Contrave vs Wegovy: Comparing Weight Loss Medications

Weight loss is a common goal for many, and there are several medical aids that can facilitate this process. Contrave and Wegovy are two prescription medications that have been gaining attention in the field of weight management. Contrave, a combination of naltrexone and bupropion, targets the central nervous system to decrease appetite and curb food cravings. Wegovy, on the other hand, contains semaglutide, which mimics a hormone that regulates appetite and food intake.

Both medications have shown efficacy in clinical trials and are prescribed as part of a comprehensive weight management program that includes diet and exercise. It is important for patients and healthcare providers to consider the unique profiles of these drugs. Factors such as how they work, the potential side effects, and the specific patient populations they serve should be weighed when deciding on a weight loss strategy. Moreover, access to treatment and cost can greatly influence the choice between Contrave and Wegovy.

Key Takeaways

  • Contrave and Wegovy are both used for weight management but have different active ingredients.
  • Patients should evaluate the side effects and potential risks of each medication before use.
  • Access to treatment and cost are significant factors when choosing between Contrave and Wegovy.

Overview of Contrave and Wegovy

Contrave and Wegovy are two prescription medications I understand are used in the management of body weight in individuals with obesity or who are overweight and have weight-related conditions. They are part of a comprehensive treatment plan that includes diet, exercise, and behavioral modifications.

Mechanism of Action

Contrave combines two medications, bupropion and naltrexone. Bupropion is primarily used as an antidepressant and smoking cessation aid, which I know affects the part of the brain that regulates appetite and energy balance. Naltrexone is generally used for alcohol and opioid dependence and works by blocking the effects of opiate drugs and decreasing cravings. When combined in Contrave, these substances work synergistically to reduce appetite and control body weight.

Wegovy, on the other hand, contains the active ingredient semaglutide, a GLP-1 (glucagon-like peptide-1) receptor agonist. GLP-1 is a hormone that I’m aware is involved in appetite regulation and insulin secretion. Semaglutide works by mimicking GLP-1, enhancing its effects to decrease hunger, leading to reduced calorie intake and weight loss.

FDA Approval and Clinical Background

Contrave received FDA approval in 2014. I recall that clinical trials demonstrated its effectiveness in helping patients achieve and maintain weight loss when used alongside a reduced-calorie diet and increased physical activity, specifically for patients with a BMI (body mass index) of 30 or greater (obese), or 27 or greater (overweight) with at least one weight-related coexisting condition.

Wegovy was approved by the FDA in 2021. It has been noteworthy for its role in weight management in adults with a starting BMI of 30 or more, or 27 or more with at least one weight-related ailment such as type 2 diabetes, high blood pressure, or high cholesterol. Clinical trials showed significant reductions in body weight, making Wegovy a promising treatment option for sustained weight management.

Efficacy of Treatments

In comparing Contrave and Wegovy, I examine their effectiveness in weight loss and the improvement of obesity-related health conditions.

Comparison of Weight Loss Results

Contrave combines naltrexone and bupropion, targeting the central nervous system to decrease appetite and increase energy expenditure. Clinical studies indicate that patients on Contrave, alongside a reduced-calorie diet and exercise, typically experience a 5% to 10% reduction in body weight over a year. On the other hand, Wegovy (semaglutide) works by mimicking the hormone GLP-1, which regulates appetite and calorie intake. Studies show that Wegovy can lead to an average weight loss of 15% to 18% of initial body weight in the same period when used with a reduced-calorie diet and increased physical activity.

  • Contrave: Average 5-10% body weight loss
  • Wegovy: Average 15-18% body weight loss

These findings position Wegovy as a more potent option for weight management in obese or overweight patients with a higher body mass index (BMI).

Impact on Obesity-Related Conditions

The efficacy of these medications extends beyond weight loss. I find that Contrave is often associated with improvements in patients with type 2 diabetes, high cholesterol, and high blood pressure, albeit to a lesser extent than Wegovy. In contrast, Wegovy demonstrates a more pronounced capacity to improve glycemic control in type 2 diabetes patients and may also significantly reduce the risk of major adverse cardiovascular events, which are critical for patients with obesity at risk for heart disease.

  • Contrave improvements:

    • Type 2 diabetes: modest
    • High cholesterol: modest
    • High blood pressure: moderate
  • Wegovy improvements:

    • Type 2 diabetes: significant
    • Heart disease risk: substantially reduced

My analysis highlights the varying levels of efficacy between Contrave and Wegovy for both weight loss results and impacts on obesity-related health conditions. Wegovy comes forth as a notably effective treatment in both domains, leading to substantial weight loss and providing considerable benefits to metabolic health.

Potential Side Effects and Risks

In my examination of Contrave and Wegovy, I’ve identified a range of potential side effects that patients may experience. It’s vital for anyone considering these medications to understand the common adverse reactions as well as the serious health concerns they might encounter.

Common Adverse Reactions


  • Nausea: A significant number of individuals may experience nausea, which is often most pronounced during the initial weeks of treatment.
  • Headache & Dizziness: These are frequent and can occur as the body adjusts to the medication.
  • Constipation & Diarrhea: Digestive issues like constipation and diarrhea are also common side effects.

Table 1: Common adverse reactions experienced by Contrave users

Side Effect Incidence Rate (%)
Nausea 30
Constipation 19
Headache 17
Diarrhea 14
Dizziness 10


  • Nausea & Vomiting: These are common, particularly when beginning therapy or after a dosage increase.
  • Diarrhea: Some users may experience gastrointestinal disturbances.
  • Constipation: Though less common than with Contrave, constipation still affects a number of Wegovy users.

Table 2: Common adverse reactions experienced by Wegovy users

Side Effect Incidence Rate (%)
Nausea 44
Diarrhea 20
Constipation 19
Vomiting 15

Serious Health Concerns

I’ve also scrutinized more severe health risks associated with these medications. It’s crucial to consult a healthcare provider to understand these risks fully.


  • Seizures: The risk of seizures is heightened, particularly if the recommended dose is exceeded.
  • Blood Pressure: Monitoring blood pressure is necessary as fluctuations can occur.

List 1: Serious health concerns for Contrave users

  • Seizures
  • Elevated blood pressure and heart rate


  • Thyroid Cancer: The drug comes with a warning for a potential risk of thyroid C-cell tumors.
  • Pancreatitis: Cases of acute pancreatitis have been reported.

List 2: Serious health concerns for Wegovy users

  • Thyroid C-cell tumors
  • Pancreatitis
  • Possible increased heart rate

In both cases, the risk of heart attack or stroke may be amplified for those already predisposed. Healthcare providers will weigh these risks against the potential benefits of the medications.

Considerations for Use

When considering Contrave or Wegovy for weight management, it is important to evaluate factors such as drug interactions, contraindications, and their suitability for long-term treatment. I’ll discuss essential details that impact their use and the role of healthcare providers in guidance and management.

Drug Interactions and Contraindications


  • Drug Interactions:

    • Antidepressants: There could be an increased risk of serotonin syndrome when combined with other antidepressants.
    • Alcohol: Use caution; sudden changes in alcohol tolerance may occur.
    • Metformin: Adjustments in dosage may be necessary as weight loss can affect metformin levels.
  • Contraindications:

    • Uncontrolled Hypertension: Contrave is not advised for individuals with uncontrolled high blood pressure.
    • Chronic Opioid Use: Patients using opioids or undergoing opiate withdrawal should not use Contrave.


  • Drug Interactions:

    • Thyroid: Wegovy can alter the need for medications in the treatment of thyroid conditions.
    • Insulin: Dosage adjustments of insulin or other glucose-lowering agents may be required.
  • Contraindications:

    • Thyroid Tumors: Patients with a personal or family history of medullary thyroid carcinoma or patients with Multiple Endocrine Neoplasia syndrome type 2 should avoid Wegovy.
    • Pregnancy: Wegovy is not recommended for use during pregnancy.

Healthcare providers must evaluate all potential drug interactions and contraindications based on a patient’s complete medical profile before initiating treatment with either Contrave or Wegovy.

Suitability for Long-Term Treatment

Contrave and Wegovy are both prescribed for chronic weight management, but their suitability for long-term use varies and requires careful consideration.

  • Long-Term Treatment:
    • Contrave: May be a suitable option, but the impact on cardiovascular outcomes remains unclear.
    • Wegovy: Has shown promise in managing weight over the long term, with a focus on maintaining a feeling of fullness.

Patients must have access to continuous care and monitoring by their healthcare provider to ensure the sustainability and safety of long-term treatment with either medication. The choice of medication should align with the patient’s health goals and medical site circumstances.

Cost and Access to Treatment

In this section, I’ll discuss the financial aspects and accessibility of Contrave and Wegovy, which are important considerations for patients seeking treatment for weight management.

Insurance Coverage and Out-of-Pocket Costs

I find insurance coverage for prescription medications like Contrave and Wegovy to vary significantly between different insurance plans, including Medicare. Some private insurance plans may cover these medications, but the extent of coverage, copay amounts, and whether a prior authorization is needed can differ.

  • Contrave: Coverage depends on the insurance provider; patients may use a savings card to reduce the cost.
  • Wegovy: Often requires prior authorization; patients might find discount codes or coupons from sources like GoodRx to lower out-of-pocket expenses.

However, not all plans cover weight management medications, leading to potentially high out-of-pocket costs for patients without coverage or with high deductible plans.

Availability and Prescribing Information

My observation of availability in the United States has shown that Contrave and Wegovy are both prescription medications that require a healthcare provider’s authorization. They are not available over-the-counter and should be prescribed as part of a comprehensive weight loss plan.

  • Contrave: Widely available through certified pharmacies; healthcare providers might offer samples or direct purchasing options.
  • Wegovy: Might be in limited supply due to high demand or production issues; it’s advisable to check with pharmacies or healthcare providers for current availability.

Eligibility to receive these medications depends on several factors, including a patient’s health history and body mass index (BMI). It’s crucial for patients to consult their healthcare provider for personalized prescribing information.

Frequently Asked Questions

In this section, I address common inquiries about the use and effects of the weight loss medications Contrave and Wegovy.

What are the comparative effectiveness of Contrave and Wegovy for weight loss?

Contrave, a combination of naltrexone and bupropion, tends to produce moderate weight loss in many patients. In contrast, Wegovy, which contains semaglutide, often results in significant weight loss, outperforming Contrave in clinical trials.

Can Contrave be used in combination with other weight loss medications like Wegovy or Saxenda?

Using Contrave with other weight loss medications like Wegovy (semaglutide) or Saxenda (liraglutide) is typically not recommended. Combined use may increase the risk of side effects without evidence of added benefit.

What are the main differences in side effects between Contrave and other weight loss drugs?

Contrave can cause nausea, constipation, headache, vomiting, dizziness, and insomnia. Other weight loss drugs like Wegovy have a different side effect profile, including gastrointestinal issues, gallbladder problems, and potential risk of thyroid tumors.

How does the weight loss potential of Contrave compare to that of newer medications like Wegovy?

Wegovy has demonstrated a higher efficacy for weight loss in comparison to Contrave, with patients using Wegovy often losing more weight.

Among weight loss treatments, how do the costs of Contrave and Wegovy differ?

Contrave may be less expensive than Wegovy, but costs can vary based on insurance coverage and discounts. Wegovy is a newer medication and may not be covered by all insurance plans, leading to higher out-of-pocket expenses.

What are healthcare professionals saying about the long-term use of weight loss medications like Contrave versus Wegovy?

Healthcare professionals advocate for careful monitoring during long-term use of weight loss medications. They recognize the substantial weight loss benefits with Wegovy but also stress the importance of evaluating individual patient response and side effects when considering long-term therapy.