Contrave Dosage Question

My doctor prescribed to take this as 2 pills 2x per day. Not a ramp up like I read about online - has anyone else done this? I have not started taking the pills yet.

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You really should gradually increase it. It isn't fun gradually, it has to really suck taking it all at once. I would think it could hurt you taking it all straight away.

The dr will write the rx for the full amount but either tell the pt to gradually increase or give them a sheet of paper. He gave me a pamphlet from the company that makes it. Ive found this to be common with other medicines that had to be brought up to a full dose over time.

You should call and ask your doctor what you should do and tell them about the titration schedule. He may not know about it. I've had to inform my doctors about a lot of things involving my medications over the years. I think they only know what the reps tell them sometimes.

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I was taking the Saxenda shot and was already doing the 3.0 injection for like 2 weeks before switching to Contrave. I heard Contrave is just the pill from of Saxenda...do i really need to follow the titration of the Contrave all over again? This is my first week and I have already noticed that I am much more hungry than i was the past few weeks and I have gained weight!! I am thinking its because my body has already tolerated the maximum Saxenda dosage and i digressed to the lowest of its pill equivalent. Please advise!!

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@MsPrez,

Because Contrave and Saxenda contain different active ingredients, Contrave could not rightfully be considered a pill form of Saxenda. Here's a few important differences that stand out to me and are indicative of why the two medications cannot be compared in such a way with regards to titration:

- Contrave contains bupropion + naltrexone

- Saxenda contains liraglutide

- Contrave is specifically indicated for treating obesity (however it's active ingredients are an antidepressant and a drug used for alcohol & opioid dependence) - Go figure how that works?! LOL

- Liraglutide is specifically indicated for regulating blood sugar levels in adults with type 2 diabetes

I just wanted to get this info across to you because taking the time to follow the titration schedule for Contrave may lay necessary groundwork for a successful regiment to take place, that might otherwise be jeopardized by unwanted side effects, etc... If in doubt, I'd still encourage you to talk with your doctor about it. That way you can rest assured you're making the right decision.

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I'm going on my second week of Contrave and I have lost 5 lbs. I have experienced some nausea, a little lightheadedness, and it feels like I have a lump in my throat at times. I eat half as much, and have no desire to drink alcohol, which I drank several days a week. Starting two pills today. Wondering if it will give me worse side effects? Seems like the one pill is working though.

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If your doctor and the pharmacy which filled the medication, did not flag the dosage, there may be reasons why. Or your doctor may have messed up and you should call his office during office hours to find out what to take for certain ( as this is not an emergency situation requiring an after- hours communication). Your physician may change your dosage. Write it down as he or she tells you the new dosage. There is no need for any pharmacy changes. The tablets all contain the exact same medications in the exact same dose per tablet.

Some of the valid reasons a doctor started the dosing on a higher part of the schedule could be:

1) Client took Bupropion at a higher dose as an anti-depressant or at the same dose as a smoking- cessation medication. Therefore, there is ample evidence that client tolerates the main ingredient well. No recent history of seizures or elevated BP with the higher dose given as an anti-depressant. NOTE- Do not take Bupropion as an anti-depressant at a higher dose and the Contrave.

2) Client's weight is high enough that 2 tablets give the same effect in this client as 1 tablet dosing would give in a person weighing much less.

An example of this is children. Children get antibiotics and other meds. prescribed according to their weight, not their age.
An adult to adult example would be...why one patient returns to a hospital room after surgery and gets 75-199mg of Meperidine for pain while another gets an injection of 50mg. max. every 4 hours as needed.

The one getting the higher dosage, most other factors being equal, would be that the first patient is a large male and the second patient is a small to average sized female.

With weight loss medications as well as other medications, there can be sufficient weight differences that a doctor will elevate the starting dose to 2 tablets. I do not have the authority to say if this is right or wrong, but it is following a principle of medication dosing and NOT the Contrave arbitrary label dosing schedule.

If neither of these apply to you, and you are having side effects or have a relative contraindication to either ingredient ( history of hypertension controlled on meds, past cardiac event, any sort of stroke, have a chronic GI tract disorder or disease),
then the doctor should be contacted immediately.

I have never taken the medication on the prescribed sliding scale, but I am an advanced practice registered nurse and I monitor my BP, my heart rate, and of course am aware of any mild GI upset. If it occurs, I monitor and then may drop the dosing back to a smaller dose. I start with one tablet every AM and PM.

In a week, I bump it up to two tablets in the AM, one in the PM for a few days, then, if all is going great, I go up to the regular dose of 2 pills every AM and PM.

The point of me telling this is NOT SO PEOPLE MESS WITH THEIR DOSING but to say personally "I have done it and it didn't hurt me, so your life is probably not in jeopardy. Approach this calmly if you have taken more than what the label says."

The truth is that doctors/ drug manufacturers KNOW that people will get their dosages wrong. They cannot make a recommended dose schedule which would be DANGEROUS to the majority of the prescribed patients. In other words, if 2 tablets twice a day were ever " dangerous" to a healthy person ( with a weight problem sufficient to take the medication which is not exactly the definition of optimal health, is it?) they would never prescribe the 4 tablets per day on week 4 and thereafter. There is a built- in margin of error owing to some patients' difficulty understanding or remembering how many tablets to take when, the very common " forgot whether I took it so I'll take it now" leading to 2 tablets being taken early on in drug therapy, and other things humans do because we are imperfect.

TL; DR- Since no one who is physically tiny or medically unstable should be prescribed this medication, most people should be OK with an accidental 2 tablets instead of one.

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I have read short but intermittent warnings about drinking alcohol while taking this drug. I've taken it now for about 5 days with minimal side effects. I enjoy an evening cocktail before dinner, but it's not worth getting sick over, right? Thanks for sharing your thoughts.

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Is there any harm in not increasing to the full dosage strength of 2 and 2?

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