New weight loss medication approved for use in Australia

Contrave, a unique dual acting weight loss medication, has been approved by the Therapeutic Goods Administration (TGA) and is listed on the Australian Register of Therapeutic Goods (ARTG).

Contrave is indicated, along with a reduced-calorie diet and increased physical activity, for the management of weight in adults with obesity (BMI ≥ 30kg/m2) or in those who are overweight (BMI ≥ 27 to < 30kg/m2) and have one or more weight-related co-morbidities, such as type 2 diabetes, dyslipidaemia, or controlled hypertension.

Developed by Professor Michael Cowley, Head of the Monash Biomedicine Discovery Institute’s Department of Physiology, Contrave works on neural pathways involved in the regulation of appetite and food cravings.

“Studies have shown two key areas of the brain are involved in the regulation of food intake – the hypothalamus (appetite regulatory centre) and the mesolimbic dopamine circuit (reward system). Both influence the ability to lose weight and sustain weight loss while on therapy.” Professor Cowley said.

“Contrave offers for the first time a unique combination of two established compounds, the opioid antagonist naltrexone and the dopamine and norepinephrine (noradrenaline) reuptake inhibitor bupropion, which are thought to act on these neural pathways to facilitate weight loss.”

Contrave tablets are extended release and should not be cut, chewed or crushed. They should be swallowed whole with water.

Upon initiating treatment, the dose should be escalated over a 4-week period to reach the maximum daily dose of 4 tablets per day (2 tablets taken twice daily).

Treatment should be discontinued after 16 weeks if patients have not lost at least 5% of their initial body weight.

The most common side effect seen in clinical trials was nausea. Headache, constipation, dizziness, vomiting and dry mouth were also experienced more frequently by patients taking Contrave than those taking placebo.

Contrave is contraindicated in some patient groups, including patients with uncontrolled hypertension, with a history of seizures or bipolar disorder, who require chronic opiate therapy, or who are pregnant.

Contrave is not listed on the Pharmaceutical Benefits Scheme (PBS) but is available by private prescription and will cost around $230-$250 per month.