-1 is ruled out.

Who Contrave may suit

Contrave may be worth asking about if:

• A GLP-1 isn’t an option for you, because of your thyroid history, your budget or how you tolerate them.
• You want a medication labeled for long-term use that isn’t a controlled substance.
• You don’t take opioids and have no history of seizures or eating disorders, and your blood pressure is controlled.

It may not suit you if you need opioid pain medicine, already take bupropion, or are aiming for the larger average results seen with GLP-1s. Our Ozempic alternatives guide compares more options, and our GLP-1 rankings compare online programs for GLP-1 treatment.

The bottom line

Contrave is a long-term weight-loss pill with modest average results (5.4% in COR-I) and a lower price than the GLP-1 pills, at $99 a month by mail as of October 27, 2026. Its boxed warning for suicidal thoughts, its seizure risk and its conflict with opioids mean it isn’t for everyone. Bring your full medication list and mental health history to a licensed clinician, and plan to judge it at the 12-week mark the label sets.