Losing weight can be a challenging process, especially as obesity rates continue to rise. In the past few years, between 2020 and 2022, there has been a significant increase in the number of individuals seeking prescription medication to aid in weight loss. Doctors have issued nearly 9 million prescriptions for weight loss drugs during this period.

However, with so many options available, it’s hard to know which drug will work best for you without compromising your health. Ozempic and Contrave are two popular choices, but how do they compare? What side effects might they have? And, importantly, which one gives you the best chance for successful weight loss?

In this article, we will compare Ozempic and Contrave. You will learn about their differences in effectiveness, suitability for various individuals, and their side effects. So, keep reading to find out which medication is better for weight loss: Ozempic or Contrave.

Key Takeaways

  • Ozempic is primarily used to manage blood sugar levels in adults with type 2 diabetes and to reduce the risk of cardiovascular events, while Contrave is primarily prescribed for weight loss.
  • Ozempic is an injectable medication, while Contrave is an oral medication.
  • Ozempic is not officially marketed for weight loss, but it has been noted to help some users lose weight, while Contrave has been specifically designed and approved for weight loss.
  • Ozempic is a glucagon-like peptide-1 (GLP-1) agonist, while Contrave contains two active drugs: naltrexone and bupropion.
  • Ozempic may cause nausea, vomiting, diarrhea, stomach pain, and constipation, while Contrave may cause nausea, constipation, headache, vomiting, dizziness, insomnia, dry mouth, and diarrhea.
  • Ozempic is contraindicated in patients with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), while Contrave is contraindicated in patients with uncontrolled hypertension, seizure disorders, or those undergoing abrupt discontinuation of alcohol, benzodiazepines, barbiturates, and antiepileptic drugs.

Comparing Ozempic vs Contrave

Ozempic (semaglutide)Contrave (bupropion/naltrexone)
Drug ClassGlucagon-like peptide-1 (GLP-1) agonistsContrave contains two active drugs: naltrexone and bupropion. Naltrexone is in a class of drugs called opioid antagonists, and bupropion is in a class called antidepressants.
Indications and UsesPrimarily prescribed to lower blood sugar levels in adults with type 2 diabetes. It is also used for cardiovascular risk reduction.Prescribed for weight loss (obesity/overweight); may be used for purposes not listed in the medication guide.
Limitations of UseNot for treating type 1 diabetes or diabetic ketoacidosis. Not a substitute for insulin.Generally not recommended for use in patients with uncontrolled hypertension or a history of seizures.
Age ApprovalApproved for adultsApproved for adults
Dosage And AdministrationSubcutaneous injection: Starts with a low dose and can be escalated based on glycemic control and tolerability.Oral tablet, extended-release: Typically initiated at a low dose and gradually increased.
Forms and StrengthsInjectable solution: Available in pre-filled pens of 0.25 mg, 0.5 mg, or 1 mg doses per 1.5 mL.Oral tablet, extended-release: 90 mg bupropion and 8 mg naltrexone.
Side EffectsCommon side effects include nausea, vomiting, diarrhea, stomach pain, and constipation. It may affect the absorption of other medications.Common side effects include nausea, constipation, headache, vomiting, dizziness, insomnia, dry mouth, and diarrhea.
Warnings and PrecautionsWarns against thyroid cancer risk, pancreatitis, retinopathy, and serious hypoglycemia. Not recommended with a personal or family history of medullary thyroid carcinoma.Includes risk of suicidality, seizure disorders, and hepatic dysfunction. Not for use in pregnancy.
ContraindicationsContraindicated in patients with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).Contraindicated in patients with uncontrolled hypertension, seizure disorders, or those undergoing abrupt discontinuation of alcohol, benzodiazepines, barbiturates, and antiepileptic drugs.

What is Ozempic?

Ozempic (semaglutide) is an injectable prescription medicine primarily used for managing blood sugar levels in adults with type 2 diabetes as part of a broader treatment plan that includes diet and exercise. Additionally, it is approved to reduce the risk of major cardiovascular events, such as heart attacks, strokes, or death, in adults with type 2 diabetes who also have known heart disease.

While not officially marketed for weight loss, Ozempic has been noted to help some users lose weight. This effect is considered an off-label use when it is specifically prescribed for weight management in patients who do not meet the typical criteria for its diabetes or cardiovascular event reduction indications. Off-label use refers to the practice of prescribing medications for a purpose outside the scope of the drug’s approved label. 

This aspect of Ozempic has gained attention, partly due to anecdotal reports and some supporting data suggesting its effectiveness in weight reduction in various contexts outside the primary diabetes treatment. However, it’s crucial to use such medication under the guidance and supervision of a healthcare provider to ensure safety and appropriateness based on individual health needs.

What is Contrave?

Contrave is a prescription medication comprised of two active ingredients, naltrexone and bupropion. Naltrexone, an opioid antagonist, and bupropion, an aminoketone antidepressant, work synergistically in the brain’s hypothalamus and mesolimbic dopamine circuits to promote satiety, reduce food intake, and increase energy expenditure. This combination helps manage weight by affecting the neurological pathways associated with hunger and satisfaction. 

The FDA approved Contrave in September 2014 as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adults with a body mass index (BMI) of 30 kg/m² or greater or overweight adults (BMI of 27 kg/m² or greater) with at least one weight-related comorbid condition such as hypertension, type 2 diabetes, or dyslipidemia.

How Effective Are Contrave vs Ozempic for Weight Loss?

While Ozempic is primarily prescribed for improving blood sugar levels in adults with type 2 diabetes, it is also noted that patients might experience some weight loss as a secondary benefit. However, it is important to clarify that Ozempic is not approved as a weight loss drug. According to a study, adults with type 2 diabetes experienced an average weight loss ranging from 8 to 14 pounds, depending on the dosage and their initial weight. 

Specifically, those taking the 0.5 mg dose lost about 8 pounds, and those on the 1 mg dose lost approximately 10 pounds. In comparison, a higher dosage of 1 mg resulted in an average loss of 12 pounds, and the 2 mg dosage resulted in around 14 pounds of weight loss. These figures are compared to a weight loss of about 3 pounds in patients receiving a placebo, emphasizing that while semaglutide has a potential for inducing weight loss, its primary use remains the management of type 2 diabetes.

On the other hand, Contrave is moderately effective for weight loss when used alongside a reduced-calorie diet and increased physical activity. The effectiveness of Contrave was studied in several clinical trials, particularly focusing on adults with obesity or who are overweight and have at least one additional health issue like hypertension or dyslipidemia.

In one of the key 56-week studies, the COR-I trial, patients treated with Contrave lost an average of 5.4% of their body weight compared to just 1.3% in those who received a placebo. This result means that people taking Contrave were significantly more likely to achieve meaningful weight loss. Furthermore, in this trial, 42% of the participants on Contrave achieved at least a 5% reduction in their body weight compared to 17% of those on placebo.

However, it’s important to note that many participants withdrew from the trials, which could affect the overall understanding of the drug’s effectiveness. About 46% of people in the Contrave group dropped out before the end of the study, with 24% leaving due to adverse reactions. This high dropout rate may suggest that while effective for some, Contrave might not be suitable for everyone, possibly due to side effects or other factors.

Dosage And Administration

Ozempic

The administration of Ozempic involves subcutaneous injections, and it comes in two dosage forms: a pen that delivers either 0.25 mg or 0.5 mg per injection and another that delivers 1 mg per injection. Initially, patients start with a 0.25 mg dose once weekly for four weeks, mainly for treatment initiation and not effective for glycemic control. After this period, the dosage is increased to 0.5 mg once weekly. 

If a dose is missed, it should be taken as soon as possible within 5 days of the scheduled dose; if more than 5 days have passed, the missed dose should be skipped, and the next dose should be taken on the regular schedule. Patients are instructed to administer Ozempic subcutaneously to the abdomen, thigh, or upper arm, rotating the injection site weekly within the chosen area to avoid skin irritation. The solution should be inspected visually for particulate matter and discoloration before administration.

Contrave

The dosage and administration of Contrave are structured to increase gradually over the first few weeks of treatment. In the first week, the recommended dosing is one tablet in the morning and none in the evening. In the second week, the dosage increases to one tablet in the morning and evening. By the third week, the patient should take two tablets in the morning and one in the evening. 

From the fourth week onward, the dosage stabilizes at two tablets both in the morning and evening, reaching a total daily dosage of two Contrave 8 mg/90 mg tablets twice daily, which sums up to 32 mg/360 mg per day. This dosage should not be exceeded. If a dose is missed, the patient should take their next dose at the regular time and should not double the dose to make up for the missed one.

Side Effects and Considerations

Ozempic

Common Side Effects

  • Nausea
  • Vomiting
  • Diarrhea
  • Stomach (abdominal) pain
  • Constipation

These side effects are most prevalent when starting treatment with Ozempic and typically decrease over time.

Serious Side Effects

  • Pancreatitis: Patients must stop using Ozempic and contact their healthcare provider immediately if they experience severe, persistent abdominal pain, which may or may not be accompanied by vomiting, as this could indicate pancreatitis.
  • Diabetic Retinopathy Complications: There is a risk of developing or worsening diabetic retinopathy. Patients should report any changes in vision to their healthcare provider.
  • Thyroid C-cell Tumors: Ozempic carries a black box warning due to the risk of thyroid C-cell tumors, including medullary thyroid carcinoma (MTC). Patients are advised to monitor for symptoms such as a lump or swelling in the neck, hoarseness, difficulty swallowing, or shortness of breath, which may be signs of thyroid cancer.
  • Hypoglycemia: When used with other diabetes medications like insulin or sulfonylureas, Ozempic can cause low blood sugar levels. Symptoms of hypoglycemia include dizziness, confusion, sweating, and palpitations.
  • Serious Allergic Reactions: Symptoms include itching, rash, or difficulty breathing. Immediate medical help should be sought if any of these symptoms occur.

Other Considerations

  • Ozempic is not recommended as a first-line treatment for patients who have inadequate glycemic control on a diet and exercise alone due to the uncertain relevance of rodent C-cell tumor findings to humans.
  • It is not suitable as a substitute for insulin and is not indicated for type 1 diabetes or diabetic ketoacidosis.
  • Patients with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 should not use Ozempic.

Contrave

Common Side Effects

The common side effects of Contrave include:

  • Nausea
  • Constipation
  • Headache
  • Vomiting
  • Dizziness
  • Insomnia
  • Dry mouth
  • Diarrhea

These side effects are generally mild to moderate and may decrease as the body adjusts to the medication.

Severe Side Effects

Severe side effects of Contrave can include:

  • Seizures: The risk is higher in individuals with a history of seizures or who exceed the recommended dose.
  • Elevated blood pressure and heart rate: Patients with uncontrolled hypertension should not take Contrave.
  • Liver damage: Some patients may experience significant liver injury.
  • Neuropsychiatric symptoms: These may include changes in behavior, hostility, agitation, depression, and suicidal thoughts or actions.

Other Considerations

  • Contrave contains bupropion, an ingredient also used in certain antidepressants and smoking cessation products, which has been linked to an increased risk of suicidal thoughts and behaviors, particularly in children, adolescents, and young adults.
  • It is not approved for use in the treatment of major depressive disorder or other psychiatric disorders.
  • Monitoring for neuropsychiatric adverse events is advised for all patients, including new or worsening depression, suicidal thoughts or behavior, and other mood changes.

Ozempic vs Contrave Cost

Ozempic

Typically Ozempic costs about $1,029.35 in the US market for a dosage of 1.5 mL at 2 mg/1.5 mL (0.25 mg or 0.5 mg dose) without insurance. In comparison, Buy Canadian Insulin offers Ozempic at a much lower price of $429.96 per injection pen. Customers purchasing from Buy Canadian Insulin can also benefit from additional savings that provide a 10% discount on first orders with the coupon code “FIRST10.”

Contrave

In the US, Contrave typically costs around $667.84 for a 120-tablet pack of the extended-release (90 mg-8 mg) formula without insurance coverage. However, Buy Canadian Insulin offers the same pack at a more affordable rate of $444.58. Customers in the US can save by purchasing from Buy Canadian Insulin, particularly if they utilize the “FIRST10” coupon code for an additional 10% off on their first order.

Final Thoughts

Both Ozempic and Contrave have shown promise in aiding weight loss efforts when used under the supervision of a healthcare provider. Ozempic’s primary use is for managing blood sugar levels in adults with type 2 diabetes, but it has also been noted to help with weight loss. 

On the other hand, Contrave is specifically marketed as a weight loss medication that affects hunger and satisfaction pathways in the brain. Ultimately, choosing these two medications depends on individual health needs and goals. It’s best to discuss with a healthcare provider to determine which medication is the most appropriate and safe option for achieving your weight loss goals.

FAQs About Ozempic and Contrave

Which is better, Ozempic or Contrave?

The choice between Ozempic and Contrave depends on your health goals and needs. Both medications work differently and may be used to treat different conditions. Ozempic is primarily used to treat type-2 diabetes and may offer dual benefits by regulating blood sugar levels and promoting weight loss. Contrave, on the other hand, is an appetite suppressant that may be more suitable if appetite control is your primary concern.

What is safer, Contrave or Ozempic?

Both Contrave and Ozempic have potential side effects and risks that should be discussed with a healthcare provider before starting treatment. It is important to consider factors such as medical history, current medications, and individual health goals when determining which medication may be safer for a specific individual.

Can you take Ozempic and Contrave together?

While there is no specific contraindication against taking Contrave and Ozempic, it is essential to consult your healthcare provider before combining these medications. Your healthcare provider may adjust the dosages of both medications to avoid potential side effects or risks.

What is the most successful weight loss pill?

GLP-1 agonists are currently the most effective anti-obesity medications and are considered safe for long-term use. Currently, only liraglutide (Saxenda), semaglutide (Wegovy), and tirzepatide (Zepbound) are approved for weight loss, though some other GLP-1 drugs may be prescribed off-label. However, it is important to remember that weight loss medication should always be combined with a healthy diet and regular exercise.

How long until Contrave works?

In clinical trials, most people had significant weight loss 4 weeks after starting treatment with Contrave. However, results may differ depending on the person. Following your healthcare provider’s instructions for taking Contrave and maintaining a healthy diet and exercise routine is important.

What is the most effective weight loss pill over the counter?

The only over-the-counter weight-loss product approved by the U.S. Food and Drug Administration (FDA) is orlistat (Alli). It is half as strong as prescription orlistat (Xenical). It blocks the body from taking in some of the fat from foods you eat. However, it is important to remember that weight loss medication should always be combined with a healthy diet and regular exercise.

What is the best alternative to Ozempic?

Mounjaro may be one of the better-known alternatives to Ozempic. Approved by the FDA for diabetic treatment and weight loss, this medication has two mechanisms of action. However, it is important to consult your healthcare provider to determine the best treatment option for your health needs.

What is the best alternative to Contrave?

The best alternative to Contrave depends on the individual’s health condition and weight loss goals. Other commonly used weight-loss drugs include Alli (orlistat), Xenical (orlistat), and Qsymia (phentermine/topiramate). However, it is important to consult a healthcare professional before starting any weight loss medication to ensure it is safe and effective.

Will I gain weight after stopping Contrave?

Once you stop using Contrave, your appetite and cravings will come back, which could lead to regaining the weight you lost. It is important to continue following a healthy diet and exercise routine after stopping Contrave to maintain weight loss.

What should I avoid while taking Contrave?

Contrave interacts with antidepressants, beta-blockers, and antipsychotic medications. You should also avoid monoamine oxidase inhibitors, opioids, and alcohol while you’re taking it. Use caution when taking Contrave with medications that can lower the seizure threshold or raise dopamine levels. To avoid potential interactions or risks, it is important to inform your healthcare provider of all medications you are currently taking.

Sources

Yanovski, S. Z., & Yanovski, J. A. (2015). Naltrexone-Extended Release plus Bupropion-Extended Release for Treatment of Obesity. JAMA. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4993523/

Novo Nordisk. (2023). What is Ozempic®? Ozempic® (semaglutide) injection. Retrieved from https://www.ozempic.com/why-ozempic/what-is-ozempic.html

National Library of Medicine. (2023, November 30). CONTRAVE extended-release – naltrexone hydrochloride and bupropion hydrochloride tablet, extended-release. DailyMed. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm