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

Most common
Nausea (up to 32.5%)
Constipation (up to 19.2%)
Headache (up to 17.6%)
Vomiting (up to 10.7%)

Adipex

Most common
Insomnia (not specified)
Dizziness (not specified)
Restlessness (not specified)
Dry mouth (not specified)

Contrave vs. Adipex Dosage

Contrave

Dosage
Dosage Table
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

Dosage
Dosage Table
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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