Wegovy vs. Contrave

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

Key Takeaways

  • Wegovy is a once-weekly injection with an added FDA approval to lower cardiovascular risk, while Contrave is a twice-daily pill approved only for weight management.

  • Both drugs commonly cause nausea, vomiting, constipation, and headache, though the rates differ between the two medications.

  • Wegovy typically costs more per month than Contrave, running roughly $1,300 to $1,350 versus $750 to $840 without insurance.

Wegovy vs. Contrave Drug Summary

Wegovy

Wegovy (semaglutide) is a GLP-1 receptor agonist given as a once-weekly injection. It's approved for chronic weight management in adults and adolescents with obesity or overweight, and separately to reduce cardiovascular risk in adults with heart disease. Doses are increased gradually over about four months to reach the 2.4 mg maintenance dose.

Contrave

Contrave combines naltrexone and bupropion, an opioid antagonist paired with an antidepressant, taken as an oral tablet twice daily. It's approved for chronic weight management in adults with obesity or overweight alongside diet and exercise. Dosing is titrated over two weeks to reach the twice-daily maintenance dose.

Wegovy vs. Contrave Side Effects

Wegovy

Most common
Nausea (up to 44%)
Constipation (up to 24%)
Vomiting (up to 24%)
Headache (up to 14%)

Contrave

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

Wegovy vs. Contrave Dosage

Wegovy

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 0.25 mg once weekly Weeks 1-4
Maximum dose 2.4 mg once weekly Week 17 onward
Dose changes 4 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

Wegovy vs. Contrave Indications

Wegovy

Wegovy is FDA-approved for long-term weight management in people 12 and older with obesity, or overweight plus a weight-related condition, when combined with diet and exercise. It also carries a separate approval to reduce the risk of heart attack, stroke, and cardiovascular death in adults with established heart disease and obesity or overweight.

  • Weight management in adults and adolescents (12+)

  • For obesity, or overweight with a related condition

  • Used with diet and exercise

  • Reduces cardiovascular risk in adults with heart disease

Contrave

Contrave is FDA-approved for long-term weight management in adults with obesity, or overweight plus a weight-related condition, when combined with a reduced-calorie diet and increased physical activity. It does not carry any additional approval for cardiovascular risk reduction or other conditions.

  • Weight management in adults only

  • For obesity, or overweight with a related condition

  • Used with reduced-calorie diet and exercise

  • No cardiovascular risk-reduction approval

Wegovy vs. Contrave Pros and Cons

Wegovy

Wegovy has shown larger average weight loss in clinical trials than most oral weight-loss medications, including Contrave. As an injectable GLP-1, it carries GI-related side effects and a thyroid tumor boxed warning, and it costs more per month than Contrave without insurance.

Pros

  • Larger average weight loss in clinical trials

  • Only needs to be taken once a week

  • Also approved to reduce cardiovascular risk

  • Approved for adolescents 12 and older

Cons

  • Requires a self-injection each week

  • Boxed warning for thyroid C-cell tumors

  • GI side effects tend to be more frequent

  • Costs roughly $1,300 to $1,350 per month before insurance

Contrave

Contrave works through a different mechanism than GLP-1 drugs, combining an opioid antagonist with an antidepressant in pill form. It's taken orally rather than injected, but it carries its own boxed warning for suicidal thoughts and has more contraindications related to seizures, opioid use, and blood pressure.

Pros

  • Oral tablet, no injections needed

  • No thyroid tumor warning or GI-heavy profile

  • Costs roughly $750 to $840 per month before insurance

  • May suit those who can't take a GLP-1 drug

Cons

  • Boxed warning for suicidal thoughts and behaviors

  • Contraindicated with seizure history, opioid use, uncontrolled hypertension

  • Twice-daily dosing schedule

  • Generally produces less weight loss than Wegovy

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