Hypothalamic POMC & Mesolimbic Craving Modulator • Rx

Naltrexone HCl / Bupropion HCl ER

Brand Reference: Contrave

Medically Reviewed by Dr. Hannah Lindqvist, MD, PhD (NPI #1457952647)
76.80%
Patient “Worth It”
18 verified logs
$99.00
Lowest Monthly Cash

Naltrexone HCl / Bupropion HCl ER Clinical & Real-World Cost Fact Matrix

Metric Verified Benchmark Source
Naltrexone HCl / Bupropion HCl ER RxNorm Concept ID 1551468 U.S. National Library of Medicine (RxNorm)
CMS NADAC Pharmacy Acquisition Unit Cost $2.8400 / unit CMS Medicaid NADAC Weekly Feed
Walk-In Chain Pharmacy Cash Average $318.00 / mo CMS NADAC + U.S. Retail Markup Index
Mark Cuban Cost Plus Wholesale Price $99.00 / mo (Direct TeleMed) Direct Telehealth Formulary
Community Mean Out-of-Pocket Paid $99.00 / mo 18 Zero-PHI Verified Patient Logs
INSTANT PRESCRIPTION & CASH ROUTING

Verified Online Prescribers & Wholesale Pharmacies for Naltrexone HCl / Bupropion HCl ER

DotMD Club Members get $29 flat-rate script renewals →
Ro Body & Metabolic Clinic (Online Doctor Consult + Delivery)
Asynchronous physician review included • Ships in ~2 days
$ 45.00
Consult / Starting Tier
Start Online Visit →
AgelessRx Geroprotective Telehealth (Online Doctor Consult + Delivery)
Asynchronous physician review included • Ships in ~3 days • Rx included in monthly tier
$ 65.00
All-In Monthly
Start Online Visit →
Midi Health Perimenopause & HRT Clinic (Online Doctor Consult + Delivery)
Asynchronous physician review included • Ships in ~2 days
$ 59.00
Consult / Starting Tier
Start Online Visit →
Hims & Hers Direct Cash Pharmacy (Online Doctor Consult + Delivery)
Asynchronous physician review included • Ships in ~2 days • Rx included in monthly tier
$ 49.00
All-In Monthly
Start Online Visit →

Naltrexone HCl / Bupropion HCl ER Clinical Pharmacology & DailyMed Monograph

RxCUI 1551468 • NDC 51267-0890-99

Bupropion stimulates hypothalamic pro-opiomelanocortin (POMC) neuron firing via dopamine/norepinephrine reuptake blockade while naltrexone blocks beta-endorphin mu-opioid autoinhibition on POMC cells, sustaining melanocortin-4 satiety tone and dampening mesolimbic reward eating.

For self-pay patients filling Naltrexone HCl / Bupropion HCl ER (NDC 51267-0890-99), direct wholesale and telehealth fulfillment drops monthly spend from $318.00 retail to $99.00 (69% savings against a $2.8400 CMS pharmacy acquisition baseline).

Clinical clearance of Naltrexone HCl / Bupropion HCl ER (Hypothalamic POMC & Mesolimbic Craving Modulator) relies on cyp2b6 (bupropion to hydroxybupropion) and cytosolicaldo-keto reductase (naltrexone) with a Bupropion 21h / 6-beta-naltrexol 13h half-life; patients absorbing at ~70% bupropion / 5%–40% naltrexone first-pass bioavailability typically observe target onset around 2–4 weeks titration.

FDA clinical labeling for Naltrexone HCl / Bupropion HCl ER restricts administration in uncontrolled hypertension; seizure disorder or bulimia/anorexia; chronic opioid agonist use; maoi within 14 days across 8 mg/90 mg ER daily (week 1), 16 mg/180 mg ER BID maintenance (total 32/360 mg), with self-reported patient tracking dominated by nausea (29% of reports), dry mouth (18% of reports), insomnia (15% of reports).

Half-Life
Bupropion 21h / 6-beta-naltrexol 13h
Bioavailability
~70% bupropion / 5%–40% naltrexone first-pass
Metabolism & Clearance
CYP2B6 (bupropion to hydroxybupropion) and cytosolicaldo-keto reductase (naltrexone)
Clinical Onset
2–4 weeks titration

Standard Adult Titration & Dosages

8 mg/90 mg ER daily (week 1) 16 mg/180 mg ER BID maintenance (total 32/360 mg)

Absolute & Relative Contraindications

  • Uncontrolled hypertension
  • Seizure disorder or bulimia/anorexia
  • Chronic opioid agonist use
  • MAOI within 14 days

Logged Side-Effect Incidence (18 Reports)

Nausea 29%
Dry mouth 18%
Insomnia 15%
Headache 13%

Naltrexone HCl / Bupropion HCl ER Patient Dosage Logs & Out-of-Pocket Cost Ledger

Across 18 verified cash-pay logs, Naltrexone HCl / Bupropion HCl ER achieves a 76.80% Worth-It rating with out-of-pocket spend averaging $99.00/mo versus $318.00/mo walk-in retail.

15-Second Anonymous Micro-Log (Zero-PHI Architecture)

Share your real dosage and monthly out-of-pocket cost—no account, email, or IP stored.

Effectiveness: 5/5 • Worth It Dosage: 8 mg/90 mg ER daily (week 1) • Paid: $87.12/mo via Local Pharmacy
Nausea

Switched to Local Pharmacy at 8 mg/90 mg ER daily (week 1) for Naltrexone HCl / Bupropion HCl ER; monthly out-of-pocket dropped to $87.12 compared with $318.00 retail.

Effectiveness: 5/5 • Worth It Dosage: 16 mg/180 mg ER BID maintenance (total 3 • Paid: $100.98/mo via TeleMed

Completed 10 weeks on Naltrexone HCl / Bupropion HCl ER (16 mg/180 mg ER BID maintenance (total 32/360 mg)). Zero notable side effects on steady dosing.

Effectiveness: 4/5 • Not Worth It Dosage: 8 mg/90 mg ER daily (week 1) • Paid: $114.84/mo via Compounding
Insomnia

Consistent biomarker response on 8 mg/90 mg ER daily (week 1) Naltrexone HCl / Bupropion HCl ER sourced via Compounding ($114.84/mo cash pay without insurance prior authorization).