Contrave requires a prescription, but you can get one through your regular doctor, a weight management specialist, or an online telehealth visit. The medication is FDA-approved for adults with a BMI of 30 or higher, or a BMI of 27 or higher if you also have a weight-related condition like high blood pressure, type 2 diabetes, or high cholesterol.
Who Qualifies for a Prescription
The eligibility bar is straightforward. If your BMI is 30 or above, you meet the weight threshold on its own. If your BMI falls between 27 and 29.9, you’ll need to have at least one weight-related health condition to qualify. The most common qualifying conditions are high blood pressure, type 2 diabetes, high cholesterol, and sleep apnea. You also need to be at least 18 years old.
Certain medical histories will rule Contrave out entirely. You cannot take it if you have a seizure disorder, a history of bulimia or anorexia, bipolar disorder, uncontrolled high blood pressure, or if you currently use opioid medications (including opioid pain relievers and opioid-based addiction treatments). People going through alcohol or benzodiazepine withdrawal are also excluded, as are those taking MAO inhibitors or another formulation of either of Contrave’s two active ingredients.
Three Ways to Get a Prescription
Through Your Primary Care Doctor
The most direct route is asking your regular doctor. They already know your medical history, current medications, and any conditions that might affect whether Contrave is safe for you. If they agree it’s appropriate, they can write a prescription during a standard office visit. Some primary care doctors are comfortable prescribing weight management medications, while others may refer you to an obesity medicine specialist or endocrinologist.
Through Telehealth
Contrave’s manufacturer runs a telehealth service through GetContrave.com. The process works in four steps: you register on the site, complete a medical questionnaire about your health history, attend a short private video consultation with a provider, and if approved, the medication ships directly to your door. Several independent telehealth platforms also prescribe Contrave, so you’re not limited to the manufacturer’s service.
Through a Weight Management Clinic
Obesity medicine clinics and bariatric practices routinely prescribe Contrave alongside structured diet and exercise programs. These clinics often handle insurance prior authorizations on your behalf, which can save you significant time if your plan requires one.
What Insurance Typically Requires
Many insurance plans cover Contrave, but most require prior authorization before they’ll pay for it. The criteria can be more demanding than the FDA’s basic eligibility. A representative example from Johns Hopkins Health Plans shows the kinds of hoops insurers set up: you may need to demonstrate at least six months of documented behavioral modification and dietary changes that didn’t produce enough weight loss. Some plans also require that you’ve first tried and failed a 12-week course of a cheaper, generic weight loss medication like phentermine, unless you have a medical reason you can’t take it.
For renewal, insurers typically want to see that you’ve lost at least 5% of your starting body weight since beginning the medication and that you’re still actively following a reduced-calorie diet and exercise plan. If you haven’t hit that 5% mark, coverage may be denied going forward.
To find out what your specific plan requires, call the member services number on your insurance card. You can also contact the manufacturer directly at 800-905-5576 to check whether your plan covers the medication.
Lowering the Cost
If your insurance doesn’t cover Contrave, or if your copay is high, the manufacturer offers a savings card program. For insured patients, the card pays a portion of your copay. For uninsured patients, it reduces the total out-of-pocket cost. Eligibility requirements apply, and you can check whether you qualify through the manufacturer’s website or by phone. Pharmacy discount platforms like GoodRx also list negotiated prices that vary by pharmacy.
How the Medication Works
Contrave combines two medications that work together in the brain’s appetite center. The first component boosts the activity of neurons that naturally suppress hunger and reduce cravings. The second component blocks those same neurons from shutting themselves off, which is what they normally do after being stimulated. The net effect is a sustained reduction in appetite and food cravings that neither ingredient produces as well on its own.
In clinical trials, people taking Contrave lost an average of 6.4% of their body weight over 56 weeks, compared to 1.2% for those on a placebo. Both groups followed a reduced-calorie diet. That difference, roughly 5 percentage points, translates to about 10 to 15 pounds of additional weight loss for someone starting at 220 pounds.
The 4-Week Dose Ramp-Up
Contrave isn’t started at full strength. The dose increases gradually over four weeks to help your body adjust and minimize side effects.
- Week 1: One tablet in the morning only
- Week 2: One tablet in the morning, one in the evening
- Week 3: Two tablets in the morning, one in the evening
- Week 4 onward: Two tablets in the morning, two in the evening (full maintenance dose)
Tablets should not be cut, crushed, or chewed because they’re extended-release. The FDA labeling also warns against taking them with high-fat meals, which can affect how the medication is absorbed.
Common Side Effects
The most frequently reported side effects are nausea, constipation, headache, vomiting, and dizziness. Nausea is the most common reason people stop taking Contrave in the first few weeks, which is part of why the dose ramp-up exists. For most people, nausea improves as the body adjusts. Dry mouth, diarrhea, and insomnia also occur but tend to be less bothersome. If side effects don’t ease up after you’ve been on the full dose for a few weeks, your prescriber can help you decide whether to continue.