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Taking Mysimba: here's how

Twice a day with a meal, built up over four weeks. Watch the video and read step-by-step how to properly take Mysimba.

Mysimba combines naltrexone and bupropion, which together suppress hunger and cravings. You build up the dose over four weeks. Below you can read how to take it properly.

Mysimba Instruction Video

Medical professional holds blue pills while writing on a clipboard with medication boxes.
Mysimba intake instruction video
A person holds a blister pack of blue heart-shaped pills labeled "Viagra" and "Legrux."

How to take Mysimba

You take Mysimba in the morning and in the evening. Link it to fixed times, such as your breakfast and dinner, then you're less likely to forget.

  1. Swallow the tablet whole with water. Do not break, chew, or crush it. The tablet releases the active ingredients slowly. If you break it, they will be released all at once.

  2. Take it with a meal. This helps against nausea. It's better not to choose a very fatty meal: then your body absorbs much more of the active ingredients.

  3. Stick to your schedule. Never take more than 2 tablets in the morning and 2 tablets in the evening, so a maximum of 4 per day.

These instructions are general information and do not replace personal medical advice. Always follow your doctor's instructions and read the package leaflet. If you have doubts or complaints, please contact your doctor or pharmacist.

Your dose escalation in 4 weeks

none provided
Week 1 – 1 tablet per day
1 tablet in the morning. Nothing in the evening yet.
Maag-darmkanaal: langer vol gevoel door vertraagde maaglediging bij medisch afvallen bij The Body Clinic
Week 2 – 2 tablets per day
1 tablet in the morning and 1 tablet in the evening.
none provided
Week 3 – 3 tablets per day
2 tablets in the morning and 1 tablet in the evening.
Brein en medisch afvallen: vermindert de eetlust en versterkt het verzadigingsgevoel bij The Body Clinic
From week 4 – 4 tablets per day
2 tablets in the morning and 2 tablets in the evening. This is your maintenance dose and also the maximum dose.

Good to know

Forgot a dose? Skip the missed dose and take the next one at the usual time. Do not take extra tablets. After 16 weeks: your doctor will check if you have lost at least 5% of your starting weight. If not, you will stop Mysimba. Blood pressure: Mysimba can increase your blood pressure and heart rate. Your doctor will measure these before starting and regularly during treatment.

Alcohol: drink as little alcohol as possible, preferably none at all. Alcohol increases the risk of an epileptic seizure. Opioids: do not use Mysimba together with opioids, such as tramadol, oxycodone, codeine (also in some cough medicines), or methadone. Are you having surgery? Then report that you are using Mysimba. You stop at least 3 days in advance, in consultation with your doctor.

Other medicines: Mysimba can affect other medicines, such as antidepressants and some heart medications. Always tell your doctor and pharmacist which medicines you are using. Kidneys or liver: if your kidneys or liver are not working properly? Then you will receive a lower dose, usually a maximum of 2 tablets per day.

Driving: especially at the beginning and when increasing the dose, you may become drowsy or dizzy. Do not drive then. Storage: store Mysimba below 30 °C in the original packaging.

Yellow KCA medical waste bin for medication disposal next to an 'Apotheek' sign.

Responsible disposal of your waste medication

Do you have tablets left over, for example because you stopped? Do not throw them in the household waste or down the toilet. Hand them in at your pharmacy or at your municipality's KCA depot (small chemical waste). An empty blister pack may be put with residual waste.

A person holds out a clear glass water bottle containing water and lime slices.

Side effects: what can you expect?

The most common side effects are nausea, vomiting, constipation, and headache. Dry mouth, dizziness, and poor sleep are also common. They mainly occur in the first weeks and when increasing the dose, and usually decrease afterwards. Tips: take your tablets with a meal, eat smaller portions, drink enough water, and eat fiber-rich foods against constipation.

Contact your doctor immediately if your mood changes, you become gloomy, restless, or anxious, or if you have thoughts of harming yourself.

Mysimba is not suitable during pregnancy or breastfeeding.

Intake gesprek met arts: telefonisch consult voor persoonlijke begeleiding bij medisch afvallen bij The Body Clinic

Contact a doctor immediately

Stop Mysimba and contact a doctor immediately if you experience: an epileptic seizure (convulsion); thoughts of suicide or self-harm, or sudden changes in your mood or behavior; rash with blisters or peeling; yellow skin or eyes, dark urine or pain in the upper right abdomen; a sudden, sharp increase in your blood pressure, for example with severe headache; fever, confusion, tremors and stiff muscles.

Call 112 for an epileptic seizure, swelling of the face, lips or throat, or shortness of breath.

Outside our opening hours, you can go to the GP out-of-hours service, or check our page Medical emergencies.

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Frequently asked questions 

  • You build up to the full dose in 4 weeks:

    • Week 1: 1 tablet in the morning.
    • Week 2: 1 tablet in the morning and 1 in the evening.
    • Week 3: 2 tablets in the morning and 1 in the evening.
    • From week 4: 2 tablets in the morning and 2 in the evening. Never take more than 4 tablets per day.

  • After 16 weeks, your doctor will assess whether you have lost at least 5% of your initial body weight. If not, you will stop using it. If you continue to use it, your doctor will annually review your weight and your risk of cardiovascular disease.

  • You should not use Mysimba if you have epilepsy or a history of seizures, uncontrolled high blood pressure, an eating disorder (bulimia or anorexia), bipolar disorder, or if you are using opioids, among other conditions. Your doctor will discuss this with you beforehand.

  • The most common side effects are nausea, constipation, vomiting, headache, dizziness, dry mouth, and difficulty sleeping. Your blood pressure and heart rate may increase, which is why they will be monitored.

  • No. Always swallow the tablet whole with a maximum of half a glass (120 ml) of water.

  • Swallow the tablets whole with water. Do not break, chew, or crush them. Preferably take them with a meal, but not with a very fatty meal.

  • No, not without consulting your doctor. Mysimba contains naltrexone, which makes opioid painkillers (such as tramadol, oxycodone, or codeine) less effective. Always tell your doctor that you are using Mysimba, even if you are having surgery.

  • Skip the forgotten tablet and simply take your regular tablet the next morning. Never take two tablets at once.

  • In moderation. Alcohol can make nausea worse. Read more in Ozempic and alcohol.