Short answer: Skip it. The Contrave label says that if a dose is missed, wait until the next scheduled dose and then continue your usual schedule. The Medication Guide says not to take more than 1 dose of Contrave at a time. The label puts this rule in its seizure section, because higher bupropion levels raise seizure risk.
| Situation | What the label says |
|---|---|
| Schedule | Twice daily, morning and evening, after a 4-week step-up (2.1) |
| Missed a dose | Wait until the next scheduled dose (5.3, Medication Guide) |
| Doubling up | Do not take more than 1 dose at a time (Medication Guide) |
| Why it matters | Seizure risk rises with dose (5.3) |
| Half-life | About 21 hours for bupropion, 5 hours for naltrexone (12.3) |
Section 5.3 (Seizures) says that if a dose is missed, the patient should wait until the next scheduled dose to resume the regular schedule. The Medication Guide says: if you miss a dose of Contrave, wait until your next regular time to take it, and do not take more than 1 dose at a time.
Example: you take Contrave at 8 a.m. and 8 p.m. and realize at 2 p.m. that you missed the morning tablets. Under the label you would not take them then; you would take your usual evening dose at 8 p.m.
Contrave contains bupropion, and section 5.3 lists ways to lower seizure risk, including not taking high-fat meals with it and not making up missed doses. Doubling a dose raises the bupropion level. The label caps the total at two tablets twice daily, reached at the start of week 4.
The Contrave label does not say how to restart after several missed days, or whether to step up again. That is a question for your prescriber.
This page summarizes FDA labeling. It is not personalized medical advice; confirm what to do with your prescriber or pharmacist.