While 1/3 of Americans are obese and 2/3 are overweight, there are currently only 5 FDA-approved prescription drugs on the market to aid weight loss. (A 6th, Vyvanse, was approved for the treatment of a related condition, binge eating disorder.)
Now that obesity has been declared a disease by the American Medical Association, new drugs are coming to market and more are likely to become available.
This chart offers an explanation of how each of the 53 prescription drugs work and their many side effects –Liz Neporent
If any of the following symptoms of overdose occur while taking bupropion / naltrexone, get emergency help immediately:
- symptoms of overdose
- blue lips, fingernails, or skin
- change in consciousness
- decreased awareness or responsiveness
- dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
- loss of consciousness
- muscle cramps or spasms
- severe sleepiness
Some of the side effects that occur with bupropion/naltrexone combination may not need medical attention. As your body adjusts to the medicine during treatment these side effects may lessen or go away completely. Your health care professional may also be able to guide you regarding ways to reduce or prevent some of these side effects.
Effectiveness: The effectiveness of Contrave was evaluated in several clinical trials that included approximately 4,500 obese and overweight patients with and without other weight-related medical problems. In one trial of patients without diabetes, those taking Contrave lost 5.4% of their body weight compared to 1.3% taking a placebo after 56 weeks. 42% of the patients in the trial taking Contrave lost 5% or more of their body weight compared to 17% of those not on Contrave. All patients followed a diet and exercise regimen.
Black Box Warning: In its release about the approval of Contrave, the FDA makes this note: “Because it contains bupropion, Contrave has a boxed warning to alert health care professionals and patients to the increased risk of suicidal thoughts and behaviors associated with antidepressant drugs. The warning also notes that serious neuropsychiatric events have been reported in patients taking bupropion for smoking cessation.”
Contrave can also cause seizures and should not be used in patients who have seizure disorders. Contrave can also raise blood pressure and heart rate and should not be used in patients with uncontrolled high blood pressure. Blood pressure and pulse should be measured prior to starting the drug and monitored at regular intervals. Other products containing bupropion, such as Wellbutrin and Aplenzin, should not be taken in conjunction with Contrave. The medication can also cause liver and vision problems.
Other groups who should not take Contrave including those who:
- have or have had an eating disorder called anorexia (eating very little) or bulimia (eating too much and vomiting to avoid gaining weight)
- are dependent on opioid pain medicines or use medicines to help stop taking opioids such as methadone or buprenorphine, or are in opiate 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 if you are not sure if you take an MAOI, including linezolid. Do not start Contrave until you have stopped taking your MAOI for at least 14 days.
- are allergic to naltrexone or bupropion or any of the ingredients in Contrave.
- are pregnant or planning to become pregnant. Tell your healthcare provider right away if you become pregnant while taking Contrave.
If a patient has not lost at least 4% of body weight at 16 weeks, the drug should be discontinued as it unlikely to offer any meaningful clinical results for weight loss after that point. In rodent studies, the drug caused thyroid gland tumors but it is not known if it will do the same in humans;
for this reason Saxenda has a boxed warning.