Brief Answer:
Hello and Welcome to HealthcareMagic

Detailed Answer:
Contrave is a prescription weight loss medication and does come with side effects as most medications do. It acts on the hunger and reward systems of the brain and are composed of two separate and distinct FDA approved medications, bupropion for depression and smoking cessation, and naltrexone for alcohol and opioid dependence.

Each of these two drugs that make up Contrave come with their own risk profile and potential side-effects, but, I do point out that it is an approved drug by the FDA thus meaning it has been studies and met certain safety protocols.

Contrave may possibly increase suicidal ideation, aggravate seizures, and interfere with blood pressure control among other potential effects.

I hope I have answered your query and feel free to write back if you need further clarification.

Regards, XXXXXXX J. Shattler, BS,MS, RDN

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Brief Answer:
I understand and will address this issue

Detailed Answer:
Let me review some of the issues that came to mind when I reviewed your current weight, other conditions listed and medications as it relates to how I feel about the safety of you taking Contrave to lose weight. I am terribly sorry about the brevity of my initial response.

I looked at your age, cardiac stability because of your blood pressure issues, the fact that you are 360 lbs. which I am guessing places you in the BMI >40 or morbid obesity category (without height, cannot classify), the medications you are on and the symptoms you listed.

If you were my patient, I would concur with the prescription of Contrave given the fact that there are no drug interactions in the profile I ran, your blood pressure is well controlled and would stabilize further if you were successful with weight loss,also your age and inability to exercise with unsuccessful diet attempts indicates you need some outside help in losing that weight. The excess weight, by itself, is a huge contributor to high blood pressure, heart failure and the inability to exercise along with the back pain.

I do suggest you again try combining good portion control with weighing/measuring foods for an appropriate low calorie diet in conjunction with the Contrave and use some form of exercise along with it even if the exercise is in your chair (search for XXXXXXX XXXXX). Most weight loss diets for men will fall in the 1500 calorie per day ,but I would like to suggest you visit with a nutritionist for an individualized plan. It takes a deficit of 1000 calories/day to lose 2 lbs. a week and I know it can seem soooo slow!

Since losing weight is a high priority and the risk of taking Contrave in your particular situation seems rather low, with proper monitoring from the prescribing physician I also think it would be a safe medication for you to take, all things taken into consideration.

You ask about clinical response. The answer to that is somewhat dependent on you and your commitment to a lifestyle change in conjunction with being compliant in taking the medication as prescribed. Contrave needs to be taken in conjunction with a controlled low calorie meal plan and exercise as permitted by the treating physician. Compliance with all these factors is essential to the degree of success and response to this medication.

I have seen very good responses and I have seen poor. Again, there are many variables, as mentioned above, to consider when looking at the outcomes involved when prescribing Contrave. I would say, given the risks with cardiac outcomes in some of the other prescription weight loss medications and the problems with the bowels with the use of Orlistat (a fat inhibitor), Contrave seems like a logical choice for you.

Did this help clarify your question? I truly want you to be happy with my answer, so if this is not enough, kindly write back and I will see how I can further provide you with the answer you are seeking.

Kind Regards, XXXXXXX J. Shattler, BS, MS, RDN

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Brief Answer:
You are most welcome

Detailed Answer:
On a final note, Saxenda is out now and may be an option, but my concern with Saxenda is that the safety profile is not complete. And, the current potential side-effects are potential pancreatitis and a rare thyroid tumor. The studies on Saxenda, a GLP-1 inhibitor, show that some people lost 2.5x the weight loss with placebo and weight loss was maintained. The study had a small sample size. So, while the effectiveness of Contave in the actual published literature is mixed at best, it seems to be a reasonable option as I mentioned earlier.

One thing I failed to elaborate on that may help this situation with controlling your blood pressure while on Contrave (if this is the decision made) is to review the principles of the DASH diet and try, by reading labels and staying away from processed foods, keep your sodium under 2300 mg or so per day or 1 teaspoon of table salt equivocally. This can be turned into a calorie controlled diet and if you visit XXXXXXX under XXXXX you will find a XXXXXX. That board contains some ideas on how to adopt the DASH diet into a low-calorie meal plan.

Best of luck to you in reaching your goals!
Kathy Shattler, BS, MS, RDN

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