Contrave dosage usually starts with one tablet in the morning and increases weekly until the usual maintenance schedule of two tablets twice daily is reached in week 4, if tolerated. This gradual titration matters because the medicine contains bupropion, which can increase seizure risk at higher exposures, and naltrexone, which can affect opioid use and pain treatment planning.
Contrave combines naltrexone, an opioid receptor antagonist, with bupropion, a norepinephrine-dopamine reuptake inhibitor. The tablet is extended release, meaning it releases medicine over time. Use this article to understand the labeled schedule, food instructions, spacing, and safety conversations to have with your prescriber.
Key Takeaways
- Weekly titration: the dose usually increases over four weeks.
- Tablet strength: each tablet contains 8 mg naltrexone and 90 mg bupropion.
- Daily maximum: the labeled maintenance dose is two tablets twice daily.
- Food rule: avoid high-fat meals when taking a dose.
- Safety checks: review seizures, blood pressure, opioids, alcohol, and interactions.
How Contrave Dosage Builds Over the First Month
The labeled dosing schedule increases step by step to help the body adjust. In week 1, the usual starting dose is one tablet in the morning. In week 2, one tablet is taken in the morning and one in the evening. In week 3, the morning dose increases to two tablets while the evening dose stays at one tablet. By week 4, the usual maintenance schedule is two tablets in the morning and two in the evening.
This schedule is sometimes called titration. Titration means increasing a medicine gradually, instead of starting at the full amount. With this medication, that approach may help manage early nausea, headache, sleep disruption, and other tolerability issues. It also keeps the plan within label limits while your prescriber monitors risk factors.
| Week | Morning Dose | Evening Dose | Total Daily Amount |
|---|---|---|---|
| Week 1 | 1 tablet | 0 tablets | 8 mg naltrexone / 90 mg bupropion |
| Week 2 | 1 tablet | 1 tablet | 16 mg naltrexone / 180 mg bupropion |
| Week 3 | 2 tablets | 1 tablet | 24 mg naltrexone / 270 mg bupropion |
| Week 4 and after | 2 tablets | 2 tablets | 32 mg naltrexone / 360 mg bupropion |
The highest labeled Contrave dosage is two 8 mg/90 mg tablets twice daily, for a total of 32 mg naltrexone and 360 mg bupropion each day. Do not take extra tablets to make up for a missed dose. If a dose is missed, the label generally directs patients to skip it and take the next dose at the regular time.
Never crush, split, or chew the tablets. Doing so can change the extended-release design and may increase adverse effects. If nausea, dizziness, insomnia, or other symptoms interfere with daily life, contact your prescriber before changing the schedule.
For a broader look at how this medication is used in weight management, see Contrave For Weight Loss.
Best Timing: Morning, Evening, and Dose Spacing
A consistent morning and early evening routine usually works best. Many people take the morning dose with breakfast and the evening dose with dinner, as long as the meal is not high in fat. The evening dose should not be taken close to bedtime because bupropion can contribute to insomnia in some people.
People often ask how many hours should separate doses. The label does not require a single exact spacing rule for every patient, but many clinicians prefer a practical morning-to-evening gap, often around eight hours or more. The main goals are to avoid dose stacking, protect sleep, and keep the routine realistic.
Work schedules can complicate timing. A night-shift worker may need a different “morning” and “evening” pattern than someone with a daytime schedule. The important point is to keep the two dosing periods separated and to avoid taking the second dose right before sleep. Your prescriber can help adapt the timing without exceeding the labeled daily maximum.
Quick tip: Use a written weekly schedule during titration, since the tablet count changes each week.
Food, Swallowing, and Absorption Rules
Contrave can be taken with food, but it should not be taken with high-fat meals. High-fat meals can increase exposure to the medicine, which may raise the chance of side effects. A modest meal or snack is often easier on the stomach than taking a dose on an empty stomach.
If morning nausea occurs, some people find that taking the dose after a small, lower-fat meal helps. Do not change dose amounts or skip steps in the titration without medical guidance. Instead, write down when nausea happens, what you ate, and whether it improves over time.
Swallow each tablet whole with water. Avoid crushing, cutting, or chewing tablets. Extended-release tablets depend on their structure to release medicine gradually. Changing that structure can make the drug act differently than intended.
Food choices also matter because this medication is meant to support a structured weight-management plan, not replace it. If you are adjusting meals while starting therapy, the Weight Management article collection may help you discuss nutrition, activity, and long-term planning with your care team.
What Is in Each Tablet?
Each tablet contains 8 mg naltrexone and 90 mg bupropion in an extended-release formulation. That means one maintenance day at two tablets twice daily contains 32 mg naltrexone and 360 mg bupropion. These numbers are useful when comparing the branded combination with separate ingredient prescriptions, but they do not tell the whole story.
The release pattern matters. Separate naltrexone and bupropion tablets may not produce the same absorption profile, even when the total milligrams seem similar. Immediate-release, sustained-release, and extended-release forms can behave differently in the body. Substituting separate products should only be discussed with a prescriber who understands the differences and risks.
Some online discussions mention naltrexone 50 mg plus bupropion SR 150 mg for weight loss. That is not the same as labeled Contrave dosage. It may involve different strengths, different release timing, and different adverse-effect considerations. Reviews and personal stories can be useful for questions to ask, but they should not be used to design a regimen.
For tablet strength and product format details, see Contrave 8 mg/90 mg Tablets. Treat product pages as a reference point for formulation, not as a substitute for prescribing advice.
Safety Checks Before and During Titration
Safety screening is essential before starting this medication. Bupropion can lower the seizure threshold, meaning it can make seizures more likely in susceptible people. Your prescriber should review seizure history, eating disorders, abrupt alcohol or sedative withdrawal, significant head injury, and other medicines that may also affect seizure risk.
Blood pressure and pulse also need attention. Contrave may increase blood pressure or heart rate in some patients, especially during dose escalation. People with uncontrolled high blood pressure generally should not use it. Home readings can be helpful, but they should be interpreted with your clinician, especially if numbers rise or symptoms appear.
Naltrexone creates another important safety issue. It blocks opioid receptors. This can reduce the effect of opioid pain medicines and can trigger withdrawal in people who are physically dependent on opioids. Tell your prescriber about any opioid pain medicines, cough products, diarrhea medicines, or treatment for opioid use disorder before starting therapy.
Alcohol deserves a specific discussion. Heavy use, sudden stopping, and alcohol-related health risks can change the safety picture. For more detail on this interaction topic, read Contrave And Alcohol.
Seek urgent medical care for symptoms such as seizure, severe allergic reaction, chest pain, fainting, or thoughts of self-harm. Also contact a clinician promptly for severe mood changes, very high blood pressure readings, or symptoms of opioid withdrawal.
Tracking Progress Without Overreading Early Results
The first month mainly shows whether you can tolerate titration. It is usually too early to judge the full weight-management response from pictures or short-term reviews alone. Body weight can fluctuate because of fluid shifts, digestion, menstrual cycles, sodium intake, and changes in activity.
A simple tracking plan is more useful than comparing yourself with 1 month results pictures. Record weight at a consistent time, waist measurement if appropriate, hunger, cravings, sleep, side effects, and missed doses. Bring the log to follow-up visits so your prescriber can assess both benefit and tolerability.
The tool below can help estimate general weight-change progress toward a goal. It does not determine whether Contrave is working, whether the dose is right, or whether you should continue treatment.
Weight-Loss Progress Calculator
Track percentage body-weight change and progress toward a target weight.
These calculations are for education only and do not replace clinical advice, diagnosis, or treatment. Always confirm medical decisions with a qualified healthcare professional.
Many labels and clinical discussions use a reassessment point after a patient has been on the maintenance dose for a defined period. Your prescriber may look at weight change, adverse effects, blood pressure, mood, and adherence before deciding whether the plan still fits. Do not stop or restart medication without asking, especially if other conditions or medicines are involved.
Why it matters: Early tracking is most useful when it captures side effects and habits, not only weight.
When a Different Weight-Management Option May Fit Better
Contrave is one medication option within long-term obesity or weight-management care. Other medicines use different mechanisms, dosing schedules, and monitoring needs. For example, GLP-1 receptor agonists affect appetite and glucose-related pathways, while sympathomimetic medicines such as phentermine have different stimulant-related considerations.
The best option depends on medical history, contraindications, side-effect tolerance, preferences, and access. A person with chronic opioid therapy, uncontrolled hypertension, or a seizure risk factor may need a different discussion than someone without those concerns. Pregnancy planning, mental health history, and substance use history can also affect the choice.
If you are comparing medication pathways, Contrave Vs Wegovy reviews key differences in format and clinical considerations. For another prescription option used in weight management, Phentermine Uses And Dosage explains how that medication differs in practical use and precautions.
Some patients also explore cash-pay options or cross-border fulfillment, depending on eligibility and jurisdiction. CanadianInsulin.com functions as a prescription referral platform, and dispensing is handled by licensed third-party pharmacies where permitted. That access context does not change the need for a valid prescription and individualized medical review.
Authoritative Sources
For labeled dosing, contraindications, high-fat meal guidance, and maximum daily dose limits, review the FDA prescribing information for Contrave.
For an independent clinical summary of naltrexone/bupropion extended release, see this peer-reviewed review on PubMed Central.
For a product monograph-style regulatory reference outside the United States, consult the Medsafe data sheet for Contrave.
Recap
Contrave dosage is built around gradual titration, twice-daily timing, and careful safety screening. The usual maintenance amount is reached at week 4 if tolerated, but the plan should remain tied to blood pressure, side effects, medication interactions, and overall response.
Take tablets whole, avoid high-fat meals, and keep the evening dose away from bedtime when possible. Use tracking notes to support follow-up conversations rather than relying on reviews or early photos. Your prescriber can help decide whether the labeled schedule, a pause in escalation, or another weight-management option is the safer fit.
This content is for informational purposes only and is not a substitute for professional medical advice.
