- Trouble sleeping
- Dry mouth
Sunday, November 9, 2014
In September, 2014, the US FDA approved a new weight loss medication called Contrave, a combination of the well known mood stabilizer, Bupropion and a narcotic deaddition medication called Naltrexone.
What is Contrave?
CONTRAVE is a prescription medication that contains 2 medicines (naltrexone HCl and bupropion HCl) that may help some obese adults*, or overweight adults who also have weight-related medical problems†, lose weight and keep the weight off.
Who should consider Contrave?
CONTRAVE should be considered for any one who is obese with a body mass index of 30 or more or those with a body mass index of >27 with other comorbidities with a reduced calorie diet and increased physical activity.
Does Contrave work for weight loss?
In one 56-week study, people who took CONTRAVE along with a program of reduced-calorie diet, behavior counseling, and increased physical activity, about 42% of the treatment group lost the minimum of 5% compared to 17% of those who did not take CONTRAVE.§ Individual results may vary.
Dosing of Contrave
The recommended daily dose of Contrave is two 8 mg naltrexone/90 mg bupropion (8/90) tablets taken twice daily for a total daily dose of 32 mg naltrexone/360 mg bupropion (32/360). Upon initiation,
Contrave dosing should be escalated starting with one tablet taken daily for the first week, followed by the addition of another tablet each day during each subsequent week, until the total daily maintenance dose of two tablets twice a day (32/360) is reached at the start of Week 4.
Assessing effectiveness in 4 months
Most patients who respond to Contrave will do so in about 4 months of treatment. If a patient has not exhibited clinically meaningful weight loss (e.g., at least 5%) after 4 months of treatment, the physician should consider discontinuation of Contrave and initiation of other weight management strategies should be considered. Patients may experience elevated blood pressure or pulse during
Contrave treatment; the risk may be greater during the initial 3 months of therapy. If clinically relevant and sustained (e.g., at least two consecutive measurements) increases in blood pressure or pulse occur, Contrave should be discontinued. As patients with hypertension or a history of hypertension may be at increased risk of blood pressure elevations, care should be exercised when initiating treatment with Contrave in such patients.
Benefits of Contrave
Contrave trials demonstrated beneficial effects on prespecified weight-related cardiometabolic parameters, including:
• waist circumference,
• triglycerides, HDL-cholesterol,
• high-sensitivity C-reactive protein (hs-CRP),
• glycemic control (fasting glucose, fasting insulin, homeostasis model assessment of insulin resistance [HOMA-IR], and, in patients with diabetes, hemoglobin A1c [HbA1c]),
• quality of life and control of eating.
Consistent with the known pressor effect of bupropion, Contrave-treated patients experienced increases in blood pressure and heart rate compared to placebo, although reduction in weight was associated with reduction in mean blood pressure in both treatment groups. Across all of the secondary manifestations of the illness of obesity, the greatest benefits of Contrave are likely in patients who achieve and maintain at least a 5% reduction in body weight.
Side effects of Contrave(also called NB)
The most common side effects of CONTRAVE include:
Price of Contrave
Contrave is priced right costing about $75.00 per month in the first two months and $65.00 thereafter without insurance and with insurance, it can be lower.
Comparision of Contrave
Compared to the other new weight loss medications approved a few years ago, Belviq and Qsymia, Contrave is somewhat in the middle in terms of weight loss results, a bit better than Belviq but less than Qsymia in the opinion of this blogger, Dr. Prab R. Tumpati, MD, founder of W8MD medical weight loss centers.
Locations for Contrave
While Contrave might be offered by many physicians, W8MD Medical Weight Loss Centers of America is one of the first weight loss programs to start offering Contrave for eligible patients to help lose weight and is available at their weight loss locations in New York, Pennsylvania and New Jersey. Call W8MD today at 1-800-W8MD-007 to learn more or to setup a consultation. As one of the very few medical weight loss centers that accepts health insurance for the physician weight loss visits, W8MD gets patients from far and near including other states!