naltrexone ER/Bupropion ER

Question 1

brand

Answer 1

contrave

Question 2

MOA

Answer 2

opiate antagonist (naltrexone)

reuptake of inhibitor of DA and NE (bupropion)

Question 3

dose

Answer 3

titrate dose
week 1: 1 tab (8/90mg) PO QAM

Week 2: 1 tab (8/90mg) PO BID

Week 3: 2 tabs (total 16/180 mg) PO QAM and 1 tab (8/90 mg ) PO QHS

Week 4: 2 tabs total (16/180 mg ) PO QHS

Question 4

side effects

Answer 4

nausea, headache, insomina, vomiting, constipation, diarhea, dizziness, anxiety, xerostomia

Question 5

contradiction

Answer 5

• pregnancy and breastfeeding
• uncontrolled hypertension
• seizure disorder
• anorexia nervosa
• bulimia nervosa
• severe depression
• drug or alcohol withdrawal
  concomitant MAOI (withing 14 days)
• chronic opioid us

Question 6

monitor for

Answer 6

• increased heart rate and BP
• worsening of depression and suicidal ideation
• worsening of migraines
• liver injury (naltrexone)
• hypoglycemia in pt with T2DM treated with insulin and/or sulfonylureas
• seizures