Contrave® vs. Wegovy® for weight loss: Which one works best in 2025?

What you’ll learn:   

• Wegovy^® and Contrave^® are FDA-approved medications for weight management.
• Wegovy^® is a weekly injection, while Contrave^® is a twice-daily oral pill.   
• Wegovy^® tends to produce more significant weight loss than Contrave^®, but Contrave^® will likely cost less.    

In recent years, the weight loss medication landscape has shifted dramatically, largely due to the rise of GLP-1 medications like Ozempic^® (often prescribed off-label). Today, the conversation is dominated by two classes of drugs: semaglutide-based medications (Ozempic^® and Wegovy^®) and tirzepatide-based options (Mounjaro^® and Zepbound^®). While these medications are highly effective, they aren’t the only choices available.

Contrave^®, a daily oral medication, is another FDA-approved prescription that can help support weight loss. So, how does it compare to Wegovy^®?

In this guide, we’ll walk you through the key differences and similarities between these two medications—how they work, how much weight you can expect to lose, what they cost, whether insurance might cover them, and more.

That way, when you’re ready, you can have a well-informed conversation with your doctor about which option may be the best fit for you.

Wegovy^® vs. Contrave^®: How do they work?

While both medications are approved for weight loss use, they work very differently. 

Wegovy^®: Wegovy^® works in the same way as Ozempic^® for weight loss since they share the same active ingredient. As a GLP-1 receptor agonist, the semaglutide in Wegovy^® mimics a natural hormone in your body called GLP-1. This hormone plays a big role in controlling appetite and digestion. Semaglutide binds with GLP-1 receptors in your digestive tract and brain to reduce appetite, slow down digestion, and regulate blood sugar levels. Many people eat less without feeling deprived.

Contrave^®: Contrave^® is a combo of two medications that work on the brain’s hunger and reward system. Here’s how they work together: 

• Bupropion is often prescribed as an antidepressant and smoking cessation aid. It may help reduce appetite and food cravings by influencing dopamine and norepinephrine, brain chemicals involved in motivation and reward. 
• Naltrexone is typically used to treat alcohol and opioid dependence, but in this case, it works a little differently. It helps dampen the brain’s reward response to food, especially highly palatable foods like sweets and salty snacks. In other words, it may make eating feel slightly less “rewarding,” which can help reduce the desire for food and emotional eating. It also boosts the appetite-reducing effects of bupropion.

Together, these two medications help interrupt the cycle of cravings, compulsive eating, and the emotional pull food can sometimes have, especially when you’re stressed or bored.

Wegovy^® vs. Contrave^®: What are the differences?

As you can see, Wegovy^® and Contrave^® work very differently. Let’s go through some other important ways they are unlike each other.

How you take them

Wegovy^® is a once-weekly injection delivered just under the skin using a prefilled pen. Contrave^®, on the other hand, is a pill taken twice daily. This can be an important distinction for people who don’t want to give themselves weekly injections. 

How much weight you can lose

Wegovy^® has been shown to produce greater weight loss than Contrave^®. People taking Wegovy^® lost an average of about 15% of their body weight over 68 weeks. Contrave, when combined with lifestyle interventions like diet and exercise, can result in an average of 5% to 8% reduction in body weight over about a year.

They have different costs and ways to save

Wegovy^® has a higher price tag, averaging $1,350 per month without insurance. There are ways to reduce the cost through insurance (unlikely) or through the manufacturer. Contrave^® is also expensive without insurance, over $500 per month. Just like Wegovy^®, insurance coverage is rare, but there are ways to save that we’ll take a look at. 

Who can take them

Wegovy^® is approved for adults with a BMI of 30+ or 27+ and a weight-related condition, like high blood pressure or high cholesterol. It’s also approved for teens ages 12 and older who meet similar criteria, making it one of the few weight-loss medications available for adolescents. Contrave^® follows the same BMI guidelines but is approved for adults only—it’s not for use in teens or children.

Wegovy^® vs. Contrave^®: What are the similarities?

Wegovy^® and Contrave^® are very different, but they share several key similarities. 

Lack of insurance coverage

Medications used for weight loss are rarely covered by insurance, so it’s unlikely you’ll get coverage for Wegovy^® or Contrave^®. Always check with your insurance carrier for the latest. 

They’re both FDA-approved for weight loss 

Both Contrave^® and Wegovy^® are FDA-approved medications for weight loss. Let’s briefly look at the history.

• Contrave^® came first in 2014. What made it stand out was that it combined two older drugs—bupropion and naltrexone. Together, they target parts of the brain that control hunger, cravings, and the reward you get from eating. It was one of the first medications designed to tackle not just physical hunger, but emotional and habitual eating too.
• Wegovy^®, approved in 2021, includes a higher dose of semaglutide—the same ingredient in Ozempic^®. Wegovy^® is specifically tested and approved for weight loss, while Ozempic^® is approved to treat type 2 diabetes. 

Both drugs show how far we’ve come in recognizing that weight loss isn’t just about willpower—it’s also about biology and brain chemistry.

They lower appetite and reduce cravings 

While they work differently, both medications help you reduce how much you eat by acting on your brain and digestive system. Wegovy^® mimics GLP-1 to lower appetite and slow digestion, helping you feel satisfied longer. Contrave^® combines bupropion and naltrexone to influence reward and hunger pathways in the brain, which can reduce food cravings.

Both follow a step-up dosing pattern

Both start at a lower dose and increase gradually over several weeks to minimize side effects. This helps your body adjust and reduces the chance of nausea, headaches, or other early symptoms. 

They take time to work

Wegovy^® and Contrave^® work best when combined with diet, exercise, and lifestyle changes. Neither is a quick fix, and it may take several weeks to start noticing meaningful results. Staying consistent with your routine can make a big difference in how well the medication works over time.

Wegovy^® vs. Contrave^®: Which is better for weight loss?

Clinical research shows that taking Wegovy^® leads to greater weight loss, which, of course, is at the top of people’s minds when they are looking for weight loss medication. But your choice will also be based on what fits your lifestyle and budget. The best choice is the one that aligns with your personal goals, lifestyle, and health needs. Let’s take a look at all of these things.

How much weight can you lose on Wegovy^® vs. Contrave^®?

The most important thing to know about these medications is that losing weight with either medication takes time; most trials last a year or more. 

Here’s what you can expect:

• Wegovy^®: People taking Wegovy^® lost an average of 15% of their body weight over 68 weeks. For someone starting at 200 pounds, that’s nearly 30 pounds lost.
• Contrave^®: In comparison, people taking Contrave^® who lost at least 5% of their starting weight by week 16 went on to lose an average of nearly 12% over 56 weeks—about 23 pounds for someone starting at 200.
  • One important thing to know about Contrave^® is that if a person hasn’t lost at least 5% of their starting weight by week 16, it may be a sign that it’s not the right fit. Providers often reassess at that point to decide whether to continue or consider other options.

Who can take Wegovy^® or Contrave^® for weight loss?

Both Wegovy^® and Contrave^® are FDA-approved for weight management, but eligibility depends on specific health factors. Before prescribing these medications, healthcare providers consider BMI, medical history, existing health conditions, and current medications.

Who can take Wegovy^®?

Wegovy^® is approved for people with a:

• BMI of 30 or higher.

or

• A BMI of 27 or higher with at least one weight-related condition, such as high blood pressure or high cholesterol.
• It’s also approved for teens (ages 12 and older) with a BMI in the 95th percentile for their age and sex.

Who should avoid Wegovy^®?

A person shouldn’t take Wegovy^® if they:

• Have a personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2).
• Severe allergy to semaglutide or any ingredient in Wegovy^®.
• Are pregnant, breastfeeding, or trying to conceive.

Talk to your doctor about whether Wegovy^® is right for you if you have:

• A history of pancreatitis, severe gastrointestinal disease, or gallbladder issues.

For a full list of warnings and safety information, visit the Wegovy^® safety page.

Who can take Contrave^®?

Contrave^® is approved for people with:

• A BMI of 30 or higher.

or

• A BMI of 27 or higher with at least one weight-related condition, such as high blood pressure or high cholesterol.

Who should avoid Contrave^®?

You shouldn’t take Contrave^® if you:

• Have uncontrolled high blood pressure.
• Have or have had seizures.
• Take other medications containing bupropion.
• Have or have had an eating disorder, such as anorexia or bulimia.
• Are dependent on opioid pain medications, taking medications to help stop opioids, or experiencing opioid withdrawal.
• Drink large amounts of alcohol and abruptly stop.
• Take sedatives, benzodiazepines, or anti-seizure medications and suddenly stop.
• Are taking monoamine oxidase inhibitors (MAOIs), including linezolid.
• Are allergic to naltrexone, bupropion, or any other ingredients in Contrave^®.
• Are pregnant or breastfeeding

For a complete list of ingredients and safety details, refer to the Contrave^® medication guide. 

Always consult a healthcare provider before starting Contrave^® to ensure it is safe for you.

If you take Wegovy^® or Contrave^® to lose weight, will you need to keep taking them forever?

These medications work by influencing appetite and metabolism, and those effects tend to diminish when you stop taking them.

Therefore, if you discontinue them, you might see:

• Weight regain.
• A return of increased hunger and cravings.
• Potential changes in your metabolic rate.

Wegovy^®

• How long will I take it? Many people stay on Wegovy^® for at least a year or more, especially if they’re still seeing benefits and tolerating it well.
• Do I need to taper off? Tapering is often recommended to help your body ease off the medication and reduce the risk of rapid appetite return. One study found that a gradual dose reduction of semaglutide over several weeks helped people maintain their weight for months after stopping.

Contrave^®

• How long will I take it? Clinical trials have focused on one year of use, but some people may stay on it longer, depending on their progress and goals.
• Do I need to taper off? Yes—because Contrave^® contains bupropion, which is also used to treat depression, suddenly stopping can lead to withdrawal symptoms. Your provider will likely guide you through a slow dose reduction if you decide to come off it.

Always follow your provider’s instructions when making changes to your medication plan. Tapering can help protect your progress and make the transition off medication feel more manageable.

Programs like Noom can help and support these lifestyle changes. Studies consistently demonstrate that combining these medications with lifestyle modifications leads to better long-term outcomes than relying on medication alone. Essentially, these medications function best as part of a comprehensive weight management plan, rather than a standalone solution.

Wegovy^® vs. Contrave^®: Dosage and administration

Wegovy^® and Contrave^® have different dosing schedules and administration methods, which may influence which fits your routine best.

Wegovy^®

Wegovy^® is a self-injection given once a week using a prefilled pen.

• How to take it: Inject on the same day each week, at any time of day, in your abdomen, thigh, or upper arm. It’s important to rotate injection sites each week to avoid irritation. 
• Doses: 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, and 2.4 mg
• Dosing: You’ll start at 0.25 mg once a week and increase gradually over several weeks to reach the maintenance dose that has you losing steady weight, 1 to 2 pounds per week, with the fewest side effects. This means that if you’re doing well on a lower dose, there’s no need to increase it.

Contrave^®

Contrave^® is taken as a tablet by mouth, typically twice a day.

• How to take it: Take Contrave^® at the same times each day—once in the morning and once in the evening—but avoid taking it with high-fat meals, as that can raise the risk of side effects like nausea or dizziness.
• Doses: Each tablet contains 8 mg of naltrexone and 90 mg of bupropion.
• Dosing: You’ll start with one tablet in the morning and gradually build up to two tablets in the morning and two in the evening (maximum of four tablets per day). Your doctor may keep you at a lower dose if you’re responding well and tolerating it better.

Can you switch between Wegovy^® and Contrave^®?

Switching between Wegovy^® and Contrave^® is possible, but these medications work in completely different ways. Let’s take a look at what might happen. 

Switching from Wegovy^® to Contrave^®

If you’re moving from Wegovy^® to Contrave^®, the way your body responds to food and hunger may change. Because these medications work differently, here are some possible shifts to expect:

• Less fullness after meals: You may not feel as physically full since Contrave^® doesn’t slow digestion like Wegovy^® does.
• Fewer cravings: Contrave^® targets brain pathways related to reward and impulse, which may reduce emotional or habitual eating.
• Changes in side effects: Nausea may ease, but new side effects like headache, trouble sleeping, or dizziness might appear.
• New daily routine: You’ll move from a once-weekly injection to taking pills twice a day.

What can help:

• Your doctor may suggest tapering off Wegovy^® gradually before starting Contrave^® to avoid rebound hunger or discomfort.
• Contrave^® dosing starts low and builds up over four weeks, so be patient while your body adjusts.
• Avoid taking Contrave^® with high-fat meals to reduce the risk of nausea or side effects.

Switching from Contrave^® to Wegovy^®

If you’re switching from Contrave^® to Wegovy^®, you might notice your appetite changing in different ways. Here’s what to expect:

• Increased sense of fullness: Wegovy^® helps you feel full for longer, especially after meals.
• Cravings may return at first: Emotional eating triggers may feel more noticeable until Wegovy^® reaches full effect.
• GI side effects may increase: Nausea, constipation, or diarrhea are more common when starting Wegovy^®.
• Simplified routine: Wegovy^® is taken just once a week, so you won’t need to manage a daily pill schedule.

What can help:

• Because Contrave^® contains bupropion (an antidepressant), your doctor will likely taper the dose to avoid withdrawal symptoms.
• Wegovy^® also starts at a low dose and increases gradually over several weeks, so you won’t be jumping into full strength right away.

Rotating your injection site and following proper storage instructions can help reduce skin irritation and keep the medication effective.

Can you take Wegovy^® and Contrave^® together? 

While some people may wonder if combining medications could lead to greater weight loss, there are currently no clinical studies or FDA recommendations supporting the use of Wegovy^® and Contrave^® together. Instead, it could increase the risk of side effects like nausea, headache, or digestive issues.

Before switching or starting either medication, talk to your doctor. They can help you decide which option is best based on your weight loss goals, health history, and how your body responds to treatment. Finding the right fit is key to long-term success!

Wegovy^® vs. Contrave^®: Costs

Cost can play a major role in deciding which weight-loss medication fits your needs. Let’s break down the typical prices, insurance coverage, and available savings programs for Wegovy^® and Contrave^®.

Wegovy^®

The list price for Wegovy^® is around $1,350 per month without insurance.

• Insurance considerations: Coverage is unlikely.
• How to save: If you get Wegovy^® through Novo Nordisk’s NovoCare^® Pharmacy, the price drops to $499 per month for all doses.

Learn more about how to qualify for this program and the cost of Wegovy^®.

Contrave^®

Contrave^® typically costs between $530 and $740 per month without insurance.

• Insurance considerations: Most insurance plans don’t cover Contrave^® for weight loss.
• How to save: Through the CurAccess™ direct savings program, Contrave^® is available for $99 per month, including free home delivery—no insurance needed.

Learn more about the cost of Contrave^®.

Wegovy^® vs. Contrave^®: Side effects

Like all medications, Contrave^® and Wegovy^® can cause side effects, varying in severity from mild to serious. It’s important to understand the potential side effects of each medication to make an informed decision with your healthcare provider.  

Common side effects

Most people experience mild to moderate side effects, especially when starting the medication or adjusting to a higher dose. These effects usually improve over time as your body adjusts to the medication or the new dose. These include:  

Wegovy^®

• Nausea
• Diarrhea 
• Vomiting
• Constipation
• Fatigue
• Stomach pain

Contrave^®

• Nausea
• Constipation
• Headache
• Dizziness
• Trouble sleeping
• Dry mouth 

Serious side effects and warnings

While Wegovy^® and Contrave^® are generally safe for most people, they carry potentially serious risks. It’s important to follow prescription guidelines, monitor your body’s response, and talk to your clinician about any concerns.  

• Boxed warning for Wegovy^®: Wegovy^® carries an FDA-boxed warning for a potential risk of thyroid C-cell tumors. This risk has only been observed in animal studies. Do not take these medications if you or a family member has a history of MTC or multiple endocrine neoplasia syndrome type 2 (MEN 2).  
• Boxed warning for Contrave^®: Contrave^® has a boxed warning due to the increased risk of suicidal thoughts and behaviors. Patients should be monitored for changes in mood, especially during the first few months of treatment and during dosage adjustments.  

Get immediate medical help if you experience any of the following:

Wegovy^®:

• Pancreatitis: This may present as severe abdominal pain that can spread to your back, and it may occur with or without vomiting.
• Vision changes: Sudden changes in your vision should be treated as a medical emergency and evaluated immediately.
• Low blood sugar (hypoglycemia): You may experience symptoms like dizziness, shakiness, blurred vision, a rapid heartbeat, or feeling jittery.
• Kidney problems: Ongoing dehydration from vomiting, diarrhea, or nausea can lead to a decline in kidney function.
• Gallbladder problems: Symptoms can include pain in the upper abdomen, fever, yellowing of the skin or eyes (jaundice), or pale, clay-colored stools.
• Allergic reaction: This may involve swelling of the face, lips, tongue, or throat, along with difficulty breathing or swallowing and a fast heartbeat.
• Depression or suicidal thoughts: Any noticeable changes in mood, behavior, or thoughts—especially those that feel intense or unusual—should be shared with a healthcare provider right away.

For a full breakdown of potential risks, see the Wegovy^® safety information.

Contrave^®:

• Seizures: Bupropion, one of the ingredients in Contrave^®, lowers the seizure threshold, increasing the risk in those prone to seizures. Symptoms include sudden convulsions, loss of consciousness, stiffening of muscles, or jerking movements.
• Mood changes and suicidal thoughts: Symptoms to watch for include sudden mood swings and changes in behavior.
• Increased blood pressure and heart rate: Symptoms include persistent headaches, chest discomfort, and shortness of breath.
• Liver toxicity: Rare cases of liver damage have been reported. Be alert for symptoms like jaundice, fatigue, and abdominal pain.
• Severe allergic reactions: Go to the nearest emergency room for any unusual swelling, difficulty breathing, or signs of anaphylaxis.

For a complete list of ingredients and safety details, refer to the Contrave^® medication guide. 

Which is safer?

Both Wegovy^® and Contrave^® are FDA-approved and considered generally safe when used as directed and under medical supervision. Individual safety depends on your health history, current conditions, and how your body responds to each medication.

Both medications can be effective for weight loss, but the right choice depends on individual health factors and lifestyle preferences. Your healthcare provider can help determine which option will work best for you.

Which is right for me when choosing between Wegovy^® or Contrave^®?

Deciding between Wegovy^® and Contrave^® for weight loss? Let’s go through everything we talked about above and compare them side by side. 

Factor	Wegovy® (semaglutide)	Contrave® (naltrexone/bupropion)
How it works	Wegovy® is a GLP-1 receptor agonist. It helps reduce appetite, slow digestion, and regulate blood sugar by binding to GLP-1 receptors.	Contrave® is a combo of two medications that reduce cravings and emotional eating by targeting the brain’s hunger and reward system.
How you take it	Weekly injection Starting dose: 0.25 mg per week Escalation doses: 0.5 mg, 1.0 mg, 1.7 mg, 2.4 mg per week	Daily pill Starting dose: One 8 mg naltrexone/90 mg bupropion pill once per day Escalation dose: Up to 2 tablets twice a day
Effectiveness	People lose an average of 15 to 20% of their body weight over a year.	People lose an average of 5 to 10% of their body weight over a year.
Cost (without Insurance)	About $1,350 per month $499 per month through NovoCare® Pharmacy.	$600–$800 per month CurAccess™ program offers it for $99 per month.
Insurance Coverage	Weight loss is rarely covered, and approval varies by plan and provider.	Same.
Side effects	Common side effects include nausea, vomiting, diarrhea, and reduced appetite.	Common side effects include nausea, constipation, headaches, dizziness, and dry mouth.

Wegovy^® and Contrave^®: Other medications to consider

While both Wegovy^® and Contrave^® can help people lose weight, they may not be the right fit for everyone. There are several alternative medications to think about if weight loss is your primary goal.

Medication	Brand names and uses	Cost per month (without insurance)	Effectiveness	How it’s taken
Semaglutide – GLP-1 receptor agonist – Same active ingredient as Wegovy®.	Ozempic®: type 2 diabetes, off-label weight loss Rybelsus®: type 2 diabetes, off-label weight loss	Ozempic®: $998 Learn more Rybelsus®: $998Learn more	Ozempic®: People lost an average of 15% of body weight in 68 weeks with injectable semaglutide Rybelsus®: People lost about 4% of their body weight	Ozempic®: Weekly injection Rybelsus®: Daily pill
Tirzepatide – GLP-1/GIP receptor agonist	Mounjaro®: type 2 diabetes, off-label weight loss  Zepbound®: weight loss and obstructive sleep apnea (OSA)	Mounjaro®: $1,080 Learn more Zepbound®: Pens: $1,087 Vials: $349 (2.5 mg) $499 (5 mg, 7.5 mg, 10 mg) Learn more	People lost an average of 21% of body weight at 72 weeks.	Weekly injection
Liraglutide – GLP-1 receptor agonist	Victoza®: type 2 diabetes, off-label weight loss Saxenda®: weight loss and heart disease Generic liraglutide: type 2 diabetes, off-label weight loss	Victoza®: $800 to $1,400 Saxenda®: $1,350 Learn more. Generic liraglutide: $470 – $700	People lost an average of 5-6% of body weight in one year.	Daily injection

Other medications

GLP-1s aren’t the only options. These medications work in different ways and can be prescribed to help people lose weight if needed. 

Medication	Brand names	Cost per month (without insurance)	Effectiveness	How it’s taken
Metformin (off-label weight loss)	Glucophage®, Fortamet®, Glumetza®	Generic: $4–$15 Brand name: $100–$500+ Learn more.	People lost an average of about 6% of their body weight over six months while taking metformin.	Pill taken up to two times daily
Phentermine	Lomaira®, Adipex-P®	$27-$100	About 80% of people with a BMI of 30 or more lost at least 5% of their body weight in 6 months.	Daily pill
Diethylpropion	Tenuate®, Tenuate Dospan®	$40-$85	People lost an average of 10% of their body weight in 6 months.	Pill taken one to three times daily
Orlistat	Xenical®, Alli®	$50-$800	People in a study lost about 10% of body weight after taking Orlistat for 1 year.	Pill taken three times daily with meals

Making the right choice: Wegovy^® vs. Contrave^®

Both Wegovy^® and Contrave^® are effective, FDA-approved tools for weight loss—but they take different paths to help you get there. Wegovy^® works by mimicking a gut hormone to reduce appetite and slow digestion, often leading to greater overall weight loss. Contrave^® targets the brain’s hunger and reward system, helping curb emotional eating and cravings. Your decision might come down to how you prefer to take medication (weekly injection vs. daily pill), how your body responds, your budget, or which side effect profile you’re more comfortable with.

Ultimately, the best medication for you is the one that fits your body, your lifestyle, and your long-term health goals. Talk with your healthcare provider about what you’re hoping to achieve, what concerns you may have, and which medication feels more manageable. You can also see if you qualify for Noom Med. If you do, our clinicians can help decide which medication is right for you and prescribe it if needed. 

Whether you choose Wegovy^®, Contrave^®, or something else entirely, pairing your treatment with supportive lifestyle changes—like mindful eating, movement, and behavior coaching—will move you toward your goal.

Note: Ozempic^®, Mounjaro^®, Victoza^®, and metformin are not FDA-approved to treat obesity or for weight loss.