Generic Bupropion + Naltrexone

Introduction

Bupropion + Naltrexone is a fixed-dose oral combination indicated for chronic weight management in adults with a body-mass index (BMI) of 30 kg/m² or higher, or 27 kg/m² or higher when accompanied by at least one weight-related comorbidity such as type 2 diabetes, hypertension, or dyslipidemia. The product is supplied as a tablet containing 8 mg of naltrexone and 90 mg of bupropion (often marketed under the brand name Contrave). It belongs to the therapeutic class of anti-obesity agents that act on central pathways of appetite regulation. In addition to its primary indication, the combination has been explored off-label for conditions like binge-eating disorder and smoking cessation, although these uses are not formally approved by major regulatory agencies.

What is Bupropion + Naltrexone?

Bupropion + Naltrexone is a two-component tablet that merges an atypical antidepressant (bupropion) with an opioid-receptor antagonist (naltrexone). The combination was developed by Currax (now part of Otsuka Pharmaceutical) and received FDA approval in 2014 for the treatment of obesity. By pairing these agents, the formulation aims to modulate both reward-driven eating and hypothalamic appetite pathways, providing a synergistic effect on weight reduction.

How Bupropion + Naltrexone Works

• Bupropion blocks the reuptake of norepinephrine and dopamine, increasing their synaptic concentrations. This action stimulates pro-opiomelanocortin (POMC) neurons in the arcuate nucleus of the hypothalamus, which promotes satiety and raises resting energy expenditure.
• Naltrexone occupies μ-opioid receptors on the same POMC neurons, preventing the autoinhibitory feedback that normally dampens the appetite-suppressing signal generated by bupropion.
• The combined effect is a sustained activation of POMC pathways, leading to reduced hunger, lower calorie intake, and modest increases in energy expenditure. Clinical trials show noticeable weight loss after 12 weeks of therapy, with continued benefit when the regimen is maintained.

Conditions Treated with Bupropion + Naltrexone

• Chronic weight management (obesity): The only FDA-approved indication. It is prescribed for adults with a BMI ≥ 30 kg/m², or BMI ≥ 27 kg/m² with associated comorbidities (e.g., hypertension, dyslipidemia). The drug is intended to be used together with a reduced-calorie diet and increased physical activity.

The efficacy in this indication is supported by multiple phase III trials (e.g., CONTRAVE Obesity Trial) that demonstrated an average of 5-10 % total body-weight loss compared with lifestyle counseling alone.

Off-Label and Investigational Uses of Bupropion + Naltrexone

• Binge-Eating Disorder (BED): Small-scale randomized studies have reported reductions in binge episodes when the combination is added to standard psychotherapy. Evidence remains limited, and regulatory approval is lacking.
• Smoking Cessation: Bupropion alone is an established aid for quitting smoking. Some clinicians have trialed the combination to address both nicotine cravings and weight gain after quitting, but this use is not approved and should only be considered under specialist supervision.
• Major Depressive Disorder (MDD): Because bupropion possesses antidepressant activity, the combo has occasionally been prescribed off-label for patients with comorbid depression and obesity. Formal trials are sparse, and safety in this context has not been established by regulatory bodies.

Safety Note: Off-label use must be guided by a qualified healthcare professional and is not covered by the product’s official labeling.

Is Bupropion + Naltrexone the Right Medication for You?

• Ideal candidates are adults with a BMI ≥ 30 kg/m², or BMI ≥ 27 kg/m² with at least one weight-related health condition, who have not achieved adequate weight loss through diet and exercise alone.
• The medication is particularly useful when patients prefer a pharmacologic adjunct that targets both appetite and reward pathways.
• Contraindications include a history of seizures, current or prior diagnosis of an eating disorder (bulimia nervosa, anorexia nervosa), concurrent use of monoamine-oxidase inhibitors (MAOIs), uncontrolled hypertension, and severe hepatic impairment. Individuals with active opioid dependence should avoid the drug because naltrexone can precipitate withdrawal.

Risks, Side Effects, and Interactions

Common

• Nausea
• Dry mouth
• Constipation
• Headache
• Insomnia
• Dizziness

Rare

• Taste alteration (dysgeusia)
• Urinary retention
• Abdominal pain

Serious

• Seizures (risk heightened by high bupropion doses)
• Hypertensive crisis, especially if taken with excessive amounts of stimulants or decongestants
• Hepatic injury (elevated liver enzymes, particularly in patients with pre-existing liver disease)
• Suicidal thoughts or behavior (monitoring required for patients with mood disorders)

Drug-Drug Interactions

• MAOIs (e.g., phenelzine, tranylcypromine): contraindicated; can cause hypertensive emergencies.
• CYP2B6 inhibitors (e.g., ticlopidine, clopidogrel) may increase bupropion plasma levels, raising seizure risk.
• CYP2B6 inducers (e.g., rifampin, carbamazepine) can reduce effectiveness.
• Opioid analgesics (e.g., morphine, oxycodone): naltrexone blocks their analgesic effect, potentially precipitating pain crises.
• Combination with other CNS stimulants (e.g., nicotine replacement therapy, amphetamines) may increase cardiovascular stress.

Drug-Food Interactions

• Alcohol: potentiates the seizure risk associated with bupropion and may worsen nausea.
• High-fat meals: do not significantly affect absorption but may increase gastrointestinal discomfort.

Use: Dosing, Missed Dose, Overdose

• Starting regimen: One tablet (8 mg naltrexone + 90 mg bupropion) taken in the morning for the first week.
• Titration: Add a second tablet in the evening after one week; increase to two tablets twice daily (total 16 mg naltrexone + 180 mg bupropion) as tolerated, which is the usual maintenance dose.
• Administration: Take tablets with a full glass of water; they may be taken with or without food, but ingesting them with food can lessen nausea.
• Missed dose: If the scheduled time is within 12 hours, take the missed tablet. If more than 12 hours have passed, skip it and resume the regular schedule; do not double-dose.
• Overdose: Symptoms may include severe nausea, vomiting, seizures, rapid heart rate, and loss of consciousness. Immediate medical attention is required; contact emergency services or a poison-control center.

FAQ

• What should I do if I feel nauseous after the first few doses? Nausea is common during the initial titration phase. Taking the tablet with a light meal and gradually increasing the dose can lessen discomfort. If nausea persists beyond the first two weeks, discuss dose adjustment with your clinician.

• Can I travel internationally with Bupropion + Naltrexone tablets? Yes, but keep the medication in its original packaging with a copy of the prescription label. Check the destination country’s import regulations for prescription medicines to avoid customs issues.

• Is the tablet coated, and does it affect swallowing? The tablet is film-coated to improve palatability and ease of swallowing. Do not crush or chew, as this may alter the release profile and increase side-effect risk.

• What inactive ingredients are present in the tablet? Typical excipients include lactose monohydrate, magnesium stearate, and microcrystalline cellulose. Patients with severe lactose intolerance should verify with the pharmacy about alternative formulations.

• Will Bupropion + Naltrexone interfere with a urine drug test? Naltrexone and its metabolites may be detected in urine screens for opioids, potentially yielding a false-positive result for opioid antagonism. Inform the testing laboratory of your medication to avoid misinterpretation.

• How long does it take to see measurable weight loss? Clinical studies report a mean body-weight reduction of 5 % after 12 weeks when combined with diet and exercise. Individual results vary; consistent use for at least six months is typically needed for optimal outcomes.

• Can the medication be taken by people with mild liver disease? Mild to moderate hepatic impairment may increase naltrexone exposure; dose adjustment or close monitoring of liver enzymes is recommended. Severe liver disease is a contraindication.

• Is it safe to use nicotine replacement therapy while on Bupropion + Naltrexone? Yes, concurrent nicotine replacement (patch, gum) is generally safe and may help prevent post-quit weight gain. However, combined stimulant effects should be monitored for increased blood pressure or heart rate.

• What storage conditions are optimal for the tablets? Store at room temperature (20-25 °C or 68-77 °F) away from moisture, heat, and direct sunlight. Do not refrigerate or freeze.

• Are there any special considerations for elderly patients? Older adults may have reduced renal and hepatic clearance, increasing the risk of side effects. Initiating therapy at the lowest dose and titrating slowly is advised, with regular monitoring of blood pressure and liver function.

Glossary

Pro-opiomelanocortin (POMC) neurons

A group of hypothalamic cells that, when activated, release hormones that suppress appetite and increase energy expenditure.

Pharmacokinetic clearance

The rate at which a drug is eliminated from the body, influencing dosing frequency and potential accumulation.

Seizure threshold

The level of neuronal excitability at which a seizure can be triggered; some drugs lower this threshold, making seizures more likely.

Hypertensive crisis

A severe, sudden increase in blood pressure (typically >180/120 mmHg) that can lead to organ damage and requires immediate medical attention.

Buying Bupropion + Naltrexone from Our Online Pharmacy

Patients who encounter limited availability of weight-management medications in local pharmacies or who seek a cost-effective generic alternative can obtain Bupropion + Naltrexone through our online pharmacy. Our service sources the product from licensed, audited overseas suppliers, ensuring that each batch complies with international quality standards.

Key benefits include:

• Affordable pricing: Prices are set close to wholesale cost, reducing the financial burden of long-term therapy.
• Verified quality: All tablets are packaged by GMP-certified manufacturers and undergo independent testing before shipment.
• Discrete delivery: Orders are shipped in unmarked packaging with secure tracking, protecting your privacy from start to finish.
• Reliable logistics: Options for express delivery (typically within 7 days) or standard airmail (approximately 3 weeks) are available, with a guaranteed delivery window.

Our pharmacy operates as a broker service, partnering with reputable international pharmacies that hold valid licenses. This model enables us to offer medicines that may not be listed on domestic formularies while maintaining the highest standards of safety and confidentiality.

Disclaimer

The information presented about Bupropion + Naltrexone is intended for educational purposes only and does not substitute professional medical advice. Treatment choices, including any off-label applications, must be made under the direct supervision of a qualified healthcare provider. Readers are presumed to be responsible adults capable of making informed health decisions. Our online pharmacy supplies Bupropion + Naltrexone to individuals who may experience restricted access through conventional pharmacies or insurance plans and who are looking for a reasonably priced generic option. Always discuss with your clinician before initiating, changing, or discontinuing any medication.