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
Farxiga
Contrave vs. Farxiga Dosage
Contrave
Farxiga
| 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 | 5 mg once daily | At the start |
| Maximum dose | 10 mg once daily | If needed |
| Dose changes | 1 increase | 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 |
Farxiga
| 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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