bupropion hydrochloride + naltrexone hydrochloride at a glance
Medicine class
Centrally acting anti-obesity treatment combining an opioid antagonist with a noradrenaline–dopamine reuptake inhibitor.
Licensed role
Weight management in eligible adults, with dietary change and increased physical activity.
Tablet type
Prolonged-release tablet that must be swallowed whole.
Important opioid warning
It blocks opioid medicines and can precipitate withdrawal in someone who is opioid-dependent.
Driving
Do not drive or use machinery if dizziness, sleepiness, faintness or other impairing effects occur.
What is bupropion hydrochloride + naltrexone hydrochloride used for?
It is licensed as an adjunct to a reduced-calorie diet and increased physical activity.
Weight management in adults with obesity.
Weight management in adults who are overweight and have at least one weight-related condition, such as type 2 diabetes, abnormal blood lipids or controlled hypertension.
How does bupropion hydrochloride + naltrexone hydrochloride work?
Bupropion increases noradrenaline and dopamine signalling in appetite-regulating pathways. Naltrexone blocks opioid feedback that would otherwise limit this activation. Together they act in brain regions involved in appetite, energy balance and food reward, although the complete mechanism is not fully understood.
bupropion hydrochloride + naltrexone hydrochloride preparations and strengths
Modified-release tablet
Route: Oral
Strengths: 8 mg + 90 mg
How to take bupropion hydrochloride + naltrexone hydrochloride
Follow the prescription label and prescriber’s instructions. Take the prolonged-release tablets by mouth, preferably with food.
Swallow tablets whole with water.
Do not cut, chew or crush them, as this can alter prolonged release.
Before planned surgery, pain treatment, or treatment for a cough or diarrhoea, tell healthcare professionals that you take naltrexone because some products contain opioids.
Avoid or minimise alcohol. People who drink heavily should not stop suddenly without medical advice.
bupropion hydrochloride + naltrexone hydrochloride side effects
Common or expected effects
- Nausea or vomiting
- Constipation
- Headache
- Dizziness or vertigo
- Dry mouth or altered taste
- Anxiety, irritability or difficulty sleeping
- Tremor
- Tiredness or sleepiness
- Abdominal pain
- Increased blood pressure or heart rate
- Excessive sweating, itching or rash
Get urgent medical advice
- Seizure or loss of consciousness
- Severe allergic reaction, including facial or throat swelling or breathing difficulty
- Suicidal thoughts, marked mood deterioration or unusual behavioural change
- Severe blistering, peeling or pustular skin reaction
- Possible serotonin syndrome, particularly with serotonergic medicines
- Severe or sustained blood-pressure elevation
- Symptoms of liver injury, such as jaundice or dark urine
- Severe muscle pain, weakness or cramps suggesting muscle breakdown
bupropion hydrochloride + naltrexone hydrochloride in pregnancy
This combination should not be used during pregnancy or while trying to conceive because human data are limited and fetal risk is uncertain. If pregnancy occurs, contact the prescriber for a treatment review rather than making unsupported changes alone.
bupropion hydrochloride + naltrexone hydrochloride while breastfeeding
Naltrexone, bupropion and their metabolites enter breast milk, and risk to a breastfed infant cannot be excluded. This product should not be used while breastfeeding; discuss alternatives with the prescriber.
bupropion hydrochloride + naltrexone hydrochloride interactions
Check prescribed, over-the-counter and recreational substances before treatment because clinically important interactions are numerous.
Opioids, including methadone, codeine, morphine, tramadol and opioid-containing cough or diarrhoea products
Naltrexone can block opioid effects, precipitate withdrawal and encourage dangerous attempts to overcome the blockade.
Monoamine oxidase inhibitors
Concurrent or recently discontinued treatment is contraindicated because catecholaminergic effects may be excessive.
SSRIs, SNRIs and other serotonergic medicines
Serotonin syndrome has been reported. Counselling and clinical monitoring are required when combined treatment is considered necessary.
Common questions about bupropion hydrochloride + naltrexone hydrochloride
Answers are fully visible for fast scanning and source review.
What is bupropion hydrochloride + naltrexone hydrochloride used for?
It is licensed with dietary change and increased physical activity for weight management in eligible adults with obesity, or overweight with a weight-related condition.
How does it reduce appetite?
It changes noradrenaline, dopamine and opioid signalling in brain pathways involved in appetite, energy balance and food reward.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.