What is Weigh In?

Weigh In is a weight management program that includes three separate tablets: bupropion, compounded naltrexone, and metformin. It is intended to be used alongside a reduced-calorie diet and increased physical activity for chronic weight management in adults.

Important: Weigh In is NOT FDA-approved for weight management.

• Bupropion is an antidepressant that, when combined with naltrexone, can help reduce appetite and cravings.
• Naltrexone is a medication that blocks opioid receptors and works with bupropion to support weight loss. The naltrexone in Weigh In is compounded and has not undergone FDA review for safety, effectiveness, or quality.
• Metformin is a medication used to manage blood sugar in type 2 diabetes. It is not FDA-approved for weight loss.

While the brand-name combination of bupropion and naltrexone (Contrave®) is FDA-approved for weight management in certain patients, the individual generic/compounded versions used in Weigh In have NOT been FDA-approved for this purpose.

Note: This summary does not contain all possible safety information. It is not a substitute for advice from your healthcare provider. Always talk to your doctor or pharmacist before taking this medication.

Who Should NOT Take Weigh In

Do Not Take the Metformin Tablet If You Have:

• Severe kidney problems (eGFR below 30)
• A known allergy to metformin
• Metabolic acidosis or diabetic ketoacidosis (a serious diabetes complication)

Do Not Take the Bupropion/Naltrexone Tablets If You:

• Have uncontrolled high blood pressure
• Have a seizure disorder or history of seizures
• Have or have had an eating disorder (anorexia or bulimia)
• Are currently stopping alcohol, benzodiazepines (like Xanax or Valium), barbiturates, or anti-seizure medications
• Are taking other products containing bupropion (such as Wellbutrin®)
• Use opioid pain medications or are dependent on opioids
• Have taken MAO inhibitors (a type of antidepressant) within the last 14 days
• Have a known allergy to bupropion or naltrexone
• Are pregnant

Important Warnings

Mental Health Warnings

SUICIDAL THOUGHTS AND BEHAVIORS

Bupropion and other antidepressants may increase the risk of suicidal thoughts and behaviors, especially in young adults. Serious mood and behavior changes have also been reported. Contact your doctor immediately if you experience worsening depression, unusual mood changes, or thoughts of self-harm.

Lactic Acidosis (From Metformin)

LACTIC ACIDOSIS WARNING

In rare cases, metformin can cause a serious condition called lactic acidosis, which can be life-threatening. Seek emergency medical help immediately if you experience:

• Unusual muscle pain or weakness
• Trouble breathing
• Unusual sleepiness or fatigue
• Stomach pain, nausea, or vomiting
• Feeling cold, dizzy, or lightheaded
• Slow or irregular heartbeat

You are at higher risk for lactic acidosis if you:

• Have kidney or liver problems
• Are 65 years or older
• Drink excessive amounts of alcohol
• Are dehydrated
• Are having surgery or a medical procedure with contrast dye

Seizure Risk (From Bupropion)

• Bupropion can increase your risk of seizures.
• To reduce this risk, follow your prescribed dosing schedule carefully and avoid taking this medication with high-fat meals.
• Tell your doctor if you have any history of seizures, head injury, or conditions that may increase seizure risk.

Heart and Blood Pressure Concerns

• Bupropion/naltrexone may increase blood pressure and heart rate.
• Your doctor should monitor your blood pressure regularly, especially if you have heart or blood vessel disease.

Liver Problems (From Naltrexone)

• Naltrexone may cause liver damage in some patients.
• Tell your doctor if you experience symptoms such as stomach pain, dark urine, yellowing of skin or eyes, or unusual fatigue.

Opioid Medications

• Do not take opioid pain medications while using naltrexone—it will block their effects.
• If you need emergency pain treatment, tell medical staff that you are taking naltrexone.
• Do not try to overcome the opioid-blocking effect by taking large doses of opioids—this can cause serious injury or death.

Low Blood Sugar Risk

• Weight loss can cause low blood sugar (hypoglycemia), especially if you take diabetes medications.
• Monitor your blood sugar levels and talk to your doctor about adjusting your diabetes medications if needed.

Vision Problems

• Bupropion may trigger angle-closure glaucoma in people with certain untreated eye conditions.
• Talk to your doctor if you have a history of glaucoma or eye pressure problems.

Vitamin B12 Deficiency (From Metformin)

• Metformin may lower your vitamin B12 levels over time.
• Your doctor may check your B12 levels periodically.
• Use with caution if you are vegan, as you may already have lower B12 levels from your diet.

Other Precautions

Talk to your doctor before taking Go Long if you have:

• Kidney problems (dose adjustment may be needed for metformin)
• Liver problems (avoid metformin; use caution with naltrexone)
• Heart disease or history of stroke
• A history of seizures
• Diabetes (blood sugar monitoring will be important)

Drug Interactions

Tell your doctor about all medications you take, especially:

Note: Bupropion may cause false-positive results on urine drug tests for amphetamines.

Common Side Effects

From Metformin:

• Diarrhea
• Nausea
• Low blood sugar (especially with other diabetes medications)

From Bupropion/Naltrexone:

• Nausea
• Constipation
• Headache
• Vomiting
• Dizziness
• Trouble sleeping
• Dry mouth
• Diarrhea

Special Populations

This medication is NOT for:

• Women
• Anyone under 18 years old
• Pregnant or breastfeeding individuals (can cause harm to babies)

Important for women who can become pregnant:

• Metformin may increase fertility. Talk to your doctor about birth control options to prevent unintended pregnancy.

Older adults (65+):

• Kidney function should be checked more frequently when taking metformin

Reporting Side Effects

If you experience any serious or unexpected side effects, report them to the FDA:

• Phone: 1-800-FDA-1088
• Online: www.fda.gov/medwatch