There’s a new science-backed weight loss pill that’s been clinically proven to help you manage your weight: the bupropion-naltrexone pill.
In this article, we’ll explore how bupropion-naltrexone pills work, their potential benefits and side effects, and what you need to know before trying them.
What Is Bupropion?
Bupropion is a mild antidepressant used to treat anxiety and SAD (seasonal affective disorder). It’s also frequently used off-label to help you quit smoking.
Bupropion is often combined with other medication, such as naltrexone, for chronic weight management.
How Does Bupropion Work?
Bupropion is a dopamine and norepinephrine reuptake inhibitor, which means it prevents these two neurotransmitters from going back into your nerve cells and being destroyed.
This means that bupropion increases the amount of dopamine and norepinephrine flowing through your body.
Since these two chemicals are responsible for your mood and motivation, the more dopamine and norepinephrine you have, the better and less depressed you’ll feel.
What Is Naltrexone?
Naltrexone is a medication that’s used to treat opioid use disorder (OUD), alcohol use disorder, opioid withdrawal, and other drug addiction problems.
It’s widely available at pharmacies, rehab centers, and treatment facilities across the nation.
How Does Naltrexone Work?
Naltrexone is an opioid antagonist, meaning that it binds to opioid receptors in the brain and blocks the ability of opioids to attach to those receptors.
This prevents the release of endorphins, which are natural chemicals that produce feelings of pleasure and relaxation.
With these feelings curbed, patients addicted to opioids have better control over their opioid cravings and no longer chase that euphoric effect.
Bupropion and Naltrexone Combination Pills
Bupropion and naltrexone pills can help overweight and obese adults lose weight. However, they have to be coupled with proper exercise and a reduced-calorie diet.
This weight loss combination is prescription-only, meaning you can’t get it over the counter at your local pharmacy or drugstore. You’ll need your doctor or healthcare provider to prescribe it after making sure it’s suitable for your specific weight loss goals and health condition.
Bupropion and naltrexone are indicated for overweight and obese patients with one of the following conditions:
- An initial body mass index (BMI) of at least 30 kg per m2
- A BMI of at least 27 kg per m2, coupled with obesity-related risk factors such as diabetes, hypertension (high blood pressure), and hyperlipidemia (high cholesterol).
How They Work for Weight Loss
Each on its own, bupropion and naltrexone treat depression and addiction, respectively. However, when combined, their effects and side effects work synergistically to help you shed extra weight. Here’s how it happens.
Bupropion Weight Loss Mechanism
Many overweight or obese patients gain weight because they suffer from binge-eating disorder, which is associated with depression. Bupropion’s antidepressant effects can help with binge-eating disorder, as well as other eating disorders, making you feel fuller and less likely to want to eat.
Studies have also shown that bupropion has a mild fat-burning effect. In fact, in one study, over two-thirds of the patients taking bupropion lost more than 5% of their baseline body weight within eight weeks of taking the drug.
At the end of 24 weeks, 14 out of 18 patients had lost over 12% of their initial body weight, proving that bupropion is useful for weight loss.
Naltrexone Weight Loss Mechanism
Naltrexone works by reducing the endorphins released in your brain when you overeat. It gives you more control over your cravings by minimizing your brain’s reward system and various other euphoria-related systems.
The less euphoria you feel following a meal, the more control you have over your food intake. When combined with bupropion, naltrexone gives you a sense of satiety, which leads to better weight management in the long run.
How to Take Bupropion-Naltrexone Pills
Naltrexone and bupropion pills typically come in the form of extended-release tablets or pills meant to be taken orally. As an extended-release tablet, the pill contains a large amount of both active ingredients, which are released slowly over time.
That’s why it’s important to swallow the pill whole without chewing or crushing it so you don’t release all of the medication at once, which can be dangerous.
As with all oral medication, remember to drink a large glass of water with naltrexone and bupropion to help the tablet get absorbed.
You can take it with or without meals, but if you plan on eating, avoid fatty meals. When taken with a high-fat meal, naltrexone and bupropion can increase your risk of having a seizure, especially if you have any kind of seizure-related disorder.
Naltrexone and bupropion pills are usually taken in gradually increasing doses on a weekly basis.
Your doctor will usually start with one tablet daily, and each week, they’ll add one more tablet. This continues until you reach the maximum daily dosage of four tablets per day, which happens by the fourth week.
Four tablets are the typical maintenance dose most patients stay on for the course of their treatment. After about 12 weeks, your doctor will measure your weight loss, and depending on how much you’ve lost, they’ll recommend whether you should stay on the medication.
Naltrexone and bupropion pills have some mild side effects, which usually go away after a few weeks of treatment. Here are some of the common side effects you may encounter:
- Nausea and vomiting
- Gastrointestinal problems such as diarrhea or constipation (depending on how your body reacts to the drugs)
- Dryness of mouth and changes in your sense of taste
- Headaches, fatigue, and slight dizziness
- Loss of appetite, which is more of a benefit in this case than a side effect
- Mild tremors and excessive sweating
How Fast Does Bupropion and Naltrexone Work?
Most studies show that naltrexone and bupropion start working within a few weeks of taking the medication. However, you won’t notice drastic changes in your weight at first. It might take up to eight weeks before you start seeing changes in the mirror.
Following a proper exercise and diet plan can help fast-track your weight loss and increase the effectiveness of bupropion and naltrexone.
However, if you don’t lose at least 5% of your baseline body weight within 12 weeks of taking this medication, you should talk to your doctor about discontinuing it.
It’s very unlikely that you’ll experience clinically meaningful weight loss if you continue past the 12-week mark.
Here are a few precautions to keep in mind when taking naltrexone and bupropion:
Severe Rashes and Skin Reactions
When taking naltrexone and bupropion, some people develop minor rashes and skin reactions. However, if they become severe or turn into reddish-purple blisters, you should stop taking the medication immediately.
These blisters can start peeling if you continue taking the drug, which can be very painful.
Remember to check your lips, face, neck, and underarms for any signs of redness or swelling. If you experience a skin reaction along with swollen glands, fever, trouble breathing, or muscle pain, it could mean that you’re allergic to naltrexone or bupropion. If so, you should avoid this combination as well as any other medication that contains either active ingredient.
Depression and Mood Swings
Naltrexone and bupropion might cause some mood swings, depression, or psychological changes. This is more common when you first start taking the medication or when you change your dose.
Patients taking naltrexone and bupropion, as well as their loved ones, should keep an eye out for signs of new or worsening depression.
Other mental changes can happen as well, such as anxiety, panic attacks, impulsiveness, hyperexcitability, and the inability to sleep. Some adolescents even have suicidal thoughts when they first start on naltrexone and bupropion.
If you or your loved one experiences any of these symptoms, make sure to contact a healthcare provider. You might need to lower your dose of naltrexone and bupropion and then gradually increase it again so your body doesn’t react negatively.
If you suffer from any kind of liver disease, such as hepatitis or alcohol liver, notify your doctor before you start taking naltrexone and bupropion pills.
The bupropion in these pills has been found to cause liver damage in some rare cases, but the chances are greater if you already have some kind of liver condition.
When you first start taking naltrexone and bupropion, keep an eye out for signs of jaundice. If you notice your skin is pale or turning yellow or your urine is getting darker, you could have jaundice caused by the pills.
Naltrexone and bupropion can interact with many different medications. Talk to your doctor first if you’re taking any of the following medications:
- Medication for opioid use disorder (medication-assisted treatment), such as methadone and buprenorphine
- MAOIs (monoamine oxidase inhibitors) such as Carbex and Parnate
- Linezolid (an antibiotic mainly used for lung infections)
- Narcotics or opioid drugs, especially within the last 7-10 days
- Other bupropion-containing medications, such as Zyban and Wellbutrin
- Methylene blue
- Blood pressure medication such as metoprolol and propranolol
- Hepatitis medication (including HIV)
- Blood thinning medication such as warfarin and clopidogrel
In most of these cases, your doctor will likely recommend that you stop taking naltrexone and bupropion. However, you should ask your doctor about how long you should wait before you can continue taking any of the medications above.
For example, with MAOIs, you’ll need to wait at least two weeks after discontinuing naltrexone and bupropion before you can take MAOIs.
When Not to Take Bupropion and Naltrexone
While naltrexone and bupropion are relatively safe, certain people with weight-related medical problems should avoid this drug and seek other weight-loss medications.
You shouldn’t take naltrexone and bupropion if you have one of the following conditions:
- Uncontrolled high blood pressure
- Seizure disorders
- Opioid addiction
- Allergy to naltrexone or bupropion
Naltrexone and bupropion pills come with a lot of contraindications, so they’re not for everyone. However, if your doctor gives you the green light to try them, you should give it a go.
These pills have helped many people shed excess weight, and if you couple it with exercise and diet, you could reach your ideal body weight, too!
What Happens if I Miss a Dose of Bupropion-Naltrexone?
Don’t panic if you miss a dose of bupropion-naltrexone. You can take the missed dose as soon as you remember it, as long as it’s not too close to the next dose.
However, your maximum allowed dose per day is four tablets, and you should never take two tablets at the same time.
What Happens if I Take Too Much Bupropion-Naltrexone?
If you take too many tablets, seek medical attention immediately and contact a poison control center until help arrives.
And keep in mind that when taken with opioid medications, a naltrexone-bupropion overdose causes dangerous side effects, leading to coma and death.