Contrave vs. Farxiga

See how Contrave and Farxiga compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Contrave is FDA-approved for chronic weight management, while Farxiga is approved for type 2 diabetes, heart failure, and chronic kidney disease, not weight loss.

  • Contrave requires a three-week dose titration to reach the full dose, while Farxiga starts at an effective dose from day one with no titration.

  • Contrave carries a boxed warning for suicidal thoughts and behaviors, while Farxiga's main serious risks are genital infections and, rarely, a severe flesh-eating infection.

Contrave vs. Farxiga Drug Summary

Contrave

Contrave combines naltrexone, an opioid antagonist, with bupropion, an antidepressant, in an extended-release tablet used for chronic weight management. It's taken twice daily, with the dose increased gradually over three weeks. It's approved for adults with obesity, or overweight plus at least one weight-related health condition.

Farxiga

Farxiga is an SGLT2 inhibitor that lowers blood sugar by causing the kidneys to remove excess glucose through urine. It's taken once daily as a single tablet, with no dose titration needed. It's approved for type 2 diabetes, heart failure, and chronic kidney disease, and is sometimes used off-label to support weight loss.

Contrave vs. Farxiga Side Effects

Contrave

Most common
nausea (32.5%)
constipation (19.2%)
headache (17.6%)
vomiting (10.7%)

Farxiga

Most common
genital yeast infections (6.9%)
nasopharyngitis (6.3%)
urinary tract infections (4.3%)
back pain (4.2%)

Contrave vs. Farxiga 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

Farxiga

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 5 mg once daily At the start
Maximum dose 10 mg once daily If needed
Dose changes 1 increase As tolerated

Contrave vs. Farxiga Indications

Contrave

Contrave is FDA-approved for chronic weight management in adults with obesity, or who are overweight with a weight-related condition such as high blood pressure or type 2 diabetes. It's meant to be used together with a reduced-calorie diet and increased physical activity. It is not approved for depression or smoking cessation, even though its two ingredients are used separately for those purposes.

  • Adults with obesity (BMI 30 or higher)

  • Adults with overweight (BMI 27+) plus a weight-related condition

  • Used alongside reduced-calorie diet and exercise

  • Not approved for depression or smoking cessation

Farxiga

Farxiga is FDA-approved to improve blood sugar control in adults and children age 10 and older with type 2 diabetes. It's also approved to reduce hospitalization risk in heart failure and to slow kidney function decline in chronic kidney disease, whether or not diabetes is present. Any use for weight loss is off-label.

  • Type 2 diabetes in adults and children age 10+

  • Heart failure, to reduce cardiovascular death and hospitalization

  • Chronic kidney disease, to slow decline in kidney function

  • Off-label weight loss use is not FDA-approved

Contrave vs. Farxiga Pros and Cons

Contrave

Contrave is the only oral, non-GLP-1 prescription combination pill approved specifically for weight loss, giving patients a pill-based option instead of an injection. Its bupropion component carries a boxed warning for suicidal thoughts, and it isn't suitable for anyone with a seizure history or opioid use.

Pros

  • Only oral non-GLP-1 combination pill approved for weight loss

  • No injections required

  • May help curb appetite-related mood eating through its bupropion component

Cons

  • Boxed warning for suicidal thoughts and behaviors

  • Contraindicated with seizure disorders, opioid use, or MAOIs

  • Requires a three-week dose titration before reaching full dose

  • Not recommended with high-fat meals

Farxiga

Farxiga has proven cardiovascular and kidney benefits beyond blood sugar control, backed by outcomes trials in heart failure and chronic kidney disease. It carries risks of genital infections and, rarely, a serious infection of the genital area, and it isn't approved for weight loss.

Pros

  • Approved for heart failure and chronic kidney disease, not just diabetes

  • Simple once-daily dosing with no titration needed

  • Approved for children age 10 and older with type 2 diabetes

Cons

  • Risk of genital yeast infections and urinary tract infections

  • Rare risk of Fournier's gangrene, a serious genital infection

  • Not approved for weight loss despite off-label use

  • Not recommended for kidney dosing below eGFR 45

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