Naltrexone–bupropion

This combination supports long-term weight management in eligible adults alongside nutrition and physical activity changes. It is not approved as a stand-alone treatment for depression or substance use disorder.

Bupropion affects norepinephrine and dopamine signaling; naltrexone blocks opioid receptors. Together they influence pathways involved in appetite and food reward.

Weight response is assessed after 12 weeks at the maintenance dose. If less than 5% of starting weight has been lost, labeling recommends stopping because meaningful longer-term benefit is unlikely. Your provider should direct that decision.

• Follow the weekly starting schedule. Swallow tablets whole; do not cut, crush, or chew.
• Do not take with a high-fat meal.
• Skip a missed dose and resume the schedule. Do not double.
• Do not combine with other bupropion-containing medications. Discuss all opioid use before starting.

• Nausea, constipation, or vomiting
• Headache, dizziness, or insomnia
• Dry mouth
• Increased blood pressure or pulse

Some side effects resolve with time; others may require a change of medication. Discuss persistent or bothersome side effects with your provider.

Antidepressants can increase suicidal thoughts in people under 25. Watch for changes in mood or behavior at any age, especially when starting treatment or changing a dose.

Tell your provider about emotional numbness, unusual agitation, or a reduced need for sleep with increased energy. These changes may call for a treatment adjustment.

Have blood pressure and pulse checked and track weight. Report new mood changes and symptoms of liver injury.

For a suspected overdose, call Poison Control at 1-800-222-1222 immediately, even if you feel well. Call 911 for a seizure, collapse, trouble breathing, or inability to wake.

Do not use with uncontrolled high blood pressure, a seizure disorder, anorexia or bulimia, ongoing opioid use, or another bupropion-containing medicine. Abrupt withdrawal from alcohol or certain sedatives can also rule out use. Stop weight-loss treatment if pregnant and contact your provider. Discuss breastfeeding.

Review all your medications with your provider, including over-the-counter medicines and supplements. Have new medications checked before taking them.

Opioids can trigger severe withdrawal or overdose-related risks. A supervised opioid-free interval is required before starting when relevant.

Do not combine with an MAOI; a 14-day separation is generally required. Review seizure-threshold-lowering drugs and medicines affected by CYP2D6.

A regular dose time and refill reminder can help prevent missed doses.

Bring a few specific observations to appointments: sleep, motivation, anxiety, and activities that have become easier or harder.

Keep medication in its labeled container, away from excess heat and moisture and out of reach of children and pets. Do not share it. Ask a pharmacy about disposal of unused medication.