Contrave vs. Wegovy for Weight Loss: 7 Differences to Consider

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Wegovy (semaglutide) has quickly become one of the country's most popular prescription weight-loss medications. In 2021 alone, over 2 million people were using semaglutide. And in May 2024, it was estimated that at least 25,000 people were starting Wegovy every week in the U.S.

But there are other effective weight-loss options out there, including oral medications like Contrave (naltrexone / bupropion). Understanding their differences can help you choose the right weight-loss medication for you.

Here, we'll look at five things to consider when it comes to Contrave versus Wegovy for weight loss.

1. Contrave and Wegovy work differently to help you lose weight

Wegovy and Contrave both help you to lose weight. But they work in different ways.

Contrave is a combination of two medications: naltrexone and bupropion. It seems to work by affecting the reward center in your brain that responds to pleasurable activities, like eating. This helps reduce food cravings. Contrave may also reduce your appetite and increase your energy use to burn more calories.

Wegovy is a glucagon-like peptide-1 (GLP-1) agonist. It works by acting like the hormone GLP-1 in your body. In doing so, Wegovy increases feelings of fullness and reduces your appetite. It also slows down the movement of food from your stomach. This helps you feel full for longer. People also report that Wegovy helps turn off "food noise," or constant thoughts of food and eating.

2. If you're living with heart disease, Wegovy may be a better option

In March 2024, Wegovy became FDA approved to reduce the risk of serious heart problems in adults who are considered overweight or obese. Over a 5-year study, Wegovy reduced the risk of major adverse cardiovascular events (heart attack, stroke, or cardiovascular-related death) by 20%. If you're living with heart disease, your prescriber may recommend Wegovy because of this added benefit.

3. Contrave is only approved for adults, while Wegovy is also approved for children

Wegovy is approved for children ages 12 years and older as well as adults. It's one of the few weight-loss medications approved for adolescents. Contrave, on the other hand, is only approved for adults.

Keep in mind that Wegovy is only indicated for children who are considered obese. Your pediatrician can help determine a healthy weight range for your child and the best way to achieve weight-loss goals.

4. Wegovy and Contrave are administered differently

One thing to consider when looking at Contrave versus Wegovy is their route of administration.

Wegovy comes as a prefilled injection pen. It's injected once weekly under the skin of your abdomen, upper leg, or outer upper arm. You can give yourself the injection at home, but if you're squeamish around needles, it may not be the best choice for you.

Contrave, on the other hand, comes as an oral tablet. You'll typically take 2 tablets twice a day after the first week. You can take Contrave with or without food. But you shouldn't take Contrave with a high-fat meal, since this can cause you to absorb more of the medication than intended. Contrave tablets should be swallowed whole and not crushed or chewed. So if you have trouble swallowing pills, that's something to consider.

Both Contrave and Wegovy require step-wise dosing. This means you'll start with a low dose and slowly work your way up to the recommended maintenance dosage at a pace your body can handle. This usually takes about 4 weeks with Contrave. But it takes longer - about 4 months - with Wegovy. However, you'll typically start to notice weight loss after about 4 weeks with either medication.

5. You may lose more weight with Wegovy than with Contrave

Wegovy and Contrave haven't been directly compared in a clinical study for weight loss. But their individual studies suggest that you may lose more weight with Wegovy than Contrave.

For Contrave, the average weight loss was about 8% of participants' starting body weight after 56 weeks of treatment in clinical studies. When Contrave was combined with intense nutrition and exercise counseling, that number went up to over 11% of starting body weight.

Wegovy resulted in an average weight loss of about 15% of starting body weight after 68 weeks of treatment. So it may result in greater overall weight loss than Contrave.

Keep in mind that both Contrave and Wegovy are effective at helping people reach their weight-loss goals. And everyone responds differently to weight-loss medications. So it's possible that one medication might work better for you while a different one works better for someone else. Your prescriber will help you choose the right medication based on your goals and your personal medical history.

6. Wegovy and Contrave have different side effects and risks

Like any medication, both Wegovy and Contrave come with potential risks and side effects. And these are a little different between the two medications.

The most common Wegovy side effects are stomach related. They include nausea, diarrhea, and vomiting. Constipation and stomach pain are also common. Rare but serious side effects linked to Wegovy include pancreatitis (inflammation of the pancreas), stomach or intestinal paralysis, and an increased risk of certain thyroid cancers. If you have a history of certain thyroid cancers, Wegovy may not be the best medication for you.

Contrave also causes stomach-related side effects, such as nausea and constipation. Other common Contrave side effects include headache, dizziness, and insomnia. Rare but serious side effects include high blood pressure and an increased risk of seizures. Bupropion, one of the medications in Contrave, can increase blood pressure and raise your chance of having a seizure. Contrave isn't recommended if you have epilepsy or have had seizures in the past.

7. Wegovy and Contrave have different drug interactions

Wegovy and Contrave interact with different medications. In general, Contrave tends to have more potential drug interactions than Wegovy.

Wegovy can lower your blood glucose (sugar). The risk of hypoglycemia (low blood glucose) with Wegovy is low. But if you have diabetes and take Wegovy with other medications that lower blood glucose, this risk can go up. It may also affect how well you absorb other oral medications since it slows down the movement of food and medications through your digestive tract.

Contrave can interact with antidepressants, some blood pressure medications, and anti-seizure medications. It's also recommended that you avoid or limit alcohol while you're taking it.

Remember, these are not all of the potential drug interactions these medications have. The best way to manage drug interactions is to be sure your healthcare team has your complete medication list. They can use it to find a weight-loss treatment that's safe to combine with your other medications.

There are ways to save on Contrave and Wegovy

Contrave and Wegovy are only available as brand-name medications. But GoodRx can help you navigate ways to save on your prescription.

• Save on Wegovy:Wegovy's price is as little as $0 per month with a manufacturer savings card. If your insurance doesn't cover Wegovy, additional discounts are available.

• Save on Contrave: If you have insurance, Contrave's price is as low as $20 per month with a copay card from the manufacturer. If you're uninsured or underinsured, you may be eligible for Contrave's access program, which provides a month of medication for $99 or less.

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