Mounjaro vs. Contrave

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

Key Takeaways

  • Mounjaro is an injectable diabetes drug used off-label for weight loss, while Contrave is an oral pill FDA-approved specifically for chronic weight management.

  • Both drugs commonly cause nausea and vomiting, but Contrave's GI side effects tend to occur at higher rates than Mounjaro's.

  • Mounjaro carries a boxed warning for thyroid tumors, while Contrave carries a boxed warning for suicidal thoughts tied to its bupropion component.

Mounjaro vs. Contrave Drug Summary

Mounjaro

Mounjaro (tirzepatide) is a dual GIP/GLP-1 receptor agonist FDA-approved to control blood sugar in adults and children 10 and older with type 2 diabetes. It is given as a once-weekly subcutaneous injection with a gradual dose increase over several months. Many prescribers also use it off-label for weight loss.

Contrave

Contrave combines naltrexone and bupropion in an extended-release tablet FDA-approved for chronic weight management in adults with obesity or a weight-related condition. It is taken twice daily by mouth after a two-week dose titration. It works on brain pathways involved in appetite and reward rather than gut hormones.

Mounjaro vs. Contrave Side Effects

Mounjaro

Most common
nausea (12-18%)
vomiting (5-9%)
diarrhea (12-17%)
decreased appetite (8-11%)

Contrave

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

Mounjaro vs. Contrave Dosage

Mounjaro

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 2.5 mg once weekly Weeks 1-4
Maximum dose 15 mg once weekly Week 21 onward
Dose changes 5 increases Every 4 weeks

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 onward
Dose changes 2 increases Every week

Mounjaro vs. Contrave Indications

Mounjaro

Mounjaro is FDA-approved to improve blood sugar control in adults and children 10 and older with type 2 diabetes, alongside diet and exercise. It is not approved for type 1 diabetes. Many people also use it off-label for weight loss, though that use is not on the FDA label.

  • Type 2 diabetes blood sugar control in adults

  • Type 2 diabetes blood sugar control in children 10+

  • Weight loss (off-label use)

Contrave

Contrave is FDA-approved for chronic weight management in adults who have obesity or are overweight with at least one weight-related health condition. It is meant to be used with a reduced-calorie diet and increased physical activity. It is not approved to treat depression, help with smoking cessation, or for use in children.

  • Chronic weight management in adults with obesity

  • Chronic weight management with a weight-related condition

  • Used alongside diet and exercise

Mounjaro vs. Contrave Pros and Cons

Mounjaro

Mounjaro's dual incretin action tends to produce substantial weight loss, though this benefit is achieved through off-label use rather than an FDA-approved indication for weight loss. It requires a weekly injection and a slow dose ramp-up over about five months to reach the highest maintenance dose.

Pros

  • Once-weekly injection instead of a daily pill

  • Also improves blood sugar control for people with type 2 diabetes

  • FDA-approved for pediatric type 2 diabetes as young as age 10

  • Lower rates of nausea and vomiting than Contrave

Cons

  • Requires a self-injection rather than a pill

  • Boxed warning for thyroid C-cell tumors seen in animal studies

  • Contraindicated with personal or family history of MTC or MEN 2

  • Weight loss use is off-label, not FDA-approved

Contrave

Contrave is taken as a pill, which appeals to people who want to avoid injections, and it is FDA-approved specifically for weight management. Its bupropion component brings a boxed warning and several contraindications that require careful screening before starting.

Pros

  • Oral tablet, no injections or needles required

  • FDA-approved specifically for chronic weight management

  • Roughly $750 to $840 per month without insurance

  • No thyroid tumor boxed warning

Cons

  • Boxed warning for suicidal thoughts and behaviors

  • Contraindicated with seizure disorders or opioid use

  • Higher rates of nausea, constipation, and headache

  • Twice-daily dosing after titration

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