Both Wegovy and Contrave are prescription medications approved by the U.S. Food and Drug Administration (FDA) to assist with weight loss. They are typically prescribed as part of a comprehensive weight management program, which may include dietary and lifestyle changes, exercise, and behavioral counseling.
While Wegovy and Contrave are both FDA-approved for weight loss, they belong to entirely different classes of drugs. Wegovy is a GLP-1 receptor agonist. This class of drugs works by mimicking the action of a naturally occurring hormone known as GLP-1 that regulates hunger and satiety (feeling full). Contrave is a combination of two drugs, an antidepressant, and an opioid antagonist; these two medications impact the chemicals in the brain relating to appetite and cravings.
Wegovy and Contrave work very differently. Wegovy has been found to be more effective for weight loss. These are not the only differences between Contrave and Wegovy.
Main Differences Between Contrave and Wegovy
Wegovy is made by Novo Nordisk, and Contrave is made by the lesser-known Orexigen Therapeutics, Inc.
Here are some more details of Contrave vs. Wegovy.
Mechanism of Action
- Wegovy: Wegovy is a glucagon-like peptide-1 (GLP-1) receptor agonist. It works by increasing feelings of fullness, slowing gastric emptying, and reducing food intake.
- Contrave: Contrave combines bupropion, which affects the brain’s neurotransmitters to reduce appetite, and naltrexone, which helps reduce cravings for food and addictive substances.
Target Populations
- Wegovy: Wegovy is FDA-approved for chronic weight management in adults with a body mass index (BMI) of 27 kg/m² or higher who have at least one weight-related condition (such as hypertension or type 2 diabetes) or adults with a BMI of 30 kg/m² or higher.
- Contrave: Contrave is approved for use in adults with a BMI of 30 kg/m² or higher or adults with a BMI of 27 kg/m² or higher with at least one weight-related condition. It is also approved to help individuals quit smoking. It is most effective for weight loss in people who suffer from obsessive eating or whose weight gain is related to other types of eating disorders.
Effectiveness for Weight Loss
- Wegovy: The active ingredient in Wegovy, semaglutide, has shown remarkable effectiveness in clinical trials, with patients experiencing significant weight loss. On average, individuals taking Wegovy have achieved a more substantial weight reduction compared to Contrave.
- Contrave: Contrave combines two medications, bupropion, and naltrexone, which work together to reduce appetite and cravings. While this can be effective for moderate weight loss in some persons, patients on Contrave cannot achieve weight loss anywhere near as substantial as Wegovy.
Wegovy and Contrave both have an impact on appetite; however, they should not be construed as merely “appetite suppressants.” They are both well-researched medications that impact overeating by targeting different neurological or biological pathways affecting hunger.
Approved for and Usage
Both Contrave and Wegovy are FDA-approved for weight loss, but they are indicated for somewhat different patient populations.
Usage
- Wegovy: Wegovy is recommended for individuals with obesity (BMI ≥ 30 kg/m²) or those who are overweight (BMI ≥ 27 kg/m²) with at least one weight-related condition. It can be taken by individuals with or without diabetes but requires monitoring of blood sugar levels.
- Contrave: Contrave is suitable for individuals with a BMI of 30 or higher or those with a BMI of 27 or higher with at least one weight-related condition. It can be considered for those looking to lose weight or quit smoking. You can take Contrave if you have diabetes; however, if you are taking a diabetes medication, your doctor may need to adjust that medication’s dose since Contrave can lower your blood sugar levels.
Both drugs are indicated for people with similar BMIs and weight-related medical conditions. However, Wegovy is better suited for anyone who struggles with weight, and Contrave tends to be better in people whose obesity is related to “emotional” issues such as stress, overeating, or other emotional disorders.
As to which is easier to get for weight loss, it may be easier to get Contrave, and it may be generally more available than Wegovy, but its results are more limited.
Dosage*
Contrave comes as an oral pill that is eventually taken twice a day. Wegovy comes in a premixed weekly injector pen.
Dosing of either medication will vary based on your condition, medical history, and weight loss goals. Generally speaking, the two drugs are given per the following schedule:
Contrave
Each tablet of Contrave contains 8 mg of naltrexone and 90 mg of bupropion. Contrave is usually started at one tablet daily for the first week and then increases by (1) tablet once per day each week until you reach the full dose of 2 tablets twice daily by week 4 as follows:
- Week Two: One tablet twice daily
- Week Three: Two tablets in the morning and only one (1) tablet in the evening.
- Week Four and beyond Two tablets twice daily.
Wegovy
Wegovy comes in a pen and is injected subcutaneously or under the skin once weekly. A typical Wegovy dosage schedule is:
- First Month: 0.25 mg once weekly (starting dosage)
- Second Month: 0.5 mg once weekly
- Third Month: 1 mg once weekly
- Fourth Month: 1.7 mg once weekly
- Fifth Month: 2.4 mg once weekly (target dosage)
Your weekly injection of Wegovy can be given at day or night, but it is recommended that you take it at the same time of day each week.
Cost**
Like all prescription medications, what you will pay for, either Wegovy or Contrave, will depend on factors ranging from your insurance coverage to the specific pharmacy where you get your prescription filled.
Prices of drugs vary; at the time of publication, without insurance, a one-month supply of Wegovy is about $1600. Right now, Contrave is considerably cheaper, running around 300- 400 a month for a one-month supply without insurance.
Both drugs are too new to have cheaper generic alternatives. Each of the drug’s manufacturers provides a discount card for Wegovy or Contrave, which could save you on the cost of your prescription. Contrave’s maker also has a program called the CurAccess Program, which can save you money by ordering Contrave from a specific mail-order pharmacy. Other pharmacy discount cards could be available that may save you money on either prescription.
Insurance Coverage
Weight loss drugs like Wegovy and Contrave may or may not be covered by health insurance, and this is changing all of the time, so it is best to check with your particular provider. Generally speaking, most insurance policies will only provide coverage for weight loss medication if you have been given a diagnosis of obesity with related health complications and have tried and failed at other ways of losing weight.
There is no indication which drug is more likely to be covered by insurance. Either drug may require “pre-authorization” before providing coverage for the medication.
Results
While both Wegovy and Contrave can be prescribed for weight loss, the results you can achieve on one versus the other really do not compare. Contrave is a combination of two drugs that interferes with the neurological pathways that make you crave certain foods, particularly high-fat and sugary foods, the kind of foods that usually lead to weight gain. Weight loss on Contrave is modest at best. Patients on Contrave typically can lose between 2% and 3% of their total body weight.
On the other hand, Wegovy works by exactly mimicking the effect of the hormone directly related to hunger and feeling full. As such, it has a more direct biological impact on weight and metabolism, and patients can achieve significantly greater weight loss on Wegovy than on Contrave. Patients taking Wegovy have lost as much as 15% of their total body weight.
Both drugs take some time before you get to the maximum daily or weekly dose and, therefore, the optimal results.
Side Effects: Contrave vs. Wegovy
Of the two drugs, the potential side effects of Contrave can be far more serious. Side effects of Wegovy are usually mild and rarely severe. Contrave has some dangerous and even potentially life-threatening side effects.
Wegovy
The most common side effects of Wegovy may include nausea, vomiting, diarrhea, and abdominal pain. It may also lower blood sugar levels, so individuals with diabetes need to closely monitor their blood sugar.
Contrave
Contrave shares some common side effects with Wegovy, such as nausea, headache, and constipation, but overall, Wegovy is much safer than Contrave.
Most side effects of Wegovy are mild and relate to gastrointestinal issues. Contrave, on the other hand, carries an FDA “boxed warning.” This is the most serious warning placed on a drug by the FDA. A boxed warning alerts doctors and patients about a drug’s effect that can be quite dangerous. The boxed warning for Contrave has to do with an increased risk of suicidal thoughts or behaviors. The warning states, “In people who have depression or other mental health conditions, antidepressants such as bupropion can increase the risk of suicidal thoughts and behaviors.” Bupropion is one of the active ingredients in Contrave.
Contrave can have other serious side effects, including increased blood pressure and heart rate, so monitoring is essential, especially for individuals with hypertension.
*Dosing, administration instructions, warnings, and other product information are provided for informational purposes only and should not be construed as any kind of medical guidance or instructions for use. Consult your physician, pharmacist, or full prescribing information for guidance regarding your particular prescription for Wegovy or Contrave.
** Prices for prescription drugs are subject to change. Prices provided are for relative comparison purposes only and may not be a reflection of the actual cost of either drug at the time of purchase.
