Naltrexone/bupropion

• This medicine is used together with a lower-calorie diet and more physical activity to help with long-term weight management in adults who are overweight or living with obesity, especially when there is also a weight-related health condition like high blood pressure or type 2 diabetes.

• Swallow the tablets whole. Do not cut, chew, or crush them.
• Take this medicine with a meal, but avoid meals that are high in fat, since this can increase side effects.
• Take this medicine exactly as your doctor tells you. The dose is usually increased slowly over about four weeks, and the amount and timing will be on your prescription label.

If you miss a dose

• If you miss a dose, skip it and take your next dose at the regular time. Do not take a double dose or extra tablets to make up for the one you missed, since this increases the risk of seizures.

• Do not use this medicine if you are pregnant, since weight loss is not recommended during pregnancy and this medicine could harm your baby.
• Do not breastfeed while taking this medicine, since it passes into breast milk.

• Tell your doctor if you have high blood pressure, especially if it is not well controlled.
• Tell your doctor if you have ever had a seizure, an eating disorder such as bulimia or anorexia, or if you drink alcohol heavily.
• Tell your doctor if you use opioid pain medicine, cough and cold products with opioids, or if you are being treated for opioid dependence.
• Tell your doctor about all other medicines you take, especially antidepressants, medicines for mental health conditions, and any other product containing bupropion.
• Do not use this medicine if you are pregnant.
• Do not use this medicine if you have taken a monoamine oxidase inhibitor (MAOI) medicine in the last 14 days.

Important warnings

• This medicine contains the same ingredient used in some antidepressant medicines. It can be associated with new or worsening depression, unusual changes in mood or behaviour, and thoughts of self-harm. Get help right away if this happens to you or if someone taking this medicine notices it in you.
• This medicine can cause seizures. The risk is higher at higher doses, if you drink alcohol, or if you stop alcohol or certain other medicines suddenly. If you have a seizure while taking this medicine, stop taking it and get medical help right away — do not restart it.
• This medicine can raise your blood pressure and heart rate, especially in the first few months. Your doctor will check these regularly.
• If you regularly use opioid pain medicine, this medicine can block its effects or cause sudden, severe withdrawal symptoms. Do not try to overcome this by taking more opioids — doing so can be fatal.

• Nausea, especially when you first start treatment.
• Constipation.
• Vomiting.
• Headache.
• Dizziness.
• Dry mouth.
• Trouble sleeping.
• Sweating more than usual.
• Feeling shaky (tremor).

When to get emergency help

• A seizure.
• Thoughts of harming yourself, or a sudden change in mood or behaviour.
• Chest pain, a fast or pounding heartbeat, or fainting.
• Signs of a severe allergic reaction, such as swelling of the face or throat, hives, or trouble breathing.
• Yellowing of the skin or eyes, or severe stomach pain.

When to contact a healthcare professional

• You have not lost a meaningful amount of weight after about 12 weeks on the full dose.
• Your blood pressure or heart rate feels unusually high.
• You notice a new rash, joint pain, or fever.
• You feel unusually anxious or agitated, or notice changes in your sleep or mood.

• Avoid drinking alcohol, and do not stop drinking alcohol suddenly, while taking this medicine, since either can increase the risk of a seizure.
• Take this medicine with food, but avoid high-fat meals.
• Tell the Care365 care team about every other medicine you take, especially opioid pain medicines, other antidepressants, and any product containing bupropion, since combining them can be dangerous.

• Store at room temperature.
• Keep out of the sight and reach of children.