Naltrexone/Bupropion
What is naltrexone/bupropion?
Naltrexone/bupropion is a combination of active ingredients that may be used in the context of medication-based weight loss and weight management. The combination contains two active ingredients with different properties: naltrexone and bupropion. Together, they can influence central signaling pathways that are involved, among other things, in appetite, eating behavior, reward response, and weight control.
Many patients know naltrexone/bupropion mainly through the medication Mysimba. However, it is important to understand that naltrexone and bupropion are the active ingredients, while Mysimba is the medication that contains this combination. The active ingredient combination, medication, approved use, dosage, availability, and treatment goal should therefore be clearly distinguished.
Mysimba is approved in the European Union. In Germany, however, the medication is currently not on the market and is not currently offered by The Body Clinic. Which medication-based options are currently available and medically appropriate in an individual case should always be assessed by a physician.
Patients who would like to have medication-based weight loss assessed can have a medical suitability assessment for available weight loss medications at The Body Clinic to clarify which currently offered treatment options may generally be considered.
What is naltrexone/bupropion used for?
Naltrexone/bupropion is classified in the context of medical weight management. The combination should not be equated with the individual active ingredients, as naltrexone and bupropion can each also be used in other medical contexts. For obesity treatment, the fixed combination of both active ingredients in the medication Mysimba is particularly relevant.
- Weight management: Mysimba is approved in the EU for weight management in certain adults with obesity or overweight with weight-related comorbidities.
- Eating behavior and appetite: Naltrexone/bupropion does not work like a GLP-1 active ingredient, but acts on central regulatory mechanisms in the brain.
- Availability: Although Mysimba is approved in the EU, the medication is currently not on the market in Germany.
- Medical decision: Whether medication-based treatment is suitable depends on the diagnosis, treatment goal, risks, comorbidities, current medication, and individual medical suitability.
This distinction is important because neither naltrexone nor bupropion alone should automatically be understood as a weight loss medication. What matters is the approved active ingredient combination, the specific availability, the medical indication, and physician assessment.
Naltrexone/bupropion in known medications
The combination of naltrexone/bupropion is best known through Mysimba. Patients who would like an initial overview of available medication-based options can find further information on our page about weight loss medications for medical weight management. Patients can also find information about the specific medication on our page about Mysimba with naltrexone and bupropion.
| Medication | Active ingredients | Dosage form | Current classification |
|---|---|---|---|
| Mysimba | Naltrexone and bupropion | Prolonged-release tablet | EU-approved for weight management, currently not on the market in Germany, and not currently offered by The Body Clinic |
How does naltrexone/bupropion work in the body?
Naltrexone/bupropion differs significantly from GLP-1 or GIP/GLP-1 active ingredients. While active ingredients such as semaglutide, liraglutide, or tirzepatide act on hormonal signaling pathways, the combination of naltrexone and bupropion primarily acts through central mechanisms associated with appetite, food intake, and reward response.
The exact mechanism of action is not fully understood. From a medical perspective, however, the combination is understood to act on areas of the brain that are involved in the regulation of food intake, energy balance, and reward-related eating behavior.
- Bupropion: This active ingredient affects neurotransmitter systems that are associated, among other things, with appetite regulation and drive.
- Naltrexone: This active ingredient is an opioid receptor antagonist and can influence signaling pathways associated with reward and craving.
- Combination: Together, the two active ingredients may help medically influence appetite, food intake, and weight-related eating behavior.
- Distinction: Naltrexone/bupropion is not a GLP-1 receptor agonist and does not work like a weight loss injection.
The effect is not the same for every person. Tolerability, comorbidities, current medication, nutrition, physical activity, and treatment duration also influence how treatment progresses.
Naltrexone/bupropion for weight loss
In medical weight loss, naltrexone/bupropion should not be viewed in isolation. The active ingredient combination is always part of a physician-supervised treatment concept that should include nutrition, physical activity, behavior, health status, side effects, and follow-up monitoring.
Naltrexone/bupropion may be medically relevant for people with obesity or significant excess weight when lifestyle measures alone are not sufficiently effective and additional health risks are present. According to the approved use, Mysimba is used in addition to a reduced-calorie diet and increased physical activity. Weight-related comorbidities may include type 2 diabetes, dyslipidemia, or controlled high blood pressure.
Important: Naltrexone/bupropion does not replace a medical diagnosis, dietary changes, or follow-up monitoring. The active ingredient combination should not be used without medical assessment, obtained from unsafe sources, or taken according to a self-directed dosing schedule.
Patients who would like a broader introduction to medication-based treatment can also read our article on medical weight loss with medication and obesity care.
Is Mysimba available in Germany?
Mysimba is approved in the European Union. This approval means that the medication has regulatory authorization for use in the EU. However, this must be distinguished from whether a medication is actually marketed in a specific country.
For Germany, the current status is: Mysimba is currently not on the market. The Body Clinic therefore does not currently offer Mysimba and cannot currently prescribe it. Patients should not confuse this information with a lack of EU approval. The correct distinction is: EU-approved, but currently not regularly marketed in Germany.
Which medication-based options are currently available and medically appropriate should be assessed individually by a physician. Our page about weight loss tablets after medical assessment provides an overview of oral treatment approaches.
Naltrexone/bupropion as a tablet
In the medication Mysimba, naltrexone/bupropion is used as a prolonged-release tablet. Prolonged-release tablets release active ingredients gradually. The exact intake, dose, dose escalation, and treatment monitoring must be determined by a physician.
| Form | Example | Classification | Important to know |
|---|---|---|---|
| Tablet | Mysimba | EU-approved active ingredient combination for weight management | Currently not on the market in Germany and not currently offered by The Body Clinic |
Patients who would like to understand the difference between oral and injectable treatment options can also refer to the overview on weight loss with injections and medical supervision.
Who may be medically suitable for naltrexone/bupropion?
Whether naltrexone/bupropion is medically appropriate cannot be answered in general terms. The decision depends on several factors and should always be made individually by a physician. Because Mysimba is currently not on the market in Germany and is not currently offered by The Body Clinic, this page focuses on the medical classification of the active ingredient combination.
A medical assessment for medication-based weight loss may generally be particularly relevant if one or more of the following criteria apply:
- Obesity or significant excess weight
- Weight-related comorbidities
- Previous unsuccessful weight loss attempts despite dietary changes and physical activity
- Increased health risk due to weight
- A desire for physician-supervised treatment instead of using medication independently
- Interest in an oral medication-based treatment option
At The Body Clinic, a specific combination of active ingredients is not automatically recommended. Instead, physicians assess whether a currently available weight loss medication, another treatment concept, or a non-medication-based approach may be better suited to the patient’s starting point. Depending on the situation, weight loss without medication with an individual plan may also be more appropriate.
Can naltrexone/bupropion be prescribed in Germany?
Medications containing naltrexone/bupropion are prescription-only. At the same time, it is important for patients in Germany to know that Mysimba is currently not on the market. The Body Clinic therefore does not currently offer Mysimba and cannot currently prescribe it.
Patients should not buy naltrexone/bupropion without medical assessment, obtain it from unsafe online sources, or use dosing recommendations from forums, social media, or patient reports. Especially with active ingredients that can affect central signaling pathways and psychological factors, medical guidance, careful medical history taking, and regular follow-up monitoring are important.
Additional context on medical indications and off-label questions is provided in our article on indications and off-label use for weight loss medications, even though naltrexone/bupropion itself does not belong to the group of GLP-1 agonists.
How much does treatment with naltrexone/bupropion cost?
Because Mysimba is currently not on the market in Germany and is not currently offered by The Body Clinic, The Body Clinic does not currently provide pricing for treatment with naltrexone/bupropion.
In general, the cost of medication-based weight loss depends on which medication is used, what type of medical supervision is needed, and how the individual treatment concept is structured. A general statement is therefore not meaningful without medical assessment.
Patients can find information about currently offered programs and general price orientation on the page prices for medical weight loss.
When is special caution important with naltrexone/bupropion?
Naltrexone/bupropion can cause side effects and is not suitable for everyone. Pre-existing conditions, current medication, blood pressure, liver and kidney function, neurological risks, mental health history, and previous intolerances should therefore be carefully assessed by a physician before any possible treatment.
Frequently described side effects mainly include nausea, vomiting, constipation, dizziness, and dry mouth. Other side effects are also possible. Which symptoms occur and how pronounced they are varies from person to person.
Special medical attention is important, among other things, in cases of:
- insufficiently controlled high blood pressure
- a history of seizures or increased seizure risk
- certain mental health conditions or noticeable mood symptoms
- regular use of other medications
- opioid use or a history of opioid dependence
- severely impaired liver or kidney function
- pregnancy, breastfeeding, or plans to become pregnant
Patients can find more information about the tolerability of the medication on our page about side effects of Mysimba with naltrexone/bupropion.
Naltrexone/bupropion, semaglutide, tirzepatide, and liraglutide compared
Naltrexone/bupropion is not the only medication-based approach that may play a role in medical weight loss. Semaglutide, tirzepatide, and liraglutide are also often considered. These active ingredients differ in several ways, including mechanism of action, administration, approved use, availability, and individual tolerability.
| Criterion | Naltrexone/bupropion | Semaglutide | Tirzepatide | Liraglutide |
|---|---|---|---|---|
| Active ingredient class | Centrally acting active ingredient combination | GLP-1 receptor agonist | GIP/GLP-1 receptor agonist | GLP-1 receptor agonist |
| Known medications | Mysimba | Wegovy, Ozempic, Rybelsus | Mounjaro | Saxenda |
| Administration | Tablet | Injection or tablet, depending on the medication | Injection once weekly | Injection once daily |
| Key characteristic | Combination of naltrexone and bupropion with a central mechanism of action | GLP-1 active ingredient available in different dosage forms | Dual mechanism of action through GIP and GLP-1 | GLP-1 active ingredient with daily administration |
| Availability at The Body Clinic | Not currently offered | To be assessed depending on the medication and medical suitability | To be assessed depending on the medication and medical suitability | To be assessed depending on the medication and medical suitability |
| To be assessed by a physician | BMI, blood pressure, current medication, mental health, seizure risk, opioid use, and treatment goal | Indication of the specific medication, current medication, risks, and treatment goal | BMI, comorbidities, tolerability, contraindications, and treatment goal | Suitability, daily administration, side effects, and long-term treatment strategy |
Patients who would like a broader comparison of the active ingredient groups can find an overview on the hub page active ingredients in weight loss medications. The detailed pages on semaglutide as an active ingredient, tirzepatide as an active ingredient, and liraglutide as an active ingredient can also help explain the differences.
Naltrexone/bupropion at The Body Clinic
The Body Clinic supports patients with medical weight loss through an individual treatment concept. The focus is not on quickly using a specific active ingredient, but on determining which treatment option is medically appropriate, tolerable, available, and suitable for long-term medical support.
Mysimba with naltrexone/bupropion is not currently offered by The Body Clinic because the medication is currently not on the market in Germany. As part of the medical assessment, physicians therefore discuss which currently available medications or non-medication-based strategies may be better suited to the patient’s starting point. Previous weight loss attempts, pre-existing conditions, current medication, possible side effects, and personal treatment goals are also taken into account.
Why medical supervision matters in weight loss is also discussed in our article on medical weight loss programs for obesity.
Frequently asked questions about naltrexone/bupropion
Is naltrexone/bupropion a medication?
Naltrexone/bupropion refers to the active ingredient combination. The specific medication is, for example, Mysimba. The active ingredient combination and the medication should not be treated as the same thing because the approved use, dosage, administration, availability, and treatment goal must be assessed medically.
Is naltrexone/bupropion approved for weight loss?
The active ingredient combination naltrexone/bupropion is approved in the EU in the medication Mysimba for weight management in certain adults with obesity or overweight with weight-related comorbidities. In Germany, however, Mysimba is currently not on the market.
What is the difference between naltrexone/bupropion and Mysimba?
Naltrexone/bupropion is the active ingredient combination. Mysimba is a medication that contains naltrexone and bupropion. For patients, it is important to understand that use always depends on the specific medication, indication, availability, and medical suitability assessment.
Is Mysimba available in Germany?
According to the current status, Mysimba is not on the market in Germany. The Body Clinic therefore does not currently offer Mysimba and cannot currently prescribe it.
Is naltrexone/bupropion a GLP-1 active ingredient?
No. Naltrexone/bupropion is not a GLP-1 receptor agonist. The combination differs from active ingredients such as semaglutide or liraglutide and primarily acts on central regulatory mechanisms in the brain.
Is naltrexone/bupropion a weight loss injection?
No. In the medication Mysimba, naltrexone/bupropion is used as a tablet. The combination is therefore one of the oral medication-based treatment options, but it still requires medical assessment and supervision.
Can naltrexone/bupropion be prescribed in Germany?
Medications containing naltrexone/bupropion are prescription-only. However, Mysimba is currently not on the market in Germany and is not currently offered by The Body Clinic.
How much does naltrexone/bupropion cost?
Because Mysimba is not currently offered by The Body Clinic, there is currently no pricing for treatment with naltrexone/bupropion. Patients can find information about currently offered programs on our page about prices for medical weight loss.
How quickly does naltrexone/bupropion work?
The effect does not start at the same pace for everyone. Many treatments with weight management medications require gradual dose adjustment and regular follow-up monitoring. Weight development, tolerability, and treatment progress should be monitored by a physician.
What side effects can naltrexone/bupropion cause?
Frequently described side effects include nausea, vomiting, constipation, dizziness, and dry mouth. Other side effects are also possible. Which risks are relevant in an individual case should be discussed with a physician.
Can I buy naltrexone/bupropion without a prescription?
Relevant medications containing naltrexone/bupropion are prescription-only. Using them without medical assessment or obtaining them from unsafe sources is not recommended and may carry health risks.
Is naltrexone/bupropion better than semaglutide, tirzepatide, or liraglutide?
This cannot be answered in general terms. Naltrexone/bupropion, semaglutide, tirzepatide, and liraglutide differ in their mechanism of action, administration, clinical evidence, tolerability, approved use, and availability. The key question is which treatment best fits the individual medical situation.
Sources
- European Medicines Agency: Mysimba, EPAR and product information on naltrexone/bupropion.
- U.S. Food and Drug Administration: Contrave, Prescribing Information on naltrexone hydrochloride and bupropion hydrochloride.
- Greenway FL et al.: Effect of naltrexone plus bupropion on weight loss in overweight and obese adults. The Lancet, 2010.
- Apovian CM et al.: A randomized, phase 3 trial of naltrexone SR/bupropion SR on weight and obesity-related risk factors. Obesity, 2013.