Contrave vs. Wegovy: Differences, similarities & side effects

In this article:

• Contrave vs. Wegovy: Key differences
• Contrave vs. Wegovy: Conditions treated
• Which is better: Wegovy or Contrave for weight loss?
• Can you take Contrave and Wegovy together?
• Contrave vs. Wegovy: Insurance coverage and cost comparison
• Contrave vs. Wegovy side effects
• Contrave and Wegovy drug interactions
• Contrave and Wegovy drug warnings

In this article

• Contrave vs. Wegovy: Key differences
• Contrave vs. Wegovy: Conditions treated
• Which is better: Wegovy or Contrave for weight loss?
• Can you take Contrave and Wegovy together?
• Contrave vs. Wegovy: Insurance coverage and cost comparison
• Contrave vs. Wegovy side effects
• Contrave and Wegovy drug interactions
• Contrave and Wegovy drug warnings

Excess body weight can be a serious health concern, with many individuals seeking support beyond diet and exercise. Contrave and Wegovy are two brand-name prescription drugs approved for weight management in adults with obesity or who are overweight with at least one weight-related condition, such as high blood pressure (hypertension) or Type 2 diabetes. 

While these medications share a common goal, they differ in their active ingredients, dosages, how they work, and potential side effects. Insurance coverage and cost for these treatments can vary, as insurance companies don’t usually cover weight-loss medications. It’s important to discuss weight-loss treatments with a healthcare provider to determine the best option.

Read on to learn more about the similarities and differences between Contrave and Wegovy. 

Contrave vs. Wegovy: Key differences

Contrave is a prescription medication that combines two active ingredients: bupropion and naltrexone. Bupropion is primarily known as an antidepressant and smoking cessation aid, while naltrexone is used to treat alcohol and opioid dependence. The combination of naltrexone and bupropion is believed to work by targeting specific areas in the brain to reduce appetite and control cravings. Contrave comes as an extended-release tablet that’s usually taken in the morning and evening. 

On the other hand, Wegovy contains the active ingredient semaglutide, which is a glucagon-like peptide-1 (GLP-1) receptor agonist. As a GLP-1 receptor agonist, semaglutide mimics a hormone that targets areas of the brain involved in managing appetite. Semaglutide, initially approved to treat Type 2 diabetes under the brand name Ozempic, can be used to promote weight loss. Unlike Contrave, Wegovy comes as a weekly subcutaneous (under the skin) injection.  

Contrave vs. Wegovy: Comparing key differences
	Contrave	Wegovy
Drug class	Opioid antagonist/antidepressant	GLP-1 receptor agonist
Brand/generic status	Brand only	Brand only
What is the generic name?	Naltrexone/bupropion	Semaglutide
What form(s) does the drug come in?	Extended-release oral tablet	Subcutaneous injection
What is the standard dosage?	1 tablet every morning during the first week, then 1 tablet every morning and evening during the second week, then 2 tablets every morning and 1 tablet every evening during the third week, then 2 tablets every morning and 2 tablets every evening during the fourth week and onward	0.25 mg injected under the skin once weekly for 4 weeks, then the dosage is gradually increased to 1.7 or 2.4 mg once weekly
How long is the typical treatment?	Long-term	Long-term
Who typically uses the medication?	Adults	Adults and children 12 years and older

Contrave vs. Wegovy: Conditions treated

Contrave and Wegovy are used for chronic weight management in adults with a significant body mass index (BMI). They are prescribed to individuals who struggle with obesity or are overweight with at least one weight-related condition, such as hypertension, high cholesterol, or Type 2 diabetes. Individuals with a BMI of 30 or greater are considered to have obesity, while those with a BMI of 27 or greater are considered to be overweight. 

Contrave is approved by the Food and Drug Administration (FDA) for weight loss in adults only. Wegovy is FDA approved for weight loss in adults and children 12 years and older with obesity and adults who are overweight. In addition to weight management, Wegovy is also approved to reduce the risk of heart attacks, strokes, and other cardiovascular events in people with obesity or who are overweight and have heart disease. 

Neither drug is a cure for obesity or any other health conditions, but they may support weight loss goals as part of a broader treatment plan that includes a calorie-restricted diet, physical activity, and lifestyle changes.

Contrave vs. Wegovy: Comparing conditions treated
Condition	Contrave	Wegovy
Weight management for patients with a BMI of 30 or greater	Yes	Yes
Weight management for patients with a BMI of 27 or greater with at least one weight-related health condition	Yes	Yes
Reduce the risk of heart attacks, strokes, and heart disease-related death in people with heart disease	No	Yes

Which is better: Wegovy or Contrave for weight loss?

Wegovy and Contrave have both been shown to be more effective than placebo in clinical trials. Various studies have promoted weight loss in people with obesity or who are overweight. However, Wegovy may lead to more weight loss than Contrave.

The 56-week COR-I trial studied the use of Contrave in patients with a BMI of 27 or higher and found that participants taking a combination of naltrexone and bupropion lost an average of 4.8% more weight than those given a placebo. Additionally, 48% of those on the treatment lost at least 5% of their body weight, compared with only 16% of those on the placebo.

The STEP 1 study evaluated the effects of Wegovy in people with a BMI of 27 or higher and found that participants using Wegovy lost an average of 12.4% more weight than those in the placebo group. In addition, 86.4% of those on the treatment lost at least 5% of their body weight, compared with only 31.5% of those on the placebo.

There are limited head-to-head trials comparing Wegovy and Contrave. It’s important to consult a healthcare provider who can consider various factors when recommending the most appropriate treatment option.

Can you take Contrave and Wegovy together?

It is not generally recommended to take Contrave and Wegovy together. Both drugs are prescribed for weight management, but they work differently. Using them together could increase the risk of side effects and may not offer extra weight loss benefits. Always consult a healthcare provider before combining any medications.

Contrave vs. Wegovy: Insurance coverage and cost comparison

Insurance coverage for Wegovy and Contrave may differ depending on the insurance provider and the individual’s health plan. Patients might need to go through a process called prior authorization to meet the insurance company’s requirements before getting coverage. For those with Medicare Part D, it’s important to check with the plan’s formulary or contact a pharmacist to see if Contrave or Wegovy is covered.

The cost of these weight-loss drugs can vary without insurance. However, Contrave is generally less expensive than Wegovy, a newer drug. Contrave and Wegovy manufacturers may have programs to help patients save on retail costs. Discount cards and programs are also available, even for those without insurance. SingleCare offers a free coupon to potentially save on Contrave and Wegovy. 

RELATED: Can you really get Wegovy for $25 a month?

Contrave vs. Wegovy: Comparing insurance & cost
	Contrave	Wegovy
Typically covered by insurance?	No	No
Typically covered by Medicare Part D?	No	No
Quantity	120, 8 mg/9 mg oral tablets	4 prefilled 2.5 mg/0.75 mL injection pens
SingleCare cost*	$630	$1,196

*Cost at the time of publication. Costs fluctuate and vary by pharmacy.

Contrave vs. Wegovy side effects

The most common side effects of Contrave include nausea, constipation, headache, dizziness, insomnia, anxiety, tremor, and dry mouth. Wegovy shares similar common side effects with Contrave, such as headache, nausea, dizziness, and constipation. However, Wegovy may cause more gastrointestinal side effects, such as nausea, diarrhea, indigestion, constipation, and stomach pain, than Contrave.

Serious side effects are possible while using either drug. Both medications may cause serious allergic reactions, low blood sugar (hypoglycemia), and increased heart rate. In addition to these serious side effects, Contrave may also cause seizures, liver problems, and visual problems. In contrast, Wegovy may cause inflammation of the pancreas (pancreatitis), gallbladder problems, and thyroid tumors.

Contrave vs. Wegovy: Comparing side effects
	Contrave		Wegovy
Side Effect	Applicable?	Frequency	Applicable?	Frequency
Nausea	Yes	33%	Yes	44%
Vomiting	Yes	11%	Yes	24%
Stomach pain	Yes	4%	Yes	20%
Diarrhea	Yes	7%	Yes	30%
Constipation	Yes	19%	Yes	24%
Dry mouth	Yes	8%	No	–
Insomnia	Yes	9%	No	–
Anxiety	Yes	4%	No	–
Tremor	Yes	4%	No	–
High blood pressure	Yes	3%	No	–
Fatigue	Yes	4%	Yes	11%
Headache	Yes	18%	Yes	14%
Indigestion	No	–	Yes	9%
Dizziness	Yes	10%	Yes	8%

Frequency is not based on data from a head-to-head trial. This may not be a complete list of adverse effects that can occur. Please refer to your healthcare provider to learn more.

Source: DailyMed (Contrave), DailyMed (Wegovy)

Contrave and Wegovy drug interactions

Contrave has a longer list of medications it can interact with than Wegovy. Taking Contrave with a monoamine oxidase inhibitor (MAOI) or within 14 days of stopping one may increase the risk of a severe increase in blood pressure (hypertensive crisis). Due to naltrexone’s chemical properties, Contrave can block the effects of opioid pain medications. 

In addition, Contrave can interact with other medications processed in the liver, including certain antidepressants, antipsychotics, and antivirals. This interaction can potentially lead to increased side effects or reduced effectiveness of Contrave or other medications. 

Wegovy can decrease the absorption rate of oral medications, potentially altering their effectiveness. Those with diabetes should note that taking Wegovy alongside insulin or diabetes medications like sulfonylureas can increase the risk of low blood sugar. As weight loss may increase the risk of hypoglycemia, caution is recommended while taking Contrave with insulin or other diabetes medications. 

Contrave vs. Wegovy: Comparing drug interactions
Drug	Drug class	Contrave	Wegovy
Nardil (phenelzine) Parnate (tranylcypromine) Marplan (isocarboxazid)	Monoamine oxidase inhibitors (MAOIs)	Yes	No
OxyContin (oxycodone) Vicodin (hydrocodone/acetaminophen) Dilaudid (hydromorphone) Duragesic (fentanyl)	Opioids	Yes	No
Sinemet (carbidopa/levodopa) Symmetrel (amantadine)	Dopaminergic drugs	Yes	No
Prozac (fluoxetine) Paxil (paroxetine) Effexor (venlafaxine) Luvox (fluvoxamine) Elavil (amitriptyline)	Antidepressants	Yes	No
Seroquel (quetiapine) Risperdal (risperidone) Zyprexa (olanzapine)	Antipsychotics	Yes	No
Lopressor (metoprolol)  Coreg (carvedilol)	Beta blockers	Yes	No
Plavix (clopidogrel)	Antiplatelets	Yes	No
Norvir (ritonavir) Kaletra (lopinavir/ritonavir) Sustiva (efavirenz)	Antivirals	Yes	No
Prednisone (prednisone) Medrol (methylprednisolone) Decadron (dexamethasone)	Systemic corticosteroids	Yes	No
Novolog (insulin aspart) Humalog (insulin lispro) Lantus (insulin glargine) Levemir (insulin detemir)	Insulin	No	Yes
Micronase (glyburide) Amaryl (glimepiride) Glucotrol (glipizide)	Sulfonylureas	No	Yes
Tradjenta (linagliptin) Onglyza (saxagliptin) Januvia (sitagliptin)	DPP-4 inhibitors	No	Yes
Starlix (nateglinide) Prandin (repaglinide)	Glinides	No	Yes

This is not a complete list of drug interactions. Please consult your healthcare provider before taking these medications.

Contrave and Wegovy drug warnings

Both medications have warnings about suicidal behavior and ideation. Contrave specifically mentions the risk in children, adolescents, and young adults, while Wegovy advises monitoring for depression and suicidal thoughts in all individuals. Contrave also carries a risk of neuropsychiatric adverse events, such as psychosis, hallucinations, and paranoia.

In addition, Contrave may cause seizures, liver issues, angle-closure glaucoma, and an increase in blood pressure or heart rate. On the other hand, Wegovy’s warnings include acute pancreatitis, gallbladder disease, acute kidney injury, diabetic retinopathy complications, and increased heart rate.

These medications are not generally recommended while pregnant or breastfeeding. Consult a healthcare professional for appropriate treatment options if you are pregnant or breastfeeding.