What it is
Mysimba is licensed as an addition to a reduced-calorie diet and more physical activity, for adults with a BMI of 30 or above, or a BMI of 27 to 30 with a weight-related health problem. It is a tablet combining naltrexone and bupropion, which act together on the brain areas that control appetite and food reward, so hunger and cravings are reduced.How it works
Naltrexone and bupropion act together on the brain areas that control appetite and food reward. The relevant targets are the mu-opioid receptor (blocked by naltrexone), the dopamine transporter and the noradrenaline transporter.What the studies reported
The pivotal trial is COR-I, published in The Lancet and registered on ClinicalTrials.gov as NCT00532779. All participants also followed a reduced-calorie diet and exercise programme, and a large proportion of people randomised did not complete the 56-week trial, which makes the average figures harder to interpret. The EMA completed a review of Mysimba on 28 March 2025, following an Article 20 referral.Who it is not suitable for
Mysimba must not be taken by people with uncontrolled high blood pressure, a history of seizures, or who are taking opioid medicines.Other weight-management options a doctor may also consider
Semaglutide (Wegovy / Ozempic)
Weekly GLP-1 receptor agonist. A doctor may prescribe it if your BMI and history match the indications. Requires follow-up.
Tirzepatide (Mounjaro)
Dual GLP-1/GIP agonist. Assessed by the doctor based on comorbidities and BMI.
Liraglutide (Saxenda)
Daily GLP-1 agonist. Indicated in selected patients with elevated BMI after medical evaluation.
Orlistat 120mg
A fat-absorption inhibitor. A non-GLP-1 alternative a doctor may consider based on your history.
Common questions
What is Mysimba and what is it used for?
What is Mysimba and what is it used for?
Mysimba is a tablet combining naltrexone and bupropion, which act together on the brain areas that control appetite and food reward. It is licensed as an addition to a reduced-calorie diet and more physical activity, for adults with a BMI of 30 or above, or a BMI of 27 to 30 with a weight-related health problem.
Why does Hi-Doctor not prescribe Mysimba?
Why does Hi-Doctor not prescribe Mysimba?
Mysimba is authorised in the EU and can be prescribed when it is clinically appropriate. However, at present Hi-Doctor’s doctors review weight-loss cases and recommend the option that fits your history — they may consider semaglutide, tirzepatide or other EU-authorised alternatives.
What did the COR-I trial show?
What did the COR-I trial show?
The COR-I trial was published in The Lancet. All participants also followed a reduced-calorie diet and exercise programme, and a large proportion of people randomised did not complete the 56-week trial, which makes the average figures harder to interpret. The EMA completed a review of Mysimba on 28 March 2025, following an Article 20 referral.
Who should not take Mysimba?
Who should not take Mysimba?
Mysimba must not be taken by people with uncontrolled high blood pressure, a history of seizures, or who are taking opioid medicines.
What is the 16-week stopping rule?
What is the 16-week stopping rule?
EU rules require Mysimba to be stopped after 16 weeks if you have not lost at least 5% of your starting weight. The doctor reassesses treatment at that point.
How Hi-Doctor handles it
Our doctors review every weight-loss option and recommend what fits your history and goals. A licensed EU doctor reviews your case and, if eligible, issues an electronic prescription valid at any EU pharmacy under Directive 2011/24/EU. Mysimba is sold under the US brand name Contrave, which is not itself an EU-authorised product. See pricing for the consultation fee — medication is paid separately, at a pharmacy of your choice.Start a consultation
Weight-loss consultation
Answer the weight-loss questionnaire and a registered doctor reviews it.
They decide whether treatment is appropriate, which one, and at what dose —
and declining is a normal outcome. See what it costs
and how the review works.