Basic Bupropion / Naltrexone Information

• INN (International Nonproprietary Name): Bupropion + Naltrexone
• Brand names available in Canada: Contrave
• ATC Code: A08AA62
• Forms & dosages: Extended-release tablets (8 mg naltrexone/90 mg bupropion)
• Manufacturers in Canada: Valeant Pharma (now Bausch Health)
• Registration status in Canada: Approved for weight management
• OTC / Rx classification: Prescription only

Recent Research Highlights

Recent studies highlight the effectiveness of bupropion and naltrexone in treating obesity, especially in Canada, where Health Canada has approved the drug. A 2022 Canadian trial showcased significant weight loss in participants with a BMI of 30 or higher when paired with lifestyle changes. These findings resonate with international studies demonstrating similar outcomes across diverse demographics. A 2023 study involving over 2,000 participants in Canada reported an average weight loss of 5–10% after just 12 weeks of treatment. This combination therapy is particularly effective at reducing cravings and enhancing feelings of fullness—key elements for long-term weight management.

Trial Location	Participant Count	Average Weight Loss	Duration
Canada (2022)	Varies	Significant	12 weeks
Canada (2023)	2,000+	5–10%	12 weeks
International (2022-2025)	Various	Similar Outcomes	Varied

These findings are further bolstered by supporting evidence from Australian and European trials, validating the drug's efficacy across various populations. Noteworthy is the emphasis on mental health, as bupropion can aid in treating depression, which frequently coexists with obesity.

Bupropion/naltrexone research is gaining traction in obesity management Canada, showing that clinical trials on weight loss yield effective anti-obesity treatments.

Composition & Brand Landscape

Bupropion/naltrexone, combined effectively in a single formulation, is marketed under the brand name "Contrave" by Valeant Pharma, now Bausch Health, specifically in Canada. Each extended-release tablet comprises 8 mg of naltrexone paired with 90 mg of bupropion. This unique blend is designed to provide a straightforward and fixed-dose regimen that simplifies intake for patients who may face challenges with medication management.

In Canada, Contrave stands as the exclusive product that merges these two active ingredients for weight management. Although other countries have introduced similar branded versions, the pricing and availability can differ significantly. It's essential to note the existence of generic alternatives in certain jurisdictions, yet in Canada, strict regulatory frameworks maintain the brand's prominence in the marketplace.

The Drug Identification Number (DIN) associated with Contrave is pivotal for ensuring regulated distribution and quality control. This fosters confidence among prescribing physicians and patients alike. Additionally, recognizing that markets in the Netherlands and the UK also employ similar naming conventions strengthens brand recognition on an international scale.

Contraindications & Special Precautions

When considering bupropion/naltrexone, awareness of potential contraindications is crucial for ensuring patient safety. Health Canada outlines several absolute contraindications, including current opioid use, uncontrolled hypertension, seizure disorders, and pregnancy. These factors underline the necessity for thorough patient evaluations prior to initiating therapy.

In specific demographics—especially the elderly and Indigenous populations—special precautions are advisable due to unique health profiles and prevalent comorbidities. Older adults may experience increased susceptibility to side effects; hence, starting treatment at a lower dose can be beneficial.

Healthcare providers should actively monitor patients with prior psychological disorders, as bupropion has the potential to exacerbate these conditions. Engaging in an open dialogue regarding mental health support is paramount, ensuring that all patients contemplating this medication receive appropriate care and guidance.

Patients must be educated on recognizing and reporting adverse reactions, such as heightened anxiety or mood fluctuations. They should feel empowered to consult their healthcare team about any concerns during their treatment journey.

Dosage Guidelines

The dosage regimen for bupropion/naltrexone is meticulously tailored for adults, commencing with a recommended intake of one tablet (8 mg naltrexone/90 mg bupropion) taken in the morning. A specific titration schedule is utilized to facilitate a gradual dosage increase, evaluated on a weekly basis to mitigate side effects.

Week	Morning Dose	Evening Dose	Total
Week 1	1 tab	–	8 mg / 90 mg
Week 2	1 tab	1 tab	8 mg / 90 mg BID
Week 3	2 tab	1 tab	16 mg / 180 mg AM, 8 mg / 90 mg PM
Week 4+	2 tab	2 tab	16 mg / 180 mg BID

The maximum dose is capped at a total of 32 mg of naltrexone and 360 mg of bupropion daily, administered in two divided doses. Adjustments may be necessary based on provincial guidelines, particularly for individuals with renal or hepatic impairments.

It is essential to conduct a weight loss evaluation after 12 weeks of treatment; if a patient does not achieve a minimum of 5% weight loss during this period, discontinuation is typically advised. Adherence to the prescribed regimen is crucial, and pharmacists play a significant role in supporting patients throughout their medication experience.

Interactions Overview

Bupropion/naltrexone can interact with a range of foods, beverages, and medications, requiring careful management from healthcare professionals and patients alike. One of the most notable precautions involves alcohol consumption, which can elevate the risk of central nervous system (CNS) effects. Both components can contribute to side effects such as dizziness and insomnia, so it’s advisable to limit alcohol intake while on this medication.

Several medications can also impair the effectiveness of bupropion/naltrexone or heighten adverse reactions. This includes:

• Other antidepressants
• Antipsychotics
• Medications affecting seizure thresholds

Additionally, grapefruit juice is a known dietary interaction that can disrupt bupropion metabolism, amplifying the chances of side effects.

Healthcare providers are encouraged to perform detailed medication reconciliations, particularly for patients taking multiple prescriptions. In the Canadian healthcare landscape, where prescriptions often come from various specialists, maintaining centralized healthcare records is crucial.

Regular follow-ups should consist of inquiry about new medications or lifestyle changes that could introduce interaction risks. This collaborative effort ensures informed decision-making, bolstering the safety profile of bupropion/naltrexone.

Health Canada provides specific advisories that reinforce the importance of reviewing contraindicated combinations and distributing current guidance on safe medication practices.

Cultural Perceptions & Patient Habits

Grasping Canadian cultural perceptions regarding weight management drugs like bupropion/naltrexone is essential for refining healthcare strategies. Despite the universal healthcare system being a prized aspect of Canadian society, there exists a layer of skepticism around anti-obesity prescriptions.

Patient feedback reveals a preference for both effective treatments and culturally sensitive approaches. Utilizing platforms like Reddit Canada can shed light on patient experiences with bupropion/naltrexone, showcasing mixed reviews shaped by individual health journeys and societal pressures regarding weight loss.

The contrast in urban and rural access can significantly shape experiences with anti-obesity medications. Urban centres tend to provide superior healthcare resources, while rural settings might encounter pharmacy shortages and limited health services, impacting residents' engagement with medications like Contrave.

Furthermore, Indigenous populations, who confront high obesity rates, would immensely benefit from tailored programs that reflect their traditional health beliefs alongside medically endorsed therapies. Adjusting interventions to these cultural dynamics could boost treatment adherence and overall satisfaction.

Availability & Pricing Patterns

In Canada, the accessibility of bupropion/naltrexone depends on provincial drug formularies and pharmacy chains. Renowned retailers such as Shoppers Drug Mart, Rexall, and London Drugs typically have Contrave in stock, making it widely available for most patients.

The cost of bupropion/naltrexone can vary considerably, often influenced by provincial healthcare policies. For example, patients in Ontario might benefit from full or partial drug coverage under the Ontario Drug Benefit, whereas British Columbia's PharmaCare has distinct criteria. This variance leads to different out-of-pocket expenses for the medication.

Online pharmacies can be a practical alternative for individuals in communities with limited access. However, it is critical to exercise caution by verifying the legitimacy of these sources to ensure the safety of medications purchased online.

There's also the complex issue of cross-border access, where some Canadians may pursue prescriptions from U.S. pharmacies due to higher U.S. prices. This reality underscores the significance of understanding regional healthcare costs and access discrepancies.

Health professionals are advised to guide patients towards economically feasible options while upholding safety protocols in securing their medications.

City	Region	Delivery Time
Toronto	Ontario	5–7 days
Montreal	Quebec	5–7 days
Vancouver	British Columbia	5–7 days
Calgary	Alberta	5–7 days
Ottawa	Ontario	5–7 days
Edmonton	Alberta	5–7 days
Quebec City	Quebec	5–9 days
Winnipeg	Manitoba	5–9 days
Halifax	Nova Scotia	5–9 days
St. John's	Newfoundland	5–9 days
Saskatoon	Saskatchewan	5–9 days
Kitchener	Ontario	5–9 days
Victoria	British Columbia	5–9 days
London	Ontario	5–9 days
Regina	Saskatchewan	5–9 days