Bupropion/Naltrexone for Weight Loss

Overview

Bupropion/naltrexone is a medication that is used to help with weight loss in adults who are obese or overweight with a weight-related condition, such as high blood pressure or type 2 diabetes. It is a combination of two active ingredients: bupropion and naltrexone.

Here’s more information on each active ingredient:

Bupropion is an antidepressant that is also used for smoking cessation. It works by preventing the reuptake of dopamine, a chemical in the brain that plays a role in regulating mood and appetite. By increasing dopamine levels, bupropion can help suppress appetite and reduce food cravings.
Naltrexone, on the other hand, is an opioid receptor antagonist. It is primarily used to treat opioid and alcohol dependence. However, studies have shown that naltrexone can also have an impact on eating habits. By decreasing dopamine release, naltrexone has been shown to lower food intake, consumption, and binge eating behavior.

When combined, bupropion and naltrexone have been found to have a synergistic effect on weight loss. Clinical trials have shown that the combination of these two medications can lead to significant weight reduction, with many participants losing around 5% to 10% of their initial body weight over one year when combined with lifestyle changes. In fact, studies have found that the combination of naltrexone/bupropion can result in greater weight loss compared to using each medication alone.

It's important to note that bupropion/naltrexone should be used in combination with changes in diet and exercise for long-term weight management. As with any medication, bupropion/naltrexone can cause side effects. Some common bupropion and naltrexone side effects include nausea, which may cause some patients to discontinue the treatment. Additionally, emotional or mental health problems can happen in people who don’t have a diagnosed mental illness, and there may be a risk of seizures, especially in patients with a previous history or excessive alcohol intake or cocaine use.

Overall, bupropion/naltrexone is one of many medication options for weight loss that can be prescribed by healthcare professionals to assist with weight loss in adults who are obese or overweight with certain weight-related conditions. It works by suppressing appetite, reducing food cravings, and potentially leading to significant weight reduction when used alongside lifestyle changes such as diet and exercise.

Who May be Prescribed Bupropion and Naltrexone for Weight Loss

Bupropion and naltrexone are approved for chronic weight management in adults with obesity or overweight who also have weight-related medical conditions. It is prescribed as part of a comprehensive approach that includes dietary changes and physical activity.

How Medication Works

Here's how bupropion and naltrexone work together to help with weight loss:

Bupropion: Bupropion belongs to a class of drugs called aminoketone antidepressants. It affects the activity of neurotransmitters called norepinephrine and dopamine, which play a role in regulating mood. While the exact mechanism of action is not fully understood, it is believed that bupropion helps prevent the reabsorption of norepinephrine and dopamine into nerve cells in the brain. This can regulate the levels of these chemicals in the brain and improve communication between nerve cells.
Naltrexone: Naltrexone is an opioid antagonist, meaning it blocks certain receptors on brain cells. By blocking these receptors, naltrexone helps prevent the release of dopamine, a neurotransmitter involved in reward and pleasure. The exact way naltrexone works for weight loss is not completely understood.

When bupropion and naltrexone are used together, they work synergistically to promote weight loss. Bupropion increases the levels of dopamine and norepinephrine, which are linked to controlling appetite and how the body uses energy. At the same time, naltrexone blocks opioid receptors, reducing the rewarding effects of food and enhancing the action of bupropion.

For readers interested in how bupropion alone affects appetite and weight, bupropion for weight loss is covered in more detail in a separate article.

How to Use Medication

To use or take bupropion/naltrexone, it is important to follow the instructions provided by your healthcare provider. Here are some general guidelines:

Take bupropion/naltrexone exactly as prescribed by your healthcare provider. Do not change your dose unless instructed to do so.
The usual dose of bupropion/naltrexone is 16/180 mg twice daily.
Bupropion/naltrexone should be taken with food to help reduce the risk of nausea.
Swallow the tablets whole. Do not crush, chew, or break them.
If you miss a dose, take it as soon as you remember. However, if it is close to the time for your next dose, skip the missed dose and continue with your regular dosing schedule.

How dosing is increased over time

Week 1: one tablet taken in the morning
Week 2: one tablet in the morning and one tablet in the evening
Week 3: two tablets in the morning and one tablet in the evening
Week 4 and beyond: two tablets in the morning and two tablets in the evening

Precautions and potential side effects of bupropion/naltrexone

Precautions:
Inform your healthcare provider about all the medications you are taking, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.
Let your healthcare provider know if you have any medical conditions, especially uncontrolled hypertension (high blood pressure).
Bupropion/naltrexone may increase blood pressure, so it is important to monitor your blood pressure regularly during treatment.
Potential side effects:
The most common side effects of bupropion/naltrexone include nausea, headache, and constipation.
Nausea can often be managed with short-term use of antiemetic medications.
Headache and constipation may also occur but usually improve over time.
Injection site reactions may occur with the extended-release injection formulation of naltrexone. These reactions are usually mild and can be treated with non-steroidal anti-inflammatory (NSAIDs) medication and hot/cold packs.

Who should not use bupropion and naltrexone

People with a history of seizures
Individuals with eating disorders such as anorexia or bulimia
People with uncontrolled high blood pressure
Those currently using opioid medications

Remember to consult your healthcare provider if you have any concerns or questions about using bupropion/naltrexone. They will provide personalized advice based on your specific situation and medical history.

Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Other side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.