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Contrave (naltrexone/bupropion)

Contrave (naltrexone/bupropion): Contrave, approved in 2014, is a combination of naltrexone, an opioid antagonist, and bupropion, an antidepressant. It helps patients lose weight by suppressing appetite and reducing cravings. Side effects include nausea, headache, and constipation.

Era of Discovery


Mechanism of Action

Combination of opioid antagonist and antidepressant

History of Use in the United States

Approved by FDA in 2014

Benefit of Weight Loss Agent or Medication

Weight loss due to appetite suppression and reduced cravings

Possible Side Effects

Nausea, headache, constipation

Current Regulatory Status in US

Available by prescription

Contrave: A Combined Approach to Addressing Obesity

Contrave emerged on the obesity management scene as a unique combination medication, bringing together two drugs previously approved for different uses. Its journey through development, approval, and use underlines the innovation and caution required in obesity treatment.

Contrave's Unique Makeup: Naltrexone and Bupropion

Contrave brings together two established drugs in a novel way: naltrexone, typically used for alcohol and opioid dependence, and bupropion, an antidepressant also used for smoking cessation. The thought behind this combination was to tackle the multifactorial nature of obesity, aiming to reduce appetite and control cravings.

The Approval Process: A Struggle and Triumph

The road to FDA approval was not straightforward for Contrave. Its manufacturer, Orexigen Therapeutics, initially applied for approval in 2010, but the FDA requested additional safety data, particularly regarding cardiovascular risks. This led to the large-scale Light Study, designed to investigate any potential cardiovascular concerns. Eventually, the FDA approved Contrave in 2014, making it the third weight loss drug approved in the U.S within two years, following Qsymia and Belviq.

Post-Marketing Journey: Successes, Challenges, and Concerns

Contrave has shown notable efficacy in promoting weight loss. However, it hasn't been without its concerns. The Light Study, initially a condition of approval, faced controversy over the premature release of data, leading to issues with the study's validity. This resulted in the FDA requesting another trial to assess cardiovascular safety.

Furthermore, Contrave's side effects, including nausea, constipation, and potential increases in blood pressure and heart rate, require careful monitoring. Additionally, the potential for severe reactions, including suicidal thoughts and behaviors, linked to one of its ingredients (bupropion), necessitates caution in prescribing.

Present Day: A Balance of Promise and Precaution

Contrave remains a part of the obesity treatment landscape today. Its combined approach, using two drugs with different mechanisms of action, offers promise. At the same time, its journey reminds us of the complex challenge of developing safe and effective weight loss drugs. Ongoing monitoring and research will continue to shape our understanding and use of Contrave in the battle against obesity.

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