Contrave
Contrave is a prescription medication manufactured by Bausch Health, Canada Inc. It was approved by Health Canada on March 26, 2018 for weight management. The drug is indicated as an adjunct to a reduced-calorie diet and increased physical activity for adults who are:
- Obese – initial body mass index (BMI) ≥ 30 kg/m².
- Overweight – BMI ≥ 27 kg/m² with at least one weight-related comorbidity (for example, hypertension, type 2 diabetes mellitus, or dyslipidaemia).
The drug comes in extended-release oral tablets. Each tablet contains 8 mg naltrexone hydrochloride and 90 mg bupropion hydrochloride.[1]
Mechanism: Contrave works on both the hypothalamus (reducing hunger signals) and the brain’s reward-system (reducing cravings) via its dual-component action: bupropion (a reuptake inhibitor of dopamine and norepinephrine) and naltrexone (an opioid antagonist).
Buying Contrave Online
In Canada, you can obtain Contrave through telemedicine platforms combined, though a valid prescription remains mandatory. The online service begins with a secure questionnaire: your weight, BMI, medical history, current medications, comorbidities and diet-/exercise status are submitted. Next, a provincial-licensed physician reviews your information, assesses whether your BMI and comorbidity meet the official indication for Contrave, and evaluates contraindications (for example opioid use or history of seizures). If approved, the prescription is electronically forwarded to a Canadian-licensed dispensing pharmacy, which then ships the medication to your home address or arranges a pickup. This route offers convenience, especially for people who live remote or cannot attend in-person visits – but it still involves a full medical consultation and prescription process. Accessing the drug without this structure would bypass the regulatory safeguards that guarantee your indication and suitability.
Contrave Without a Prescription?
Contrave is strictly a prescription-only medicine in Canada. The fact that you use a tele-medicine platform does not change the requirement for a valid prescription. If a website offers Contrave without any medical evaluation, it does not adhere to Canadian regulation. A legitimate tele-medicine model includes: detailed medical history review, screening of contraindications (for instance opioid use, seizure history, eating-disorders), prescription issuance based on licensed provider judgement. Buying Contrave directly without these steps risks counterfeit or substandard products, lack of appropriate monitoring (e.g., blood pressure, liver function, mental health changes) and potentially dangerous interactions (notably with opioids or other bupropion-containing medications). Compliance with the regulatory process is essential for safety and efficacy.
Prices in Canada
The out-of-pocket cost of Contrave in Canada depends on pharmacy mark-ups, location, insurance coverage, and eligibility for savings programs. On the official Canadian site, there is mention of a savings/coupon card for patients to pay no more than $199 a month for a full bottle (120 tablets) if insurance does not cover.[2]
Private insurance or employer-sponsored plans may cover part or all of the cost if the indication is met and prior authorisation is granted, but many plans require specific criteria and still may deny coverage. Because public provincial formularies often consider weight-management drugs under restricted conditions, full coverage is not guaranteed.
Use and Outcomes
Contrave is taken by mouth and must be swallowed whole – never crushed, divided, or chewed. The tablets are extended-release, so damaging the coating can alter absorption and raise the risk of side-effects such as nausea or headache. Treatment begins gradually to let your body adjust to the bupropion/naltrexone combination. The maximum daily dose is 4 tablets (32 mg naltrexone / 360 mg bupropion). Tablets should be taken with meals, but not with high-fat food, since this may increase nausea and raise bupropion levels.
If a dose is missed, skip it and take the next one at the regular time – never double up. Because Contrave contains bupropion, taking extra doses can increase seizure risk. Contrave is used alongside a reduced-calorie diet and increased physical activity, not instead of them. The official indication emphasises adults with BMI ≥ 30 or BMI ≥ 27 with a weight-related comorbidity.
Clinical trials show modest but notable weight reduction: in COR-II studies, adults on Contrave achieved average weight losses of ≥5 % over 28 weeks – 55.6%, and 56 weeks – 50.5% vs placebo (17.5% and 17.1%).[3]
Side Effects and Contraindications
Contrave carries several important warnings and requires careful screening before use.
Common side effects:
- Nausea
- Constipation
- Headache
- Vomiting
- Dizziness
- Insomnia
- Dry mouth
- Diarrhoea
These symptoms often appear early in treatment and may lessen as the body adjusts to the medication.
Serious risks and contraindications:
- Seizures, especially in people with a history of epilepsy or those taking drugs that lower the seizure threshold.
- Opioid use or withdrawal – naltrexone blocks opioid receptors and can trigger acute withdrawal if opioids are present in the body.
- Uncontrolled hypertension (high blood pressure).
- History of eating disorders such as anorexia nervosa or bulimia.
- Use of monoamine oxidase inhibitors (MAOIs) within the previous 14 days.
Additional warnings specific to Canada:
- Possible increases in heart rate or blood pressure.
- Potential liver injury.
- Manic or hypomanic episodes in patients with bipolar disorder.
- Rare unmasking of Brugada syndrome (a genetic heart rhythm condition).
Patient Reviews of Contrave
Real-world reports on Contrave are mixed. One long-term user wrote: “Lost 50 pounds over 2 years… got me back to exercising” and noted no major side effects. Another reviewer highlighted early benefits but also headache/constipation during titration: “I have lost 35 pounds in 3 months… cravings have significantly subsided,” alongside mild side-effects.[4]
WebMD’s crowd data (hundreds of reviews) show a mid-range satisfaction score (3.5/5), reflecting both appetite control for some and tolerability issues for others.[5]
Alternatives
If Contrave is unsuitable due to cost, contraindications or lifestyle mismatch, alternatives exist. Newer GLP-1 agents (e.g., semaglutide or tirzepatide formulations) show larger average weight loss and different mechanisms. Older options include off-label medications or surgery in appropriate candidates. In every case the decision should align with your health profile, budget and long-term readiness.
Comparison with Xenical
Xenical (orlistat 120 mg, oral capsule) is alternative to Contrave.
- How it works: Xenical blocks GI lipases so 30% of dietary fat isn’t absorbed; Contrave acts centrally (bupropion/naltrexone) to dampen hunger and cravings.
- Dosing: Xenical is taken with each fat-containing main meal (up to three times daily). Contrave is titrated to 2 tablets twice daily.
- Effect size: Xenical delivers modest average losses when meals are low-fat; Contrave’s trials show moderate reductions with adherence.
- Side effects: Xenical – oily stools, urgency, reduced absorption of fat-soluble vitamins. Contrave – nausea, insomnia, headache; watch BP/HR and seizure risk.
- Who may prefer it: Those avoiding CNS-active meds, okay with strict low-fat eating and meal-time dosing; budget can also influence the choice.
FAQ
Yes. Contrave is a prescription-only medication. It cannot be sold or imported legally without a valid prescription from a licensed Canadian health-care provider. Even telemedicine services require a proper medical consultation before issuing one.
If you haven’t lost ≥5% of baseline body weight after 12 weeks at the maintenance dose, the product labelling advises discontinuation.
Limit or avoid alcohol. Bupropion can increase seizure risk, which is higher with heavy drinking or abrupt alcohol withdrawal.
Key issues:
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Opioids (including methadone, buprenorphine) – contraindicated; naltrexone blocks opioids.
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MAOIs – do not use within 14 days.
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Other bupropion-containing products (e.g., Wellbutrin, Zyban) – avoid duplication.
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Drugs that lower seizure threshold (e.g., some antipsychotics, tramadol) – use caution.
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CYP2D6 substrates (e.g., certain SSRIs/TCAs, beta-blockers) – bupropion inhibits CYP2D6 and may raise their levels.
No. Naltrexone will block opioid effects and can precipitate acute withdrawal. Patients must be opioid-free for an appropriate interval before starting.
It’s not recommended. Discuss contraception and plans for pregnancy before starting. If pregnancy occurs, stop and speak with your clinician promptly.
Store at room temperature (generally 15–30 °C). Keep in the original container, away from moisture and heat. Keep out of reach of children.
References
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1. Bausch Health, Canada Inc. PRODUCT MONOGRAPH INCLUDING PATIENT MEDICATION INFORMATION CONTRAVE. Canada; [August 21, 2023]. Retrieved November 7, 2025
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2. Contrave. Experience Contrave patient support program. Canada. Retrieved November 7, 2025
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3. Apovian CM, Aronne L, Rubino D, Still C, Wyatt H, Burns C, Kim D, Dunayevich E; COR-II Study Group. A randomized, phase 3 trial of naltrexone SR/bupropion SR on weight and obesity-related risk factors (COR-II). Obesity (Silver Spring). 2013 May;21(5):935-43. doi: 10.1002/oby.20309. PMID: 23408728; PMCID: PMC3739931. Retrieved November 7, 2025
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4. Drugs.com. Contrave User Reviews & Ratings. Retrieved November 7, 2025
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5. Webmd. User Reviews for Contrave (naltrexone/bupropion). Retrieved November 7, 2025
