Ozempic vs. Contrave
See how Ozempic and Contrave compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Ozempic is a once-weekly GLP-1 injection approved for type 2 diabetes and heart and kidney protection, while its use for weight loss is off-label; Contrave is a twice-daily pill approved specifically for chronic weight management.
Both drugs commonly cause nausea, but Contrave's rates of nausea and constipation run notably higher, while Ozempic carries a boxed warning for thyroid tumors and Contrave carries one for suicidal thoughts.
Contrave typically costs less per month than Ozempic, but Ozempic has FDA-backed evidence for lowering cardiovascular and kidney risks that Contrave does not have.
Ozempic vs. Contrave Drug Summary
Ozempic
Ozempic is a once-weekly GLP-1 receptor agonist injection approved to control blood sugar in adults with type 2 diabetes and to lower cardiovascular and kidney risks in those with the condition. It is not FDA-approved for weight loss, though it is commonly used off-label for that purpose. Dosing starts low and increases gradually to limit nausea and other digestive side effects.
Contrave
Contrave combines naltrexone and bupropion in an oral tablet taken twice daily and is FDA-approved for chronic weight management in adults with obesity or with overweight plus a weight-related condition. It works through appetite and reward pathways in the brain rather than the gut hormone system GLP-1 drugs target. Dosing is titrated over three weeks up to a fixed maintenance dose.
Ozempic vs. Contrave Side Effects
Ozempic
Contrave
Ozempic vs. Contrave Dosage
Ozempic
Contrave
| STAGE | DOSE | WHEN |
| Starting dose | 0.25 mg once weekly | Weeks 1-4 |
| Maximum dose | 2 mg once weekly | If needed |
| Dose changes | 3 increases | Every 4 weeks |
| 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 |
Ozempic
| STAGE | DOSE | WHEN |
| Starting dose | 0.25 mg once weekly | Weeks 1-4 |
| Maximum dose | 2 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 onward |
| Dose changes | 2 increases | Every week |
Ozempic vs. Contrave Indications
Ozempic
Ozempic is FDA-approved to improve blood sugar control in adults with type 2 diabetes, used alongside diet and exercise. It also carries approvals to lower the risk of major cardiovascular events and to slow kidney disease progression in adults with type 2 diabetes who have heart or kidney disease. Weight loss is a common but off-label use of Ozempic.
Blood sugar control in type 2 diabetes
Lower cardiovascular event risk with known heart disease
Slow chronic kidney disease progression
Off-label: weight loss in people without diabetes
Contrave
Contrave is FDA-approved for chronic weight management in adults with obesity, or with overweight plus a weight-related condition such as high blood pressure. It is meant to be used together with a reduced-calorie diet and increased physical activity. Contrave is not approved for diabetes, depression, or smoking cessation.
Chronic weight management in adults with obesity
Weight management with overweight plus a related condition
Used with reduced-calorie diet and exercise
Not approved for diabetes or depression treatment
Ozempic vs. Contrave Pros and Cons
Ozempic
Ozempic has the strongest evidence base of the two, with FDA approval to reduce cardiovascular events and slow kidney disease in people with type 2 diabetes, benefits Contrave does not have. It requires a weekly injection and carries a boxed warning for thyroid tumors seen in animal studies. Coverage often hinges on a type 2 diabetes diagnosis, since weight loss use is off-label.
Pros
FDA-approved to reduce cardiovascular events in type 2 diabetes
FDA-approved to slow kidney disease progression
Only needs to be injected once a week
Generally lower rates of nausea and constipation than Contrave
Cons
Requires a weekly injection instead of a pill
Boxed warning for thyroid C-cell tumor risk
Not FDA-approved for weight loss, so use for that purpose is off-label
Typically costs more per month than Contrave, roughly $935 to $1,043 without insurance
Contrave
Contrave is the only oral combination pill FDA-approved specifically for chronic weight loss, which appeals to people who want to avoid injections. It lacks Ozempic's cardiovascular and kidney protection data, and it carries its own boxed warning for suicidal thoughts tied to the bupropion component. Contrave also has more restrictions, including contraindications for seizure disorders and uncontrolled high blood pressure.
Pros
Oral tablet, no injections needed
FDA-approved specifically for chronic weight management
No boxed warning for thyroid tumors
Typically costs less per month than Ozempic, roughly $750 to $840 without insurance
Cons
Boxed warning for suicidal thoughts and behaviors
Contraindicated with seizure disorders or uncontrolled hypertension
Higher rates of nausea and constipation than Ozempic
Not approved for diabetes management or cardiovascular risk reduction
Common Symptoms and Related Diseases You Can Explore
Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.