Contrave vs. Adipex
See how Contrave and Adipex compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Contrave is approved for long-term weight management, while Adipex is approved only for short-term use lasting a few weeks.
Contrave carries a boxed warning for suicidal thoughts and behaviors, while Adipex is a Schedule IV controlled substance with abuse potential.
Contrave typically costs $750 to $840 per month before insurance, compared to Adipex's typical $50 to $150 per month.
Contrave vs. Adipex Drug Summary
Contrave
Contrave pairs naltrexone and bupropion in an extended-release tablet to help adults with obesity, or a weight-related condition, manage weight long-term. It's taken twice daily following a step-up dosing schedule and used alongside diet and exercise. It's not approved for depression, smoking cessation, or use in children.
Adipex
Adipex is phentermine, a stimulant-based appetite suppressant taken once daily and approved only for short-term use in adults with obesity. It works by curbing appetite through the central nervous system and is meant to pair with diet and exercise for a limited stretch of time. It's not approved for long-term weight management or for patients under 17.
Contrave vs. Adipex Side Effects
Contrave
Adipex
Contrave vs. Adipex Dosage
Contrave
Adipex
| STAGE | DOSE | WHEN |
| Starting dose | 8 mg/90 mg once daily | Week 1 |
| Maximum dose | 16 mg/180 mg twice daily | Week 3 |
| Dose changes | 2 increases | Every week |
| STAGE | DOSE | WHEN |
| Starting dose | 18.75 mg once daily | At the start |
| Maximum dose | 15 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
Contrave
| STAGE | DOSE | WHEN |
| Starting dose | 8 mg/90 mg once daily | Week 1 |
| Maximum dose | 16 mg/180 mg twice daily | Week 3 |
| Dose changes | 2 increases | Every week |
Adipex
| STAGE | DOSE | WHEN |
| Starting dose | 18.75 mg once daily | At the start |
| Maximum dose | 15 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
Contrave vs. Adipex Indications
Contrave
Contrave is approved for chronic weight management in adults with obesity or overweight who also have a weight-related condition, such as high blood pressure or type 2 diabetes. It's meant for ongoing, long-term use combined with a reduced-calorie diet and increased physical activity. Despite containing bupropion, it is not approved to treat depression or to help with smoking cessation.
Adults with obesity (BMI 30 or higher)
Adults with overweight (BMI 27+) plus a weight-related condition
Intended for long-term, ongoing use
Used alongside diet and exercise changes
Not approved for depression or smoking cessation
Adipex
Adipex is phentermine, approved only for short-term use, typically just a few weeks, as an adjunct to diet and exercise for weight loss in adults with obesity. It's designed to give an initial boost rather than serve as an ongoing treatment plan. Long-term, chronic use is not FDA approved for this drug.
Adults with obesity needing short-term appetite suppression
Approved for only a few weeks of continuous use
Used alongside diet and exercise changes
Not approved for chronic or long-term weight management
Not approved for patients 16 and younger
Contrave vs. Adipex Pros and Cons
Contrave
Contrave offers a non-controlled, long-term oral option for chronic weight management, unlike short-term stimulant alternatives. Its opioid-antagonist and antidepressant combination carries a boxed warning for suicidal thoughts and several important drug interaction contraindications. It also costs more out of pocket than older, generic weight-loss medications.
Pros
Approved for long-term, ongoing use
Not a controlled substance
Only oral non-GLP-1 branded weight-loss combination pill
May help curb cravings through a dual mechanism
Cons
Boxed warning for suicidal thoughts and behaviors
Contraindicated with opioid use, seizure history, or uncontrolled hypertension
Should be avoided with high-fat meals due to increased drug exposure
Roughly $750 to $840 per month without insurance, before savings programs
Adipex
Adipex is one of the oldest, most familiar weight-loss medications, with decades of prescribing history behind it. As a Schedule IV controlled substance approved only for short-term use, it carries abuse potential and cardiovascular warnings that limit who can safely take it. It is also far less expensive than newer prescription weight-loss options.
Pros
Roughly $50 to $150 per month, far less costly than newer options
Decades of clinical use and prescribing familiarity
Simple once-daily dosing option available
Lower pill burden with a single active ingredient
Cons
Schedule IV controlled substance with abuse potential
Approved for only short-term use of a few weeks
Contraindicated with a history of cardiovascular disease
Rare risk of pulmonary hypertension or cardiac valve disease
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