Contrave® combines two medications (naltrexone/bupropion) to help manage your food intake. Used twice daily, Contrave® works in different areas of the brain to control appetite and cravings.
Select your Contrave® supply and get started today with your weight management journey
Contrave® combines two medications (naltrexone/bupropion) to help manage your food intake. Used twice daily, Contrave® works in different areas of the brain to control appetite and cravings.
Select your Contrave® supply and get started today with your weight management journey
*Your information is secured and encrypted at-rest and in-transit. *You will only be charged for the applicable doctor consult and fees. The medication will not be charged until the doctor has deemed that the treatment is applicable to you. *A member of our Allied Health Team will reach out to advise you of your eligibility and next steps. *Includes 3-months prescription if approved and access to our clinicians. *100% refundable if you are declined the prescription after a medical review
How to use Contrave®?
At Gambit, our weight management program will involve a personalized approach to reaching your weight goals. If Contrave® is prescribed, a licensed healthcare practitioner will provide you with a customized dosing regime that gradually allows your body to start adjusting to the treatment plan. Usually once your treatment plan progresses, Contrave® is taken once in the morning, and once in the evening. It can be taken with or without food.
How does Contrave® fit into my Weight Management Program?
Contrave® acts as an appetite suppressant, which reduces the amount of food that your body wants to consume, thus in general reducing your calorie intake.
Contrave® is one step forward to assist with your weight management journey. Our program provides you with the guidance you need to use Contrave® safely and effectively. Gambit’s Weight Management Program is created by licensed healthcare providers with an emphasis on holistic treatment plans.
What is CONTRAVE used for? CONTRAVE should be taken with a reduced-calorie diet and increased physical activity. It is for weight management in:
obese
overweight patients who have at least one weight-related condition, such as:
high blood pressure that is controlled by medicine
Type 2 diabetes
a high amount of lipids (cholesterol or other types of fat) in the Blood
It is not known if it is safe to take CONTRAVE with other weight loss products. Other products include prescription drugs, over the counter drugs, and natural health products. It is not known if CONTRAVE changes your risk of heart problems or stroke or of death due to heart problems or stroke. CONTRAVE is not for use in patients 18 years of age and younger. How does CONTRAVE work? CONTRAVE contains two medicines, naltrexone hydrochloride and bupropion hydrochloride. These medicines work on two separate areas of the brain that are involved in controlling eating (hunger and cravings). What are the ingredients in CONTRAVE? Medicinal ingredients: naltrexone hydrochloride and bupropion hydrochloride Non-medicinal ingredients: colloidal silicon dioxide, crospovidone, edetate disodium, FD&C Blue No. 2 indigo carmine aluminum lake, hydroxypropyl cellulose, hypromellose, lactose anhydrous, lactose monohydrate, L-cysteine hydrochloride, macrogol/peg, magnesium stearate, microcrystalline cellulose, polyvinyl alcohol-part hydrolyzed, talc, and titanium dioxide. CONTRAVE comes in the following dosage form: Extended release tablets. Each tablet contains 8 mg naltrexone hydrochloride and 90 mg bupropion hydrochloride. The tablets are blue, round, and have “NB-890” on one side. Do not use CONTRAVE if you:
are allergic (hypersensitive) to naltrexone, bupropion or any of the other ingredients in CONTRAVE
have uncontrolled high blood pressure
have severe liver problems
have end-stage kidney failure
have or had seizures
are taking thioridazine, an antipsychotic An ingredient in CONTRAVE may cause the level of thioridazine in your blood to increase
use other medicines that contain bupropion such as WELLBUTRIN® SR, WELLBUTRIN® XL and ZYBAN®
have or had an eating disorder such as:
anorexia (eating very little)
bulimia (eating too much and throwing up so you don’t gain weight)
are dependent on opioid pain medicines or use medicines to help stop taking opioids such as methadone or buprenorphine, or are in opioid withdrawal.
drink a lot of alcohol and abruptly stop drinking, or use medicines called sedatives (these make you sleepy), benzodiazepines, or anti-seizure medicines and you stop using them all of a sudden
are taking medicines called monoamine oxidase inhibitors (MAOIs).
Ask your healthcare provider or pharmacist professional if you are not sure if you take an MAOI.
Do not start CONTRAVE until you have stopped taking your MAOI for at least 14
are pregnant or planning to become Tell your healthcare professional right away if you become pregnant while taking CONTRAVE.
To help avoid side effects and ensure proper use, talk to your healthcare professional before you take CONTRAVE. Talk about any health conditions or problems you may have, including if you:
have or had depression or other mental illnesses (such as bipolar disorder)
have attempted suicide in the past
have or had liver problems
have high blood pressure
have or had a heart attack
have kidney problems
are over the age of 65
are lactose intolerant because CONTRAVE contains Lactose is an ingredient in milk.
are breastfeeding or plan to CONTRAVE can pass into your breast milk and may harm your baby. You and your healthcare professional should decide if you should take CONTRAVE or breastfeed. You should not do both.
Other warnings you should know about:New or Worsened Emotional or Behavioral Problems, Including Self-Harm
One of the ingredients in CONTRAVE is Bupropion has caused some people to experience unusual feelings of agitation, mania (feeling very high, talking fast, taking more risks, and needing less sleep), hostility or anxiety, or have impulsive or disturbing thoughts such as thoughts of self-harm, or harm to others.
Pay close attention to any changes, especially sudden changes, in mood, behaviors, thoughts, or This is very important when you start taking CONTRAVE and when your dose changes.
Keep all follow-up visits with your healthcare professional as scheduled. Call your healthcare professional between visits as needed, especially if you have concerns about
Your healthcare professional will monitor you for any signs of suicidal thoughts or
If you are depressed and taking CONTRAVE, you may experience a worsening of your symptoms, including having suicidal thoughts or behaviors.
If you, your family, or friends notice mental health changes that are unusual for you while on CONTRAVE, stop taking the drug and talk to your If the symptoms are severe, seek immediate emergency help.
Risk of seizures
Bupropion, one of the ingredients in CONTRAVE, can cause seizures. The risk of having a seizure while taking CONTRAVE is related to the It is important that you take CONTRAVE exactly as your healthcare professional tells you to.
If you have a seizure while taking CONTRAVE, stop taking CONTRAVE and call your healthcare provider right away.
The risk of having a seizure while taking CONTRAVE is higher if you have certain medical conditions. Tell your healthcare professional if you have or had any of the following, as they might increase your risk of seizures:
Seizures
Head injury
Eating disorder
Severe stroke
Heart problems
Tumor or infection in your brain or spine
Low blood sugar (hypoglycemia)
Low levels of salt (sodium) in your blood (hyponatremia)
Liver problems
Abuse of alcohol, sedatives (drugs that make you sleepy), street drugs or are in withdrawal from sedatives
Have diabetes and are taking insulin or other medicines to control your blood sugar
The risk of having a seizure while taking CONTRAVE is higher if you take other medicines that increase the risk of seizures, which include:
Other drugs that contain bupropion
Antipsychotics
Other antidepressants (tricyclic antidepressants)
Theophylline (used to treat asthma)
Steroids (used to treat inflammation)
Risk of opioid overdose Naltrexone, one of the ingredients in CONTRAVE, can increase your chance of having an opioid overdose if you take opioid medicines while taking CONTRAVE. Examples of opioids or opioid-containing medicines include heroin, prescription pain medicines, and methadone. You can accidentally overdose in 2 ways:
Naltrexone blocks the effects of opioids. Because of this, do not take large amounts of opioids to try to overcome the opioid-blocking effects of It can lead to serious injury, coma, or death.
After you take naltrexone, its blocking effect slowly decreases and goes away over
If you have used opioid street drugs or opioid-containing medicines in the past, using opioids in amounts that you used before treatment with CONTRAVE can lead to overdose and death.
You may also be more sensitive to the effects of lower amounts of opioids:
after you have gone through detoxification
when your next dose of CONTRAVE is due
if you miss a dose of CONTRAVE
after you stop CONTRAVE treatment
It is important that you tell your family and the people closest to you of this increased sensitivity to opioids and the risk of overdose. Sudden opioid withdrawal
People who take CONTRAVE must not use any type of opioid for at least 7 to 10 days before starting CONTRAVE. This includes street drugs, prescription pain medicines (including tramadol), cough, cold, or diarrhea medicines that contain opioids, or opioid dependence treatments, such as buprenorphine or methadone.
Using opioids in the 7 to 10 days before you start taking CONTRAVE may cause you to suddenly have symptoms of opioid withdrawal when you take it. Sudden opioid withdrawal can be severe, and you may need to go to the hospital.
Tell your healthcare professional you are taking CONTRAVE before a medical procedure or surgery.
Increase in Blood Pressure and Heart Rate
CONTRAVE may cause an increase in blood pressure and heart rate. Your healthcare professional will monitor you before you start taking CONTRAVE and during
You may be more at risk if you already have high blood
If you have a significant increase in your blood pressure or heart rate while taking CONTRAVE, your treatment will be stopped.
Patients with Type 2 Diabetes Mellitus who are Taking Antidiabetic Medicines
You may be more at risk of developing low blood sugar (hypoglycemia) if you have Type 2 diabetes and you lose weight while taking This applies only if you take medicines to treat Type 2 diabetes such as insulin or sulphonylureas. Your healthcare professional will monitor your blood sugar levels before and during treatment with CONTRAVE.
You may need a change in your antidiabetic
Angle-Closure Glaucoma CONTRAVE may cause an acute attack of glaucoma. Get immediate medical attention if you have:
eye pain
changes in vision
swelling or redness in or around the
Liver Damage CONTRAVE may cause damage to your liver. See your healthcare professional right away if you have any of the following symptoms:
abdominal pain
dark urine
diarrhea
fatigue
fever
headache
loss of appetite
yellowing of the skin and the whites of the eyes
nausea and vomiting
Tell your healthcare professional about all the medicines you take, including any drugs, vitamins, minerals, natural supplements or alternative medicines.The following may interact with CONTRAVE:
Medicines to treat depression or Parkinson’s disease (monoamine oxidase inhibitors such as phenelzine, selegiline, or rasagiline).
Alcohol:
You should only drink a very small amount of alcohol or none at all while taking
Opioids and opioid-containing medicines, used to treat:
cough and cold (mixtures containing dextromethorphan or codeine)
opiate addiction (methadone)
pain (morphine, codeine, tramadol)
diarrhea (loperamide).
Medicines used to prevent
Antibiotics to treat infections (quinolones such as ciprofloxacin).
Medicines to treat asthma (theophylline).
Medicines to treat hay fever, itch, swelling and other allergic reactions (antihistamines and steroids).
Medicines to lower sugar levels in your blood (metformin, insulin, glyburide or glibenclamide, nateglinide or repaglinide).
Medicines to help you to sleep (sedatives such as diazepam).
Medicines to treat depression (desipramine, venlafaxine, imipramine, paroxetine, citalopram) or other mental health problems (risperidone, haloperidol, thioridazine).
Some medicines used to treat high blood pressure (metoprolol, clonidine).
Some medicines used to treat irregular heart rhythm (propafenone, flecainide).
Some medicines used to treat cancer (cyclophospamide, ifosphamide, tamoxifen).
Some medicines for Parkinson’s disease (levodopa, amantadine or orphenadrine).
Medicines mainly used in the treatment of heart disease or stroke (ticlopidine, digoxin, or clopidogrel).
Medicines used in the treatment of HIV infection and AIDS (efavirenz, lopinavir and ritonavir).
Medicines used to treat epilepsy (valproate, carbamazepine, phenytoin or phenobarbital).
If you take a urine drug screening test, CONTRAVE may give a positive test result for amphetamines. Tell the laboratory technician that you are taking CONTRAVE. They can do a more specific drug screening test for you. How to take CONTRAVE:
Use CONTRAVE with a reduced calorie-diet and increased physical
Take CONTRAVE exactly as your healthcare professional tells you
Do not change your CONTRAVE dose without talking with your healthcare
Do not take more CONTRAVE than your healthcare professional tells you to, or it may increase your risk of seizures.
Your healthcare professional will change your dose if
Your healthcare professional should tell you to stop taking CONTRAVE if you have not lost a certain amount of weight after 16 weeks of treatment.
Your healthcare professional will monitor:
your blood pressure and heart rate before you take CONTRAVE and during your
you for side effects if you have kidney or liver
Swallow CONTRAVE tablets Do not cut, chew, or crush the tablets. Tell your healthcare professional if you cannot swallow CONTRAVE tablets whole.
Take each dose of CONTRAVE with Do not take CONTRAVE with high-fat meals. It may increase your risk of seizures.
Your dose may be decreased if you:
have kidney or liver
take certain
Do not drink a lot of alcohol while taking CONTRAVE. Talk with your healthcare professional if you drink a lot of If you suddenly stop drinking alcohol, you may increase your chance of having a seizure.
Usual dose: The table below explains how your dose of CONTRAVE will be slowly increased over the first 4 weeks. At week 4, you will be taking the usual adult dose:
2 tablets in the morning and 2 tablets in the
This is also the maximum daily dose for It is important that you not take more than the maximum daily dose:
Do not take more than 2 tablets in the morning and 2 tablets in the evening.
Do not take more than 2 tablets at the same time or more than 4 tablets in 1 day.
Morning Dose
Evening Dose
Week 1
1 tablet
None
Week 2
1 tablet
1 tablet
Week 3
2 tablets
1 tablet
Week 4 and Onward
2 tablets
2 tablets
Overdose:Risk of opioid overdose: You may be at risk of having an opioid overdose if you take opioid medicines while taking CONTRAVE. You should get emergency medical help right away if you:
have trouble breathing
become very drowsy with slowed breathing
have slow, shallow breathing (little chest movement with breathing)
feel faint, very dizzy, confused, or have unusual symptoms
Missed Dose: If you miss a dose of CONTRAVE, wait until your next regular time to take it. Do not take more than 1 dose of CONTRAVE at a time. This will help reduce your risk of having a seizure. What are the possible side effects from using CONTRAVE?These are not all the possible side effects you may feel when taking CONTRAVE. If you experience any side effects not listed here, contact your healthcare professional. Please also see the warnings section. In clinical trials, patients who were elderly, had Type 2 diabetes or kidney problems had more of certain side effects than other patients. The common side effects of CONTRAVE include: Nausea
Constipation
Diarrhea
Dizziness
Feeling off balance or like everything is spinning (vertigo)
Dry mouth
Headache or migraine
Trouble sleeping
Vomiting
Abdominal pain
Indigestion
Shaking (tremor)
Foul, salty, rancid or metallic taste in the mouth
Sleepiness, feeling tired, lack of energy
Trouble paying attention
Abnormal dreams
Flu
A lot more sweating than usual
Itching
Rash
Hair loss
Ringing in the ear
Blurred vision
Serious side effects and what to do about them
Symptom / effect
Talk to your healthcare professional
Stop taking drug and get immediate medical help
Only if severe
In all cases
VERY COMMONNew or worse anxiety
COMMONNew or worse depression
UNCOMMONVisual problems (angle-closure glaucoma): – eye pain; – changes in vision; – swelling or redness in or around the eye.
Unusual changes in behavior or mood: agitation, sadness, feeling over-excited.
Increases in blood pressure or heart rate: your blood pressure and heart rate should be monitored during your treatment. Symptoms may include: headaches, nosebleeds, dizziness, a flushed face, fatigue, and fast heart rate.
Liver damage or hepatitis: – pain in the stomach area lasting more than a few days; – dark urine; – yellowing of the whites of your eyes; – tiredness.
RARESeizures
New or Worsened Emotional or Behavioral Problems: – thoughts about suicide or dying; – attempts to commit suicide; – new or worse irritability.
Increased risk of low blood sugar (hypoglycemia) in people with Type 2 diabetes mellitus who also take medicines to treat their diabetes: you should check your blood sugar before you start taking CONTRAVE and while you take CONTRAVE. Symptoms may include: sweating, nervousness, shaking, faintness, palpitations, and hunger.
VERY RARESevere allergic reactions: – chest pain; – fever; – hives; – itching in your eyes; – painful sores in your mouth or around; – rash; – swelling of your lips or tongue; – swollen lymph glands; – trouble breathing.
New or Worsened Emotional or Behavioral Problems: feeling very agitated or restless; acting aggressive; being angry or violent; acting on dangerous impulses.
UNKNOWN Manic episodes: mania (feeling very high, talking fast, taking more risks, and needing less sleep).
Panic attacks: sudden intense fear and discomfort.
Hallucinations: Sensing or seeing things that are not there.
If you had taken opioid medicines less than 7 – 10 days before taking CONTRAVE. Opioid withdrawal: nausea and vomiting, anxiety, insomnia, hot and cold flushes, perspiration, muscle cramps, diarrhea.
If you take opioid medicines while taking CONTRAVE. Opioid overdose: having trouble breathing, becoming very drowsy with slowed breathing, having slow, shallow breathing, feeling faint, very dizzy, confused, or having unusual symptoms.
If you have a troublesome symptom or side effect that is not listed here or becomes bad enough to interfere with your daily activities, talk to your healthcare professional. Tell your healthcare professional about any side effect that does not go away. Storage: Store CONTRAVE at room temperature between 15°C to 25°C. eep out of reach and sight of children. If you want more information about CONTRAVE:
Talk to your healthcare
Find the full product monograph that is prepared for healthcare professionals and includes this Patient Medication Information by visiting the Health Canada website (https://health-products.canada.ca/dpd-bdpp/index-eng.jsp) or by calling the manufacturer at 1-800-361-4261