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Opening late October in 13 states. Reserve your 90-Day StartPrescribed only if it’s right for youDiscreet packaging for your privacy
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Custom Weight Capsule

One capsule, made for you, without a GLP-1. Your provider chooses what goes in your capsule from naltrexone, bupropion, metformin and topiramate, adds vitamin B12 if they decide to, and sets each strength for you. They prescribe it only when they determine a compounded medication is medically necessary for you, and a licensed pharmacy prepares it from your prescription. Compounded medications are not FDA-approved; the FDA does not review them for safety, effectiveness or quality. FDA-approved oral options also exist, and your provider can prescribe one of those instead.

  • Only when your provider determines it’s medically necessary for you
  • Medicines and strengths chosen for you, in one capsule
  • Capsules by mouth, no needles, not a GLP-1
  • Not FDA-approved

Daily capsules · from $55/mo. Prices are preliminary.

How it works

  1. Answer the evaluation: your health and history, your weight and goals, whether you could become pregnant, and every medicine and supplement you take, including any opioid pain medicine.
  2. Get lab work, including your kidney function.
  3. If your provider determines a compounded medication is medically necessary for you, a licensed pharmacy prepares your capsules from your prescription and ships them in discreet packaging to protect your privacy.
  4. Take them exactly as directed, starting low and going up step by step, and drink plenty of water. Never take more than prescribed.
What’s in it
Your provider’s choice of naltrexone, bupropion, metformin and topiramate, with vitamin B12 if they add it, at strengths set for you
Form
Capsules by mouth; your provider starts low and raises the dose over a few weeks
Who it’s for
Adults for whom a provider determines a compounded medication is medically necessary
FDA status
Not FDA-approved: the FDA does not review compounded medications for safety, effectiveness or quality. None of these medicines is FDA-approved for weight management on its own
Labs
Usually blood work first, including your kidney function
Cost
$55 for 30 days or $90 for 90 days. Visits: $65 to start, then $45 for each follow-up or dose change.

Chosen for you, in one capsule.

  • Naltrexone (If your provider includes it): Blocks the effects of opioids. On its own it’s FDA-approved to help treat alcohol and opioid dependence.
  • Bupropion (If your provider includes it): An antidepressant also FDA-approved to help people quit smoking. It acts on dopamine and norepinephrine, brain chemicals involved in mood and reward. With naltrexone, it acts on parts of the brain involved in appetite and food cravings; exactly how isn’t fully understood.
  • Metformin (If your provider includes it): FDA-approved for type 2 diabetes. It lowers the amount of sugar your liver releases and helps your body respond to insulin.
  • Topiramate (If your provider includes it): FDA-approved for epilepsy and to prevent migraines. How it affects appetite isn’t fully understood.
  • Vitamin B12 (If your provider adds it): A vitamin your nerves and blood cells need. Metformin can lower B12 levels over time.

What the research does and doesn’t show

Naltrexone with bupropion is the best studied of these. As an FDA-approved extended-release tablet it was tested in four 56-week trials alongside diet and activity; in the largest, COR-I, people taking it lost 5.4% of their body weight on average, against 1.3% on placebo, and 42% lost at least 5%, against 17%. About half of people in both groups stopped taking the study drug before the end.

Metformin: in the Diabetes Prevention Program, adults with raised blood sugar lost about 2 kg (5 pounds) on average over about 3 years. Topiramate is FDA-approved for weight management only in combination with phentermine, which isn’t in this capsule.

No trial has tested compounded capsules combining these medicines. They’re made at strengths your provider sets, and they don’t release the medicines the way the FDA-approved tablets do, so results may differ.

Studies: CONTRAVE (naltrexone HCl and bupropion HCl) extended-release tablets, prescribing information, Currax Pharmaceuticals, 2025: section 14, Table 6 (COR-I: 538 on naltrexone/bupropion 32 mg/360 mg a day, 536 on placebo; ITT/LOCF; LS mean change in body weight -5.4% vs -1.3%; at least 5% weight loss 42% vs 17%; 49.2% and 50.1% discontinued study drug). Knowler et al., N Engl J Med 2002 (Diabetes Prevention Program: mean weight loss 2.1 kg on metformin vs 0.1 kg on placebo; PMID 11832527). QSYMIA (phentermine and topiramate extended-release) prescribing information: the FDA-approved weight management use of topiramate.

What to expect

First weeks
A low starting dose, raised over a few weeks. Nausea, constipation or diarrhea, headache, dizziness, trouble sleeping, dry mouth, tingling in the hands or feet and changes in how food tastes are among the most common side effects, depending on what’s in your capsule.
Around 3 months
Your provider checks how it’s going and may change what’s in your capsule, or stop it and talk through other options.
Ongoing
Your provider checks your blood pressure, mood and lab work, and adjusts your plan. Everyone responds differently.

Important safety information

Before you start

Your provider reviews your health history, medicines and allergies before prescribing, and prescribes only if it’s right for you. Tell your care team about any side effect, and get emergency care for chest pain, trouble breathing, or swelling of the face, lips or throat.

Common side effects

They depend on what’s in your capsule. Naltrexone and bupropion: nausea, constipation, headache, vomiting, dizziness, trouble sleeping and dry mouth. Metformin: diarrhea, nausea, gas, stomach pain and a metallic taste. Topiramate: tingling in the hands or feet, changes in how food and fizzy drinks taste, tiredness, dizziness, and trouble concentrating or finding words. Most are worst in the first weeks as the dose goes up. Tell your provider if they don’t ease.

Important safety information

Bupropion carries a boxed warning: antidepressants raised the risk of suicidal thoughts and behaviors in children, teens and young adults; topiramate, like other seizure medicines, can also cause mood changes and suicidal thoughts. Tell your provider right away about new or worse depression, anxiety, agitation, unusual changes in mood or behavior, or thoughts of suicide. Bupropion can cause seizures, so it isn’t used with a seizure disorder, an eating disorder such as bulimia or anorexia, or while suddenly stopping alcohol, benzodiazepines, barbiturates or seizure medicines. It can raise blood pressure and heart rate. It isn’t used with another bupropion medicine, or with an MAOI antidepressant or within 14 days of one. Naltrexone blocks opioids: it isn’t used with opioid medicines, and trying to overcome the block with large amounts of opioids can cause a fatal overdose. It can also harm the liver. Metformin carries a boxed warning for lactic acidosis, a rare but serious buildup of acid in the blood. The risk is higher with kidney or liver problems, heavy drinking, dehydration, surgery, and X-ray dye, so it isn’t used with serious kidney disease. Over time it can lower vitamin B12. Topiramate can harm an unborn baby, including cleft lip and palate. It isn’t used during pregnancy, people who could become pregnant need reliable birth control, and it can make hormonal birth control less effective. Get help right away for sudden eye pain or blurred vision. It can also cause kidney stones (drink plenty of fluids), acid buildup in the blood, and less sweating, so watch for overheating. Weight medications aren’t used during pregnancy.

FDA status

This is a compounded medication: it is not FDA-approved, and the FDA does not review compounded medications for safety, effectiveness or quality. A licensed pharmacy prepares it from your prescription, only when your provider determines it’s medically necessary for you. Each medicine in it is FDA-approved for other uses: naltrexone for alcohol and opioid dependence, bupropion for depression and to help people quit smoking, metformin for type 2 diabetes, and topiramate for epilepsy and to prevent migraines. None is FDA-approved for weight management on its own. FDA-approved oral options exist, including a naltrexone and bupropion extended-release tablet, and your provider can prescribe one of those instead.

About Custom Weight Capsule

What will be in my capsule?

Your provider decides, based on your health, your history and the medicines you take, and only if a compounded capsule is medically necessary for you. Not everyone gets every ingredient.

Why would my provider prescribe a compounded medication?

Only when they determine it’s medically necessary for you, for example because you need a combination or strength that isn’t made commercially. Otherwise, they’ll go over FDA-approved options with you.

Is it FDA-approved?

No. Compounded medications are not FDA-approved: the FDA does not review them for safety, effectiveness or quality. None of these medicines is FDA-approved for weight management on its own. An FDA-approved naltrexone and bupropion tablet and an FDA-approved GLP-1 tablet exist, and your provider can prescribe one of those instead.

Is this a GLP-1?

No. These medicines work differently from GLP-1 medications. Your provider can talk you through the differences, and whether either kind is right for you.

Who shouldn’t take it?

It depends on what’s in it. People who are pregnant or could become pregnant without reliable birth control, and people with seizures, an eating disorder, serious kidney disease or uncontrolled high blood pressure, or who take opioids or an MAOI antidepressant, may not be able to take some of these medicines. Your provider goes over your whole history.

What does it cost?

$55 for a 30-day supply, or $90 for a 90-day supply. Visits: $65 to start, then $45 for each follow-up or dose change.

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