Contrave interactions: Alcohol, medications, and other factors

Before you start treatment with Contrave, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Contrave interacts with supplements, herbs, or vitamins, see the “Contrave and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Contrave. Keep in mind that this table doesn’t include all drugs that may interact with Contrave. Some of these interactions are described in detail just below in “Drug interactions in depth.”

* For details about this interaction, see the “When to avoid Contrave” section below.

In some cases, factors or conditions could prevent your doctor from prescribing Contrave due to the risk of harm. These are known as contraindications. The contraindications of Contrave include:

Having anorexia or bulimia

Doctors typically won’t prescribe Contrave for people with bulimia or anorexia. This is because these conditions may increase the risk of seizures as a side effect of Contrave.

If you have bulimia or anorexia, talk with your doctor before taking Contrave. They’ll likely prescribe a treatment other than Contrave for your condition.

Having blood pressure that isn’t well-managed

Doctors typically won’t prescribe Contrave for people with high blood pressure that isn’t well-managed. This is because Contrave may increase blood pressure even further.

If you have high blood pressure that isn’t well-managed, talk with your doctor before taking Contrave. They’ll likely prescribe a different treatment for your condition.

Having seizures

Doctors typically won’t prescribe Contrave for people with seizures or seizure disorders. This is because these factors may increase the risk of seizures as a side effect of Contrave.

If you have seizures or a seizure disorder, talk with your doctor before taking Contrave. They’ll likely prescribe a treatment other than Contrave for your condition.

Having suddenly stopped drinking alcohol or taking certain medications

Doctors typically won’t prescribe Contrave for people who’ve suddenly stopped drinking alcohol recently.

Doctors also typically won’t prescribe Contrave for people who’ve suddenly stopped taking certain medications recently. These include:

• benzodiazepines, such as alprazolam (Xanax, Xanax XR) and diazepam (Valium)
• barbiturates, such as primidone (Mysoline) and phenobarbital (Sezaby)
• antiseizure drugs, such as oxcarbazepine (Oxtellar XR, Trileptal) or phenytoin (Dilantin, Phenytek)

This is because these factors may increase the risk of seizures as a side effect of Contrave.

If you’ve recently stopped drinking alcohol or taking any of the medications listed above, talk with your doctor before taking Contrave. They’ll likely prescribe a different treatment for your condition.

Having opioid withdrawal symptoms

Doctors typically won’t prescribe Contrave for people having symptoms of opioid withdrawal. This describes having uncomfortable side effects after stopping an opioid that your body has become dependent on. With opioid dependence, your body needs the opioid to function as it usually would.

Starting Contrave during this time may worsen opioid withdrawal symptoms.

If you have symptoms of opioid withdrawal, talk with your doctor before taking Contrave. They’ll tell you when it’s safe to begin Contrave treatment.

Taking opioids

Doctors typically won’t prescribe Contrave in combination with opioids. This is because naltrexone (an active ingredient in Contrave) could make opioids less effective.

Examples of opioids include:

• buprenorphine (Brixadi, Sublocade, others)
• hydrocodone (Hysingla ER)
• methadone (Methadose)
• oxycodone (Oxycontin, Xtampza ER, others)

If you take an opioid, talk with your doctor before starting Contrave treatment. They’ll likely have you wait at least 7 to 10 days between treatment with Contrave and an opioid. Your doctor can recommend what pain medication to take with Contrave.

Taking a monoamine oxidase inhibitor

Doctors typically won’t prescribe Contrave in combination with an MAOI. This is because taking Contrave with an MAOI can increase the risk of very high blood pressure, which can be life threatening.

Examples of MAOIs include:

• isocarboxazid (Marplan)
• methylene blue (Provayblue)
• linezolid (Zyvox)
• phenelzine (Nardil)
• selegiline (Emsam)

If you take an MAOI, talk with your doctor before taking Contrave. They’ll likely have you wait at least 2 weeks between treatment with Contrave and an MAOI.

Taking other drugs that contain bupropion

Doctors typically won’t prescribe Contrave in combination with other forms of bupropion. (Buproprion is one of the active ingredients in Contrave.) This is because taking other forms of bupropion with Contrave could increase your risk of side effects from either drug.

Examples of other forms of bupropion include:

• dextromethorphan/bupropion (Auvelity)
• bupropion (Aplenzin, Forfivo XL, Wellbutrin SR, Wellbutrin XL)

If you take bupropion, talk with your doctor before starting Contrave treatment. They’ll recommend the right treatment option for your condition.

Having had an allergic reaction to Contrave or any of its ingredients

If you’ve had an allergic reaction to Contrave or any of its ingredients, your doctor will likely not prescribe Contrave. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note: Before you start treatment with Contrave, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe Contrave.

Your doctor will likely recommend that you limit or avoid alcohol while taking Contrave. They may also advise you not to take any prescription or over-the-counter drugs that contain alcohol during Contrave treatment.

Consuming alcohol and taking Contrave may lead to mental health changes. Examples include anxiety and agitation. Contrave may also cause your body to be more sensitive to the effects of alcohol.

In addition, consuming large amounts of alcohol may increase the risk of seizures as a side effect of Contrave.

If you have concerns about limiting or avoiding alcohol while you’re taking Contrave, talk with your doctor before starting treatment. They can tell you whether light drinking, such as social drinking, may be safe.

Here’s a closer look at certain drug interactions of Contrave.

Certain beta-blockers

Beta-blockers are prescribed to treat high blood pressure and other heart-related conditions.

Interaction result: Taking Contrave with certain beta-blockers may increase the risk of side effects from the beta-blocker.

Interaction explained: Contrave may slow the activity of an enzyme (protein) that helps break down certain beta-blockers in your body. As a result, taking these drugs together can cause the beta-blocker to build up in your system. This can lead to a high level of the beta-blocker in your body, raising your risk of side effects.

Examples of beta-blocker drugs: Here are some beta-blockers that may interact with Contrave:

• propranolol (Inderal LA, Innopran XL)
• metoprolol (Lopressor, Toprol XL, others)
• nebivolol (Bystolic)

Steps you or your doctor may take: Before starting treatment with Contrave, tell your doctor if you’re taking a beta-blocker. They can tell you whether it’s safe to take these medications together.

If your doctor prescribes Contrave with certain beta-blockers, they may prescribe a lower beta-blocker dosage than is typical. Doing so may help lower the risk of side effects from the beta-blocker.

To learn more about Contrave and beta-blockers, talk with your doctor or pharmacist.

Certain antidepressants

Antidepressants are prescribed to treat depression and other mental health conditions.

Interaction result: Taking Contrave with certain antidepressants may increase the risk of side effects. Combining Contrave with other antidepressants may raise the risk of seizures.

Interaction explained: Contrave may slow the activity of an enzyme (protein) that helps break down certain antidepressants in your body. Taking these drugs together could result in a high level of the antidepressant in your system. This could increase your risk of side effects from the antidepressant.

In addition, Contrave and certain antidepressants may raise the risk of seizures when taken individually. This risk may be increased by taking these medications together.

Examples of antidepressant drugs: Here are some antidepressants that may interact with Contrave:

• fluoxetine (Prozac)
• paroxetine (Brisdelle, Paxil)
• amitriptyline

Steps you or your doctor may take: Before you take Contrave, tell your doctor if you’re taking an antidepressant. They can tell you whether it’s safe to take these medications together.

In some cases, your doctor may still prescribe Contrave with an antidepressant that has a seizure risk. If so, they’ll likely adjust your Contrave dosage to lower the risk of this side effect.

To learn more about Contrave and antidepressants, talk with your doctor or pharmacist.

Antipsychotics

Antipsychotics are prescribed to treat schizophrenia, bipolar disorder, and other mental health conditions.

Interaction result: Taking Contrave with an antipsychotic may increase the risk of side effects from the antipsychotic. Taking these drugs together could also increase the risk of seizures.

Interaction explained: Contrave may slow the activity of an enzyme (protein) in your body that helps break down antipsychotics. This effect may lead to a high level of the antipsychotic in your system, increasing your risk of side effects from the drug.

Contrave and antipsychotics may also increase the risk of seizures when taken individually. Combining these medications may increase this risk even further.

Examples of antipsychotic drugs: Here are some antipsychotics that may interact with Contrave:

• haloperidol (Haldol)
• aripiprazole (Abilify, Aristada, others)
• thioridazine

Steps you or your doctor may take: Before starting Contrave treatment, tell your doctor if you’re taking an antipsychotic. They can recommend whether it’s safe to take these medications together.

If your doctor prescribes Contrave with an antipsychotic, they may adjust the dosage of either drug. Doing so may help lower the risk of side effects, including seizures.

To learn more about Contrave and antipsychotics, talk with your doctor or pharmacist.

Contrave may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Contrave.

Contrave interactions with supplements

Contrave may interact with caffeine supplements. Taking Contrave with these supplements can increase the risk of seizures. Your doctor will likely recommend that you avoid caffeine supplements during your Contrave treatment.

Before you start treatment with Contrave, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Contrave and herbs

There are no reports of herbs interacting with Contrave. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Contrave treatment.

Contrave and vitamins

There are no reports of vitamins interacting with Contrave. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Contrave.

Contrave interactions with food

Doctors may advise you to avoid taking Contrave with high fat foods, such as avocado or cheese. This is because high fat foods may raise the level of Contrave in your system and increase your risk of side effects.

Contrave may also interact with caffeine. Consuming too much caffeine while taking Contrave can increase the risk of seizures. Examples of foods and beverages that contain caffeine include:

• chocolate
• coffee
• energy drinks
• tea

Because of this interaction, your doctor will likely recommend limiting how much caffeine you drink while taking Contrave.

If you’d like to learn more about specific foods to avoid during treatment with Contrave, talk with your doctor.

Contrave and vaccines

There aren’t any known interactions between Contrave and vaccines. Talk with your doctor or pharmacist to see whether you’re due for any vaccines.

Contrave interactions with lab tests

Contrave may interfere with the results of certain urine drug screening tests. Taking the medication may cause a false-positive result for the presence of amphetamines. This means the test could show that you have amphetamines in your urine even if you do not.

Because of this, it’s important to tell the person giving you the test that you’re taking Contrave. For additional information, talk with your doctor or pharmacist.

CONTRAVE INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have been reported to interact with Contrave. Taking these drugs together may make Contrave less effective or could increase the risk of side effects from Contrave.

Before you start treatment with Contrave, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.

Note: Cannabis is illegal at a federal level but is legal in many U.S. states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Contrave. Before you take this drug, be sure to talk with your doctor about your health history. Contrave may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Contrave include:

Bulimia or anorexia: Doctors typically won’t prescribe Contrave for people with bulimia or anorexia. For details, see the “When to avoid Contrave” section above.

High blood pressure and other heart-related problems: Doctors typically won’t prescribe Contrave for people with high blood pressure that isn’t well-managed. For details, see the “When to avoid Contrave” section above.

If you’ve ever had other heart-related problems, including heart attack or stroke, talk with your doctor before taking Contrave. The drug may increase your blood pressure. It isn’t known what effect this may have on people with other heart-related problems. Your doctor can recommend whether Contrave is a safe treatment option.

Seizures or related factors: Doctors typically won’t prescribe Contrave for people with seizures or seizure disorders. For details, see the “When to avoid Contrave” section above.

If you have health factors that raise your risk of seizure, talk with your doctor before taking Contrave. Examples include past head injury or an infection or tumor in your brain or spinal cord. Your doctor can tell you whether Contrave is a safe treatment option.

Opioid withdrawal: Doctors typically won’t prescribe Contrave for people having symptoms of opioid withdrawal. For details, see the “When to avoid Contrave” section above.

Mental health conditions: If you or a family member has a mental health condition, such as depression or bipolar disorder, talk with your doctor before taking Contrave. Taking the drug may increase the risk of a mixed or manic episode. Your doctor can recommend whether Contrave is a safe treatment option.

Diabetes: If you have type 1 or type 2 diabetes, talk with your doctor before taking Contrave. Especially tell them if you use insulin or oral diabetes drugs, which may increase your risk of low blood sugar. This is because low blood sugar can also raise your risk of seizures as a side effect of Contrave.

Weight loss can also increase the risk of low blood sugar in people with type 2 diabetes taking oral diabetes drugs. (Contrave is used for weight management in certain adults.) Your doctor can recommend whether Contrave is a safe treatment option.

Liver or kidney damage: Before starting Contrave treatment, tell your doctor if you have liver or kidney damage. They can tell you whether Contrave is a safe treatment option. In some cases, your doctor may prescribe a lower Contrave dosage than is typical.

Narrow eye angles: Before you take Contrave, your doctor may advise you to have an eye exam. Contrave may cause dilated pupils, which could lead to closed-angle glaucoma in people with narrow eye angles. Closed-angle glaucoma is a medical emergency that can cause vision loss and severe eye pain. Your doctor can recommend whether Contrave is a safe treatment option.

Allergic reaction: If you’ve had an allergic reaction to Contrave or any of its ingredients, your doctor will likely not prescribe Contrave. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Breastfeeding: Your doctor may advise you not to take Contrave while breastfeeding. The drug may pass into breast milk, but it isn’t clear what effects Contrave may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before taking Contrave. They can talk with you about treatment options and ways to feed your child.

Pregnancy: Doctors are unlikely to prescribe Contrave during pregnancy. This is because weight loss during pregnancy is not typically recommended. (Contrave is prescribed for weight management in certain adults.) If you become pregnant while taking the drug, tell your doctor right away. They’ll likely advise you to stop taking Contrave.

Risk of suicidal thoughts and behaviors: Contrave has a boxed warning about the risk of suicidal thoughts and behaviors. This is a serious warning from the FDA. A boxed warning alerts doctors and patients about drug effects that may be dangerous. For details, see the boxed warning at the top of this article.

You can take certain steps to help prevent interactions with Contrave. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Contrave label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Contrave doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Contrave by taking it exactly as your doctor prescribes.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.