Medical uses

Naltrexone/bupropion is indicated, as an adjunct to a reduced-calorie diet and increased physical activity, for the management of weight in adults with an initial Body Mass Index (BMI) of:^[1][2]

• 30 kg/m² (obese), or^[1][2]
• 27 kg/m² to < 30 kg/m², (overweight) in the presence of one or more weight-related comorbidities, like type 2 diabetes, dyslipidaemia, or controlled high blood pressure^[1][2]

Contraindications

The manufacturer recommends against its use in people that have/are:^[1]

• History of seizures
• History of an eating disorder such as bulimia nervosa or anorexia nervosa
• Taking opioid pain medicines, taking medicines to stop opioid addiction, or are in opiate withdrawal
• Taking an MAOI or have taken an MAOI in the last 14 days
• Pregnant
• Abruptly stopped using: alcohol, benzodiazepines, barbiturates, or antiepileptic drugs

Read the Medication Guide if available from your pharmacist before you start taking naltrexone/bupropion and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth with a low-fat meal as directed by your doctor, usually twice daily.

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You may have trouble sleeping when you start taking this drug. Do not take your evening dose too close to bedtime.

Swallow the tablets whole. Do not crush or chew this medication. Doing so can release all of the drug at once, increasing the risk of side effects such as seizures.

The dosage is based on your medical condition, response to treatment, and other medicationsyou may be taking. Your dose will be slowly increased to lower the risk of seizures and to limit side effects such as sleeplessness, symptoms of withdrawal from opiates, and high blood pressure. Do not increase your dose, take it more often, or stop taking it without your doctor’s approval.

Use this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day.

Tell your doctor if you have not lost weight after 16 weeks on this medication.

Side Effects

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Nausea, vomiting, constipation, stomach pain, headache, dizziness, trouble sleeping, increased sweating, flushing, and dry mouth or strange taste in the mouth may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: mental/mood changes (anxiety, agitation, confusion, memory loss), uncontrolled movements (tremor), ringing in the ears, fainting, severe headache, fast/pounding/irregular heartbeat, chest pain.

Get medical help right away if you have any very serious side effects, including: eye pain/swelling/redness, widened pupils, vision changes (such as seeing rainbow around lights at night).

If you have been taking opioid medications regularly, you could have withdrawal symptoms within minutes after taking naltrexone. Tell your doctor right away if you have any of the following symptoms of narcotic withdrawal: mental/mood changes (such as anxiety/irritability), fast breathing, yawning, sweating, watering eyes, goose bumps, muscle twitching.

This drug may rarely cause seizures. Get medical help right away if you have a seizure. If you have a seizure while taking bupropion, you should not take this drug again.

Naltrexone may rarely cause serious (possibly fatal) liver disease. The risk is increased when larger doses are used. Discuss the risks and benefits with your doctor. Stop using this medication and tell your doctor right away if you have symptoms of liver damage, including: persistent nausea/vomiting, loss of appetite, severe stomach/abdominal pain, yellowing eyes/skin, dark urine.