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

Most common
Nausea (up to 20.3%)
Vomiting (up to 9.2%)
Diarrhea (up to 8.8%)
Abdominal pain (up to 7.3%)

Contrave

Most common
Nausea (up to 32.5%)
Vomiting (up to 10.7%)
Constipation (up to 19.2%)
Headache (up to 17.6%)

Ozempic vs. Contrave Dosage

Ozempic

Dosage
Dosage Table
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

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

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

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