Naltrexone-bupropion (Contrave)

What it means

Contrave combines bupropion, an antidepressant also used to help people quit smoking, with naltrexone, which blocks opioid receptors. Together they act on brain areas that control appetite and cravings. The FDA approved it in 2014, and the dose is stepped up over about four weeks.

Because bupropion is an antidepressant, the label carries a boxed warning about suicidal thoughts and behavior, especially in young people. It can also raise blood pressure and heart rate and, rarely, cause seizures.

It should not be used with uncontrolled high blood pressure, a seizure disorder, an eating disorder such as bulimia or anorexia, or with opioid medicines, since naltrexone blocks them. Nausea, constipation, headache, dizziness and trouble sleeping are common.

The label advises stopping if weight loss is less than 5% after 12 weeks on the full dose.

Why it matters

Contrave is a pill option that targets cravings, but its opioid and mental health warnings rule it out for some people.