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Contrave Review (2026) — Does It Work for Weight Loss in Canada?

Contrave is a prescription weight-loss medication combining naltrexone (an opioid antagonist) and bupropion (an antidepressant). Approved by Health Canada in 2014, it represents a newer approach to pharmacological weight management. This review examines its effectiveness, safety, cost, and suitability for Canadian patients seeking evidence-based weight loss support.

7.2
✓ RecommendedOverall: 7.2/10

Contrave is a Health Canada-approved prescription pill combining naltrexone and bupropion that produces modest but meaningful weight loss — averaging 5–9% of body weight over 56 weeks in clinical trials. Unlike GLP-1 medications (Ozempic, Wegovy, Saxenda), it is an oral tablet taken twice daily, which many Canadians prefer over weekly injections. However, most provincial drug plans do not cover it, making the –/month out-of-pocket cost a significant barrier. It works best as an adjunct to diet and lifestyle changes, not as a standalone solution. We recommend it for Canadians who cannot tolerate or access injectable GLP-1 medications, have private drug coverage, and are committed to concurrent lifestyle changes.

Best for

Adults with BMI ≥27 (or BMI ≥25 with weight-related conditions) who have struggled with diet and exercise alone, tolerate medication well, and commit to lifestyle changes. Those with depression or smoking cessation goals may see additional benefits.

Not for

Pregnant or breastfeeding women, people with uncontrolled high blood pressure, seizure disorders, opioid use, or a history of anorexia/bulimia. Those taking MAOIs or with severe liver/kidney disease should avoid this medication.

Key Facts

Typenaltrexone/bupropion combination (8 mg/90 mg per tablet)
ManufacturerCurrax Pharmaceuticals (US); distributed in Canada through licensed pharmacies
Health Canada StatusApproved by Health Canada (2014) as an adjunct to reduced-calorie diet and increased physical activity for chronic weight management
Price (CAD)$300–$450/month (approximately $3,600–$5,400 annually)
Prescription RequiredYes
Where to Buylicensed Canadian pharmacies, online pharmacies with valid prescriptions

Ratings Breakdown

Effectiveness for Weight Loss7.5/10

Clinical trials show average 5-9% body weight reduction over 56 weeks compared to 1-3% with placebo. Results are modest but clinically meaningful for many users.

Safety Profile7/10

Generally well-tolerated long-term, but initial side effects (nausea, headache, dizziness) are common. Requires monitoring for blood pressure and psychiatric symptoms.

Ease of Use7.5/10

Tablet form taken twice daily. Titration period (4 weeks) required to reach full dose. Straightforward dosing once established.

Cost-Value in Canada6.5/10

Expensive at $300–$450/month. Most provincial drug plans (ODB, PharmaCare) do not cover it; limited private insurance coverage. Cost remains a significant barrier.

Scientific Evidence8/10

Supported by multiple Phase III RCTs and long-term safety data. Evidence is robust, though weight loss gains are modest compared to some newer GLP-1 agonists.

Suitability for Canadian Context7/10

Widely available through Canadian pharmacies with prescription. No major supply issues. Requires physician oversight and monitoring.

Pros & Cons

Pros

  • ✓Dual mechanism (naltrexone + bupropion) may provide weight loss and mood benefits, particularly for those with depression or low motivation
  • ✓Health Canada approved with established long-term safety data from multiple clinical trials
  • ✓Tablet form is convenient; no injections required, unlike some newer alternatives
  • ✓May help reduce appetite and increase energy; some users report improved focus and motivation
  • ✓Available through most Canadian pharmacies; does not require specialty clinic referral

Cons

  • ✗Modest weight loss (5-9% average) compared to newer GLP-1 agonists (10-15%+); not suitable for those seeking dramatic results
  • ✗High cost ($300–$450/month) with minimal provincial drug plan coverage; most patients pay out-of-pocket
  • ✗Common initial side effects (nausea, headache, dizziness, constipation) require 4-week titration and adjustment period
  • ✗Requires ongoing physician monitoring for blood pressure, psychiatric symptoms, and adherence
  • ✗Contraindicated with several medications and conditions; not suitable for pregnant women or those with seizure history

How It Works

Contrave combines naltrexone, which blocks opioid receptors in the brain's appetite-control centers, with bupropion, an antidepressant that increases dopamine and norepinephrine. Together, they work to reduce hunger signals, increase feelings of fullness, and boost energy and motivation. The combination targets multiple pathways involved in appetite regulation and mood, which may explain why some users experience both weight loss and improved mood.

What the Evidence Says

Contrave is supported by multiple Phase III randomized controlled trials (COR-I, COR-II, COR-BMOD) published in major journals including Obesity and The Lancet. These studies showed average weight loss of 5-9% over 56 weeks, compared to 1-3% with placebo. Weight loss was greater in those who combined medication with lifestyle modification. Long-term follow-up data (up to 3 years) demonstrates sustained benefits and acceptable safety. However, effect sizes are smaller than newer GLP-1 receptor agonists (semaglutide, tirzepatide), which show 10-15%+ weight loss.

Side Effects

Who Should Consider This

Adults with BMI ≥27 kg/m² (or BMI ≥25 with weight-related comorbidities like hypertension or type 2 diabetes) who have tried diet and exercise without adequate results. Best suited for those willing to commit to lifestyle changes, tolerate medication side effects, and can afford out-of-pocket costs. Particularly appropriate for those with concurrent depression or low motivation, as bupropion may provide dual benefits.

🍁 Canadian Availability

Contrave is available through licensed Canadian pharmacies with a valid prescription. It has been approved by Health Canada since 2014 under the brand name Contrave (naltrexone HCl/bupropion HCl extended-release). **Provincial drug coverage (2026):** - **Ontario (ODB):** Not routinely covered. Exception Drug Status (EDS) possible in some cases — requires application. - **BC PharmaCare:** Not on the formulary. Regular Special Authority may apply in select cases. - **Alberta (NIHB):** Not listed. Off-formulary access requires special approval. - **Quebec (RAMQ):** Not covered under public plan. - **Nova Scotia, Manitoba, Saskatchewan:** Not routinely covered by provincial plans. - **Private insurance:** Some employer group benefit plans provide partial coverage — check your benefits booklet. **Cost without coverage:** Approximately –/month (,600–,400/year). Manufacturer patient support programs may offer savings — ask your pharmacist about the Contrave Savings Program. **Where to get a prescription:** Family doctors, obesity medicine specialists, and online telehealth platforms (e.g., Maple, Felix Health) can prescribe Contrave in Canada. Bring records of prior weight loss attempts for the strongest case with provincial special authority applications.

How It Compares to Alternatives

Comparing naltrexone/bupropion combination to other weight loss options available in Canada.

1

Ozempic/Wegovy (semaglutide)

GLP-1 agonist with stronger weight loss (10-15%+) but higher cost and injection-based delivery. Growing evidence of cardiovascular benefits. More difficult to obtain in Canada; limited provincial coverage.

2

Saxenda (liraglutide)

GLP-1 agonist with 4-6% weight loss, injectable, similar cost to Contrave. Fewer drug interactions than Contrave but requires daily injections.

3

Orlistat (Xenical)

Over-the-counter lipase inhibitor with minimal weight loss (2-3%), fewer side effects, and lower cost. Less effective than Contrave but more accessible and affordable.

4

Lifestyle modification alone (structured programs)

No medication cost but requires significant time and effort. Can achieve 5-10% weight loss with intensive counseling; ideal first-line approach, often combined with medication.

⚠ Medical Disclaimer: This review is for informational purposes only. This is not medical advice. Consult a qualified healthcare provider before starting, stopping, or changing any medication or treatment program.

Frequently Asked Questions

Most provincial drug plans, including Ontario Health (ODB) and BC PharmaCare, do not routinely cover Contrave due to its cost and modest efficacy relative to other options. Coverage varies by province and individual circumstances. Patients should check with their provincial plan or private insurer. Some employers' extended health plans may offer partial coverage.

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Ready to Explore Contrave?

If you're considering Contrave for weight loss, schedule a consultation with your family doctor, nurse practitioner, or obesity specialist. Come prepared to discuss your medical history, current medications, and weight-loss goals. Ask about cost, coverage options, and whether Contrave is appropriate for your individual circumstances. Remember: medication is most effective when combined with sustainable diet and exercise changes.