Your capsule is a compounded medication that includes Naltrexone HCl, Bupropion HCl,  and Topiramate. Each ingredient plays a role in how it works:

Naltrexone HCl: a medication that blocks opioid receptors in the brain and can also help regulate appetite and cravings.

Bupropion HCl:  An antidepressant medication that affects norepinephrine and dopamine levels in your brain that can enhance metabolism and aid in weight loss.

Topiramate: A medicine that helps control seizures, reduces appetite, and changes how things taste, which can help with weight loss.

Other Ingredients:  Microcrystalline cellulose 

Do not use this medication if you:

• Are allergic to naltrexone, bupropion, or metformin
• Have uncontrolled high blood pressure
• Have a history of seizures
• Currently taking or expecting to need prescription opioid pain medications in the next three months
• Have moderate to severe liver or kidney disease
• Have history of disordered eating behaviors such as anorexia or bulimia
• Have been diagnosed with glaucoma
• Are taking a monoamine oxidase inhibitor (MAOI), citalopram, or atomoxetine
• Are pregnant or breastfeeding

Speak to your medical provider before starting Nurx 3-in-1 Pill if you have:

• Experienced mental health conditions including depression, bipolar disorder, anxiety. 
• A history of alcohol or substance use disorder
• Diabetes or prediabetes 
• Heart disease, including history of heart attack or heart failure
• Graves Disease, hyperthyroidism, or overactive thyroid
• Any other medications or supplements you take regularly

Stop using Nurx 3-in-1 Pill and notify your clinician if you experience any of the following:

• Severe mood changes, including depression or suicidal thoughts* 
• Kidney stones 
• Liver dysfunction (yellowing of skin or eyes, dark urine) 
• Severe gastrointestinal distress (persistent nausea, vomiting, or abdominal pain) 
• Allergic reactions (rash, swelling, difficulty breathing) 
• Low blood sugar (especially if taken with other glucose-lowering medications)
• Sudden vision changes, eye pain, or blurred vision.
• High fever or trouble sweating. 
• Skin rash, blisters, or peeling
• Severe side or back pain, blood in urine or painful urination. 

Side effects may include:

• Nausea, vomiting,or upset stomach 
• Dry mouth 
• Headache, dizziness, tremor, drowsiness, tingling or feeling pins and needles in hands/fet
• Insomnia or sleep disturbances 
• Increased sweating 
• Constipation or diarrhea 
• Fatigue, drowsiness, excessive sweating, feeling jittery
• High blood pressure, palpitations
• Joint pain, muscle pain, muscle weakness
• Rash
• Ringing in the ears

Warnings:

• May increase suicide risk*, particularly in young adults. Monitor mood changes and immediately report to healthcare provider.
• Potential serious mental health side effects include mood swings, hallucinations, paranoia, or aggression. Discontinue medication and seek immediate medical assistance if these symptoms develop.
• Increases seizure risk, particularly for those with prior seizure history, eating disorders, or concurrent medication use. Strictly adhere to prescribed dosage.
• May elevate blood pressure and heart rate. Monitor blood pressure periodically.
• Should not be used with chronic opioid pain medications, as naltrexone can block their effects and cause withdrawal.
• Liver problems possible. Consult your provider if experiencing yellowing skin/eyes, dark urine, or extreme fatigue.
• May trigger angle-closure glaucoma in susceptible individuals.
• Weight loss from these medications can cause low blood sugar in people with diabetes who are on insulin or other diabetes medicines. Blood sugar should be monitored closely.
• Rarely causes lactic acidosis in people with kidney, liver, heart issues, dehydration, or severe infections. Symptoms include unusual tiredness, muscle pain, breathing difficulties, or stomach pain.
• Not recommended for patients with severe kidney disease. Requires kidney function monitoring before and during treatment.

Storage guidance:  These tablets should be stored at controlled room temperature (68 F to 77 F / 20 C to 25 C.  Keep it in a safe place where children and pets cannot access it. Protect from moisture and direct sunlight.  

*If you’re experiencing a mental health crisis, please call 911 or  go to your nearest emergency department. If you are contemplating suicide, call 911 or call/text the National Suicide and Crisis Lifeline at 988. These services are available 24/7.

Nurx 3-in-1 Pill (Naltrexone HCl 5 mg/Bupropion HCl 50 mg/Topiramate 25 mg capsule), an Rx only compound drug, has not been FDA-approved or evaluated for safety, efficacy, or quality but can be used to reduce hunger and appetite and promote weight loss. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch  or call 1-800-FDA-1088.

Disclaimer: Information contained on this handout is provided as an informational aide and for reference use only. The content herein is not intended to be, act as, or replace medical advice or diagnosis for individual health conditions nor is it making evaluations as to the risks or benefits of particular compounded preparations. Please consult a licensed healthcare professional about diagnosis and treatment. Information and statements within this handout have not been evaluated by the Food and Drug Administration.