Contrave vs. Trulicity
See how Contrave and Trulicity compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Contrave is a twice-daily pill, while Trulicity is a once-weekly injection, so the route and frequency of use are very different.
Contrave is FDA-approved specifically for chronic weight management, while Trulicity is approved for type 2 diabetes and used off-label for weight loss.
Both carry boxed warnings, but for different reasons: Contrave for suicidal thoughts and behaviors, Trulicity for thyroid C-cell tumors.
Contrave vs. Trulicity Drug Summary
Contrave
Contrave combines naltrexone and bupropion in an oral extended-release tablet and is FDA-approved for chronic weight management in adults with obesity or overweight plus a weight-related condition. It works on brain pathways involved in appetite and reward, and is taken twice daily with a step-up dosing schedule over three weeks.
Trulicity
Trulicity is a GLP-1 receptor agonist approved to control blood sugar in adults and children 10 and older with type 2 diabetes, and to reduce cardiovascular risk in adults with heart disease or multiple risk factors. It is given as a once-weekly injection using a prefilled pen, and is also used off-label for weight loss in people without diabetes.
Contrave vs. Trulicity Side Effects
Contrave
Trulicity
Contrave vs. Trulicity Dosage
Contrave
Trulicity
| 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 | 0.75 mg once weekly | Weeks 1-4 |
| Maximum dose | 4.5 mg once weekly | If needed |
| Dose changes | 3 increases | Every 4 weeks |
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 |
Trulicity
| STAGE | DOSE | WHEN |
| Starting dose | 0.75 mg once weekly | Weeks 1-4 |
| Maximum dose | 4.5 mg once weekly | If needed |
| Dose changes | 3 increases | Every 4 weeks |
Contrave vs. Trulicity Indications
Contrave
Contrave is FDA-approved for chronic weight management in adults with obesity, or with overweight plus at least one weight-related condition such as high blood pressure or type 2 diabetes. It's meant to be used alongside a reduced-calorie diet and increased physical activity, not on its own. It is not approved for depression or smoking cessation, even though its individual components are used separately for those conditions.
Chronic weight management in adults with obesity
For adults with overweight plus a weight-related condition
Used with diet and exercise, not alone
Not approved for depression or smoking cessation
Trulicity
Trulicity is FDA-approved to improve blood sugar control in adults and children 10 and older with type 2 diabetes. It's also approved to lower the risk of major cardiovascular events in adults with type 2 diabetes who have heart disease or multiple cardiovascular risk factors. Using it for weight loss in people without diabetes is off-label.
Blood sugar control in type 2 diabetes, age 10+
Lowers cardiovascular risk in adults with heart disease
Off-label use for weight loss without diabetes
Not approved for type 1 diabetes or DKA
Contrave vs. Trulicity Pros and Cons
Contrave
Contrave offers an oral option for people who prefer not to inject a medication, reaching full maintenance dose within three weeks. Weight loss in trials tends to be more modest than with GLP-1 injections, and the drug has several contraindications tied to its bupropion component. Insurance coverage for weight-loss medications varies widely regardless of which drug is prescribed.
Pros
Oral tablet, no injections required
Reaches full maintenance dose in 3 weeks
Only non-GLP-1 branded weight-loss pill available
Lower monthly list price than Trulicity ($750-$840 vs $987-$1,065)
Cons
Contraindicated with seizure history or uncontrolled hypertension
Cannot be combined with opioid use or acute opiate withdrawal
Boxed warning for suicidal thoughts and behaviors
Not recommended with high-fat meals
Trulicity
Trulicity offers once-weekly dosing, which many patients find easier to stick with than a daily pill. It's approved for pediatric type 2 diabetes and backed by cardiovascular outcomes data, but it requires an injection and has no generic alternative. Its list price runs higher than Contrave's, which can matter for people paying out of pocket.
Pros
Only needs to be injected once a week
Approved for pediatric type 2 diabetes (age 10+)
Backed by cardiovascular risk-reduction data
Four maintenance dose options for flexibility
Cons
Requires injection with a prefilled pen
No generic version available
Boxed warning for thyroid C-cell tumors
Higher monthly list price than Contrave ($987-$1,065 vs $750-$840)
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