Table of Contents
Introduction
Obesity is a common and serious health condition that affects millions of people around the world. It increases the risk of many health problems such as type 2 diabetes, heart disease, high blood pressure, stroke, sleep apnea, and certain types of cancer. For many people, losing weight is not just about looking better—it is about improving health and reducing the risk of life-threatening conditions. While changes in diet, exercise, and lifestyle are the first steps toward weight loss, some people need more help to reach their goals. This is where prescription weight loss medications can play an important role.
Two prescription drugs used to help with weight loss are Contrave and Semaglutide. These medications work in different ways and come with their own benefits and side effects. Doctors prescribe these drugs to people who have obesity, or who are overweight with weight-related medical problems. Each medication is approved by the U.S. Food and Drug Administration (FDA) for weight management. However, they are not the same, and they do not work the same way in every person.
Contrave is a combination of two drugs: bupropion and naltrexone. Bupropion is often used as an antidepressant and to help people stop smoking. Naltrexone is used to treat addiction to opioids or alcohol. When used together in Contrave, these medicines help reduce hunger and food cravings. The brain plays a large role in appetite, and Contrave works on specific parts of the brain that control reward and eating behavior.
Semaglutide is part of a group of drugs called GLP-1 receptor agonists. These medications work by copying a hormone that the body naturally makes after eating. This hormone helps the body control blood sugar, slows down how fast the stomach empties, and reduces appetite. Semaglutide is given as a weekly shot under the skin. It is approved in different doses under brand names like Wegovy and Ozempic, depending on whether it is used for weight loss or for type 2 diabetes. When used for weight loss, it is often prescribed at a higher dose.
When comparing Contrave and Semaglutide, several important questions come up. People want to know which drug helps more with weight loss. They want to understand what side effects they might face and how serious those side effects could be. There are also questions about how easy these drugs are to use, how much they cost, and whether they are covered by insurance. Some people may wonder which drug is better for someone who also has diabetes or other health problems. Others may want to avoid taking a daily pill or getting weekly injections. These are common and important concerns.
This article compares Contrave and Semaglutide in detail to help explain the most important differences. The focus is on how each drug works, how effective each one is for helping people lose weight, and what kinds of side effects are most common. The article also explains who should or should not take these medications, based on their health history or other risk factors. Readers will also learn about how easy or hard it may be to take these medications, how they affect other health problems, and how much they may cost.
The goal is to give a full and clear picture of both Contrave and Semaglutide based on scientific evidence, medical guidelines, and results from clinical trials. This information can help patients and healthcare providers make better decisions about which treatment may be more appropriate for different individuals. By understanding how each medication works, what benefits it offers, and what risks it carries, people can make more informed choices about managing their weight and improving their health.
What Is Contrave? Mechanism and FDA Approval
Contrave is a prescription medication that helps people lose weight. It is made of two different drugs combined into one tablet: bupropion and naltrexone. Each of these medicines works in a different way, and together they help reduce hunger and food cravings.
What is Bupropion?
Bupropion is a drug that affects the brain. It helps control the chemicals dopamine and norepinephrine, which are involved in mood, reward, and energy. Bupropion is also used to treat depression and help people stop smoking. In Contrave, it plays a different role. It helps reduce appetite and may help people feel more motivated to lose weight.
What is Naltrexone?
Naltrexone is a drug that blocks opioid receptors in the brain. These receptors are part of the brain’s reward system. When people eat, especially foods high in sugar or fat, this system gets activated and creates a feeling of pleasure. Naltrexone helps reduce that pleasure response. This can lower food cravings, especially for “comfort foods.”
How Does Contrave Work in the Brain?
Contrave works by affecting two parts of the brain:
- Hypothalamus – This area controls hunger. Bupropion helps reduce the urge to eat by changing brain chemicals linked to appetite.
- Mesolimbic Reward System – This system controls feelings of pleasure and reward. Naltrexone helps reduce the “reward” feeling some people get from eating certain foods.
By targeting both appetite and reward, Contrave can help people eat less and feel fewer cravings.
FDA Approval and Use
The U.S. Food and Drug Administration (FDA) approved Contrave in 2014 for weight loss. It is meant for adults with:
- A body mass index (BMI) of 30 or more, which is considered obese
or - A BMI of 27 or more (overweight) with at least one weight-related health problem, such as high blood pressure, type 2 diabetes, or high cholesterol.
Contrave is not a short-term diet pill. It is part of a long-term weight management plan. People taking Contrave are also expected to follow a reduced-calorie diet and increase physical activity.
How Contrave Is Taken
Contrave comes in tablet form and is taken by mouth. It is usually taken twice a day. The dose is increased slowly over the first four weeks to help reduce side effects. The goal is to reach the full dose of two tablets twice a day (a total of four tablets daily).
Here is a typical dosing schedule:
- Week 1: 1 tablet in the morning
- Week 2: 1 tablet in the morning and 1 tablet in the evening
- Week 3: 2 tablets in the morning and 1 tablet in the evening
- Week 4 and onward: 2 tablets in the morning and 2 tablets in the evening
Tablets should not be crushed, chewed, or split. They must be swallowed whole. They should be taken with food but not with high-fat meals, as that can increase the risk of seizures.
When to Stop Contrave
Doctors usually check how well Contrave is working after 16 weeks. If a person has not lost at least 5% of their starting weight, the doctor may decide to stop the medication. This is because the drug is less likely to help after that point.
Who Should Not Take Contrave
Contrave is not safe for everyone. It should not be used by people who:
- Have uncontrolled high blood pressure
- Have or had seizures
- Have an eating disorder like bulimia or anorexia
- Are taking opioid medications or going through opioid withdrawal
- Are using other forms of bupropion, such as for depression or smoking
- Are pregnant or planning to become pregnant
Doctors usually review a person’s full medical history before prescribing Contrave.
Contrave is a weight loss medicine that combines bupropion and naltrexone. It works by reducing hunger and lowering cravings for certain foods. The FDA approved it in 2014 for adults who are overweight or obese and who are ready to make lifestyle changes. Contrave is taken as a pill, twice a day, and works best when used along with diet and exercise. Because it affects the brain and has some serious risks for certain people, it must be used under medical supervision.
What Is Semaglutide? Mechanism and FDA Approval
Semaglutide is a medication used to help people lose weight and manage type 2 diabetes. It is part of a group of medicines called GLP-1 receptor agonists. These medicines copy the action of a natural hormone in the body called glucagon-like peptide-1 (GLP-1). This hormone helps control blood sugar, makes people feel full, and slows how quickly food leaves the stomach.
How Semaglutide Works in the Body
Semaglutide works in several ways to support weight loss and blood sugar control. First, it acts on the brain to reduce appetite. When GLP-1 receptors in the brain are activated, it sends signals that help a person feel full more quickly after eating. This can lead to eating less food and fewer calories over time.
Second, semaglutide slows down how fast food moves from the stomach into the intestines. This is known as delayed gastric emptying. When food stays in the stomach longer, people feel full for a longer time, which also helps reduce hunger and food intake.
Third, semaglutide increases insulin release from the pancreas when blood sugar is high. Insulin is a hormone that lowers blood sugar levels by helping the body use glucose for energy or store it for later. At the same time, semaglutide lowers the amount of another hormone called glucagon, which normally raises blood sugar. This balance helps people with type 2 diabetes keep their blood sugar in a healthier range.
These combined effects—reduced appetite, slower digestion, and better blood sugar control—help semaglutide support weight loss and improve health in people who are overweight or obese.
Types and Forms of Semaglutide
Semaglutide is available in different forms and brand names. The two main brand names are Ozempic and Wegovy.
- Ozempic is approved by the U.S. Food and Drug Administration (FDA) for treating type 2 diabetes. It is used to lower blood sugar and also reduce the risk of heart problems in people with type 2 diabetes and heart disease. Even though Ozempic is not officially approved for weight loss alone, many people taking it notice weight loss as a side effect.
- Wegovy is the version of semaglutide that is FDA-approved specifically for weight loss. It is meant for adults who are obese or overweight and have at least one weight-related health condition such as high blood pressure, type 2 diabetes, or high cholesterol. In 2021, the FDA approved Wegovy for long-term weight management. It can also be used by teens aged 12 and older who meet certain weight and health criteria.
Both Wegovy and Ozempic are given as weekly injections under the skin. The injection is usually given in the stomach, thigh, or upper arm. Patients can give the injection at home using a prefilled pen device. The injection is simple and does not require a trip to a clinic or hospital.
Another form of semaglutide called Rybelsus is available as a daily pill, but it is approved only for blood sugar control in people with type 2 diabetes—not for weight loss. Unlike the injectable forms, Rybelsus is not used for obesity treatment at this time.
FDA Approval and Usage
The FDA approved Wegovy (semaglutide 2.4 mg) in June 2021 for chronic weight management in adults. To qualify for treatment, a person must have a body mass index (BMI) of 30 or higher (which means they are considered obese), or a BMI of 27 or higher (overweight) with at least one weight-related condition.
The approval was based on several large clinical trials, including the STEP (Semaglutide Treatment Effect in People with Obesity) studies. These trials showed that people taking semaglutide lost significantly more weight than those taking a placebo (a dummy treatment). Many patients lost around 15% or more of their starting body weight, especially when the medication was combined with healthy eating and exercise.
Semaglutide is not meant to be a quick fix. It is used together with a reduced-calorie diet and increased physical activity. The goal is to help people lose weight and keep it off for the long term, while also improving other health problems linked to obesity, such as diabetes, high blood pressure, and heart disease.
Semaglutide is a powerful medication that mimics a natural hormone in the body to help with weight loss and blood sugar control. It reduces appetite, slows digestion, and helps regulate insulin and glucagon. The injectable form, Wegovy, is FDA-approved for chronic weight management in adults and teens with obesity or overweight and related health conditions. Semaglutide is taken once a week and works best when combined with healthy lifestyle changes.
How Effective Is Contrave for Weight Loss?
Contrave is a prescription medication used to help people lose weight. It is a combination of two drugs—bupropion and naltrexone. Bupropion is an antidepressant that can help reduce appetite. Naltrexone is used to treat alcohol and drug dependence, and it can also help reduce food cravings. Together, these two medicines work on parts of the brain that control hunger and reward. The goal is to help people eat less and feel full sooner.
Clinical Trial Results
The effectiveness of Contrave has been tested in several large studies. These studies involved thousands of people with overweight or obesity. Most people in these studies had a Body Mass Index (BMI) of 30 or more, or a BMI of 27 or more with weight-related health problems like high blood pressure or type 2 diabetes.
In one major study called the COR-I trial, people took Contrave for one year. They also received lifestyle advice about eating healthier and getting more exercise. At the end of the study:
- People taking Contrave lost an average of 5% to 6% of their starting body weight.
- People who took a placebo (a sugar pill) lost about 1% to 2% of their weight.
- About 48% of people taking Contrave lost at least 5% of their body weight.
- Only 16% of people taking placebo reached that goal.
This shows that Contrave helped more people lose a significant amount of weight compared to no medication.
In another study called COR-BMOD, participants also joined an intensive behavior program. This included regular meetings with dietitians and coaches. The results were stronger:
- The average weight loss was around 8.1% of starting weight with Contrave.
- People on placebo lost about 4.9%.
These results suggest that using Contrave along with lifestyle changes can help people lose more weight than lifestyle changes alone.
Timeline of Weight Loss
Contrave does not cause instant weight loss. Most people begin to notice some weight loss in the first 4 to 8 weeks. Weight loss continues gradually over time, usually reaching a peak at 6 months to 1 year. After that, weight loss may slow down or level off. Continuing healthy habits is important to keep the weight off.
Doctors often check progress at 12 weeks (3 months). If a person has not lost at least 5% of their starting weight by then, the doctor may recommend stopping the medicine. This is because studies show that people who do not lose 5% by 12 weeks are not likely to lose much weight later.
Efficacy in Different Groups
Contrave works for many people, but not for everyone. Studies show that people without diabetes usually lose more weight than those with diabetes. However, people with diabetes still benefit, especially when combined with blood sugar management.
In people with type 2 diabetes, one study found that Contrave led to an average weight loss of about 5%, while people on placebo lost about 1.8%. Even this smaller amount of weight loss can still improve blood sugar levels and reduce the risk of complications.
Contrave has also been studied in people with binge eating, and it may help reduce the urge to overeat. However, more research is needed in that area.
Comparison with Placebo
Across all trials, Contrave has consistently performed better than a placebo. People taking Contrave are at least 2 to 3 times more likely to lose a meaningful amount of weight. This includes goals such as:
- Losing at least 5% of body weight
- Losing at least 10%, which can bring bigger health benefits
These numbers are important because even a 5% weight loss can:
- Lower blood pressure
- Improve cholesterol levels
- Reduce the risk of type 2 diabetes
- Ease joint pain and improve mobility
Contrave helps many people lose weight, especially when combined with healthy eating and exercise. Most people can expect to lose 5% to 10% of their weight over a period of 6 to 12 months. Results vary from person to person. Doctors use progress at 12 weeks to decide whether it’s the right treatment to continue. Contrave works best as part of a full weight loss plan, including support and behavior change.
How Effective Is Semaglutide for Weight Loss?
Semaglutide is a medication originally used to treat type 2 diabetes. It works by copying a natural hormone in the body called GLP-1 (glucagon-like peptide-1). This hormone helps control blood sugar and reduces hunger. When used at higher doses, semaglutide is also approved to help with weight loss in people who are overweight or have obesity.
Several large clinical trials have tested how well semaglutide helps people lose weight. These trials showed that semaglutide can lead to significant weight loss when used along with diet and exercise. One of the most important studies is called the STEP program. The STEP trials included thousands of adults with different health backgrounds. They showed that semaglutide can help many people lose more weight than other weight-loss medicines available today.
Average Weight Loss with Semaglutide
In the STEP 1 trial, people who took semaglutide 2.4 mg once a week lost about 15% of their body weight on average after 68 weeks. This means a person weighing 230 pounds could lose about 35 pounds. In comparison, people who took a placebo (a shot with no medicine) lost about 2.4% of their weight. That is around 5 to 6 pounds. These results were seen in people who were overweight or had obesity, even if they did not have diabetes.
In the STEP 2 trial, which focused on people with type 2 diabetes, the average weight loss was slightly less. Those taking semaglutide lost about 10% of their body weight. Weight loss was still better than what was seen with placebo or other diabetes medicines used in the study. This is important because losing even 5% of body weight can improve blood sugar, cholesterol, and blood pressure.
When Results Start to Show
Weight loss with semaglutide usually begins within the first few weeks. Some people may start to notice weight loss after about 4 to 8 weeks. The weight loss continues over several months, especially as the dose is slowly increased to the full amount. In most studies, the full effects of the medicine are seen after 1 year or more. Most people do not lose all the weight in the first few months. Instead, the weight loss happens slowly and steadily.
How Long to Stay on Semaglutide
People often need to keep taking semaglutide long-term to keep the weight off. Stopping the medicine usually leads to weight regain. One study found that people who stopped semaglutide gained back much of the weight they had lost within a year. This suggests that semaglutide works best when used as a long-term part of a weight management plan, along with healthy eating and exercise.
Different Groups and Their Results
Semaglutide has been tested in different groups of people. These include people with and without diabetes, people of different races and ages, and people with high blood pressure or sleep apnea. In most groups, semaglutide helped people lose weight. The amount of weight loss varied slightly, but the medicine was generally effective for many types of patients.
Some research also shows semaglutide may help reduce the risk of heart problems. In people with type 2 diabetes and heart disease, semaglutide helped lower the risk of heart attacks and strokes. These effects are still being studied in people who take it mainly for weight loss.
Semaglutide is one of the most effective medications for weight loss currently available. Clinical trials show that it can lead to a loss of 10% to 15% of body weight for most people. This is much more than what is seen with many other weight-loss medications. Results appear gradually over months, and continued treatment is often needed to maintain weight loss. People with or without diabetes can benefit from semaglutide when it is used together with lifestyle changes such as eating better and being more active.
Contrave vs Semaglutide: Head-to-Head Effectiveness Comparison
Contrave and semaglutide are both approved to help with weight loss, but they are not equally effective. Research shows that semaglutide usually helps people lose more weight than Contrave. Understanding how much weight people lose with each medication, how quickly they lose it, and how long the results last can help explain the key differences between the two options.
How Much Weight Is Lost
On average, people lose more weight with semaglutide than with Contrave. In studies, semaglutide helped people lose about 12 to 15 percent of their body weight after a little more than a year of treatment. This means that someone weighing 200 pounds could lose 24 to 30 pounds or more.
With Contrave, weight loss tends to be smaller. In clinical trials, most people lost about 5 to 9 percent of their body weight after one year. For the same 200-pound person, this would equal a loss of 10 to 18 pounds. While this is still helpful for health, the results are not as strong as those seen with semaglutide.
The larger weight loss seen with semaglutide is one of the main reasons it has become a popular option for people who are overweight or have obesity.
How Many People Respond to Each Treatment
Semaglutide also has a higher success rate. More people who use it reach important weight loss goals. For example, in one major study, more than eight out of ten people taking semaglutide lost at least 5 percent of their starting weight. More than two-thirds lost at least 10 percent.
In contrast, fewer people reach these goals with Contrave. In trials, about half of those using Contrave lost 5 percent or more of their weight. Fewer than half were able to lose 10 percent or more.
This means that people are more likely to see strong results with semaglutide. It works for a wider group of people and helps more of them reach a higher level of weight loss.
How Long It Takes to Lose Weight
Weight loss begins at different times for each medication. With semaglutide, people often start to notice results within the first month. Weight loss continues for several months, and most people reach their lowest weight after about six months of full-dose treatment.
The dosing for semaglutide starts low and increases slowly over several weeks. This helps reduce side effects. Once the full dose is reached, the body responds more strongly, and the weight loss continues more steadily.
Contrave also starts at a low dose, with the full dose reached over four weeks. People may start to lose weight after one month, but the results usually come more slowly than with semaglutide. The most weight loss often happens between 3 to 6 months, with some people continuing to lose small amounts for up to a year.
How Long the Weight Loss Lasts
Keeping weight off is just as important as losing it. Semaglutide has been shown to help people maintain their weight loss over time, especially if they keep using the medicine. When treatment stops, some weight may come back, but many people still keep off more than they would without it. Lifestyle changes like healthy eating and physical activity help keep the weight off longer.
Contrave can also help with weight maintenance, but fewer long-term studies are available. Some people who stop taking Contrave regain weight, especially if they have trouble continuing with diet and exercise plans. The chance of keeping the weight off is higher when the medicine is used along with regular support and behavior changes.
Overall Effectiveness Comparison
Semaglutide leads to more weight loss for more people. The results appear faster and are more likely to last. Contrave is still a useful option, but it may not be as strong or reliable as semaglutide for long-term weight reduction.
Each medicine works best when combined with a healthy diet and regular exercise. The right choice depends on many factors, including how much weight needs to be lost, the person’s medical history, and their ability to use an injection or take pills daily. While semaglutide offers stronger results, Contrave may still be a better match for some people based on their individual needs.
What Are the Common and Serious Side Effects of Contrave?
Contrave is a prescription weight loss medicine that contains two drugs: bupropion and naltrexone. Bupropion is an antidepressant that helps reduce appetite, and naltrexone is used to treat addiction and helps reduce cravings. While Contrave can help with weight loss, it may also cause side effects. These side effects can range from mild to serious. Understanding them can help people make informed decisions with their doctor.
Common Side Effects of Contrave
Many people taking Contrave experience side effects during the first few weeks. Some of the most common side effects include:
- Nausea
Nausea is the most common side effect of Contrave. It happens to many people, especially when first starting the medicine. The nausea usually improves after a few days or weeks as the body gets used to the drug. Eating smaller meals and taking the medicine with food may help reduce this problem. - Constipation
Some people have trouble with constipation while using Contrave. This can make bowel movements hard or painful. Drinking more water, eating fiber-rich foods, and staying active can help ease constipation. - Headache
Headaches are also common in people taking Contrave. These headaches can range from mild to strong. If headaches continue, a doctor may recommend adjusting the dose or trying a different treatment. - Dizziness
Some people feel lightheaded or dizzy. This may happen more often when first starting the medicine or when changing the dose. - Insomnia (Trouble Sleeping)
Bupropion, one of the ingredients in Contrave, can make it harder to fall asleep or stay asleep. Taking the last dose earlier in the evening may help with sleep problems. - Dry Mouth
Dry mouth is another possible side effect. Chewing sugar-free gum or drinking water can help with this issue.
These common side effects are usually not dangerous and may go away with time. However, they can still be bothersome and may lead some people to stop the medication.
Serious Side Effects of Contrave
While less common, some side effects of Contrave can be serious and need medical attention. These include:
- Increased Blood Pressure and Heart Rate
Contrave can raise blood pressure and heart rate. People with uncontrolled high blood pressure or heart disease should be very careful when using this medicine. Blood pressure and pulse should be checked regularly while on Contrave. If blood pressure becomes too high, the medicine may need to be stopped. - Seizures
Bupropion increases the risk of seizures. This risk is higher if the dose is too high or if the person has certain medical conditions, such as a history of seizures, eating disorders, or alcohol or drug withdrawal. For safety, Contrave should not be used in people with seizure disorders or in those at high risk of seizures. - Liver Damage
There have been rare reports of liver problems in people taking Contrave. Signs of liver damage include yellowing of the skin or eyes (jaundice), dark urine, or pain in the upper right side of the belly. If these symptoms appear, medical help is needed right away. - Neuropsychiatric Symptoms (Mood and Behavior Changes)
Because bupropion affects the brain, it may cause changes in mood or behavior. Some people may feel more anxious, angry, or restless. Others may experience depression or even thoughts of suicide. This is more likely in people who have had mood problems in the past. Family members and caregivers should watch for mood changes, especially in the first few weeks. - Allergic Reactions
Though rare, some people may have a serious allergic reaction to Contrave. Signs include rash, itching, swelling, or trouble breathing. If these occur, emergency care is needed.
Who Should Be Cautious About Taking Contrave?
Certain people should not take Contrave or should use it only with close monitoring. This includes:
- People with a seizure disorder
- People who are withdrawing from alcohol, benzodiazepines, or other drugs
- People with an eating disorder like bulimia or anorexia
- People who are using opioids (because of the naltrexone component)
- People with uncontrolled high blood pressure
Doctors usually check a person’s full medical history before prescribing Contrave to make sure it is safe.
Contrave may cause a variety of side effects. Most are mild and improve with time, such as nausea, constipation, headache, and insomnia. Serious side effects, while less common, can include high blood pressure, seizures, liver damage, mood changes, and allergic reactions. People considering Contrave should discuss all medical conditions and other medications with their doctor to avoid problems. Regular checkups help catch any issues early and ensure the treatment remains safe and effective.
What Are the Common and Serious Side Effects of Semaglutide?
Semaglutide is a medicine that helps people lose weight and manage blood sugar. It works by acting like a natural hormone in the body called GLP-1. This hormone helps control hunger and slows down how fast food leaves the stomach. While semaglutide can help with weight loss and type 2 diabetes, it also has some side effects. These can range from mild to serious. Understanding these side effects can help people know what to expect and when to speak with a healthcare provider.
Common Side Effects
The most common side effects of semaglutide are related to the stomach and digestive system. These include:
- Nausea
Nausea is the most frequent side effect. Many people feel sick to their stomach, especially after starting the medication or increasing the dose. Nausea may be mild or more intense, and it often gets better after a few weeks as the body gets used to the drug. Eating smaller meals and avoiding fatty or fried foods may help reduce nausea. - Vomiting
Some people may throw up, especially during the first few weeks of treatment. Vomiting is more likely to happen if the dose is raised too quickly. That is why semaglutide doses are increased slowly over time. - Diarrhea
Loose stools or frequent bowel movements are also common. Diarrhea can cause discomfort and dehydration. Drinking plenty of fluids and avoiding foods that upset the stomach may help manage this side effect. - Constipation
Although less common than diarrhea, some people experience constipation instead. This can be managed by eating high-fiber foods, staying active, and drinking enough water. - Abdominal pain
Stomach pain or cramping may happen, especially when starting semaglutide. This pain is usually mild but can be bothersome. If the pain becomes severe or does not go away, medical help may be needed.
These side effects often lessen with time. They are usually not dangerous but can make it harder to keep taking the medicine. Starting with a low dose and increasing it slowly can help reduce these problems.
Serious Side Effects
Although serious side effects are not as common, they can happen and may need quick medical attention.
- Pancreatitis
Pancreatitis is swelling or inflammation of the pancreas. This can cause strong stomach pain that may reach the back, along with vomiting or fever. If this happens, semaglutide should be stopped right away. People with a history of pancreatitis may not be good candidates for this drug. - Gallbladder problems
Semaglutide may increase the risk of gallstones or gallbladder disease. Signs of gallbladder issues include pain in the upper right side of the belly, nausea, and yellowing of the skin or eyes (jaundice). Gallstones can lead to serious infections if not treated. - Thyroid tumors
Animal studies have shown that semaglutide can cause a type of thyroid tumor called medullary thyroid carcinoma (MTC). So far, this risk has not been clearly proven in humans, but the medicine comes with a warning. People with a personal or family history of MTC or a rare condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) should not take semaglutide. - Low blood sugar (hypoglycemia)
Semaglutide does not usually cause low blood sugar on its own. However, when used with other diabetes medications like insulin or sulfonylureas, the risk of hypoglycemia goes up. Symptoms of low blood sugar include sweating, shaking, confusion, hunger, and dizziness. Adjusting the doses of other diabetes drugs may be necessary when starting semaglutide. - Kidney problems
Severe dehydration from vomiting or diarrhea can sometimes lead to kidney injury. This is more likely in people who already have kidney disease. Drinking enough fluids and managing stomach side effects can help protect kidney function. - Allergic reactions
Although rare, some people may have allergic reactions to semaglutide. This could include rash, itching, swelling, or trouble breathing. These reactions need emergency medical care.
Semaglutide is effective for many people, but it is important to watch for side effects. Most are mild and improve over time. Serious problems are less common but should be taken seriously. Talking with a healthcare provider before starting semaglutide can help reduce the risk of side effects and make sure the treatment is safe and appropriate. Regular check-ups can also help catch any problems early.
Who Should Avoid Contrave or Semaglutide?
Not every person is a good match for weight loss medications like Contrave or Semaglutide. Certain health conditions, medications, or risks can make these drugs unsafe or less effective. Knowing when to avoid these treatments helps prevent serious side effects and improves safety for patients. This section explains the most important reasons why a person might not be able to take Contrave or Semaglutide.
Contrave: When It May Not Be Safe
Contrave contains two drugs—bupropion and naltrexone—that affect the brain. These ingredients can cause problems for people with specific health conditions.
Seizure Risk
Bupropion can increase the risk of seizures. This makes Contrave unsafe for people who have a seizure disorder or a history of seizures. It also should not be used by people who are at higher risk for seizures, such as:
- Those with serious head injuries
- People with brain tumors
- Individuals with alcohol or drug withdrawal symptoms
- People who take other medications that also raise seizure risk (like some antidepressants or antipsychotics)
Eating Disorders
Contrave should not be used by individuals with anorexia nervosa or bulimia. These conditions often cause electrolyte imbalances, which can raise the chance of having a seizure while taking bupropion.
Uncontrolled High Blood Pressure
Contrave can increase blood pressure and heart rate. People with uncontrolled hypertension may face a higher risk of heart problems or stroke. Blood pressure should be well-managed before starting this medication.
Use of Opioids or Opioid Withdrawal
Naltrexone blocks opioid receptors in the brain. It can cause sudden opioid withdrawal in people currently using opioid pain medications or street drugs like heroin. Even small amounts of opioids in the body can lead to serious withdrawal symptoms when mixed with naltrexone. This includes:
- Methadone
- Hydrocodone
- Oxycodone
- Codeine
People should be completely free from opioids for at least 7 to 10 days before starting Contrave. A urine drug test may be needed to confirm this.
Recent Use of MAO Inhibitors
MAOIs (monoamine oxidase inhibitors) are a type of antidepressant. Taking Contrave with MAOIs or within 14 days of stopping an MAOI can cause dangerous blood pressure changes. Drugs in this class include:
- Phenelzine
- Tranylcypromine
- Isocarboxazid
Serious Mental Health Conditions
Bupropion can sometimes cause mood changes, anxiety, or even suicidal thoughts, especially in younger people. Those with a history of bipolar disorder, manic episodes, or serious depression should talk with a doctor before using Contrave.
Pregnancy and Breastfeeding
Contrave is not recommended during pregnancy or breastfeeding. The effects on unborn babies are not well known, and naltrexone may pass into breast milk.
Semaglutide: When It May Not Be Safe
Semaglutide is a GLP-1 receptor agonist. It affects how the stomach and pancreas work. Though it is useful for many people with obesity or type 2 diabetes, it should be avoided in certain cases.
Personal or Family History of Thyroid Cancer
Semaglutide has a boxed warning about a type of thyroid cancer called medullary thyroid carcinoma (MTC). It is not safe for people with a personal or family history of MTC. It is also not safe for those with a rare genetic condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
Pancreatitis
Some people who use Semaglutide develop pancreatitis, which is inflammation of the pancreas. It may cause strong stomach pain, vomiting, and nausea. People with a past history of pancreatitis may need to avoid Semaglutide or be monitored closely by a doctor.
Severe Gastrointestinal Disorders
Semaglutide slows down the emptying of the stomach. This can make stomach problems worse. People with conditions like gastroparesis or severe digestive issues may have more side effects or worsening symptoms. In these cases, Semaglutide is not usually recommended.
Kidney Problems
Severe dehydration from vomiting or diarrhea (common side effects of Semaglutide) can lead to kidney damage. People with reduced kidney function or chronic kidney disease should be cautious and stay well-hydrated.
Diabetic Eye Disease
Semaglutide may worsen diabetic retinopathy in some patients with type 2 diabetes. This condition affects the blood vessels in the eyes and may lead to vision loss. Doctors often monitor eye health during treatment.
Pregnancy and Breastfeeding
There is not enough data to prove that Semaglutide is safe during pregnancy. It is usually stopped at least 2 months before trying to become pregnant. It is also not recommended during breastfeeding.
Drug Interactions and Medical Supervision
Both Contrave and Semaglutide can interact with other medications. For example:
- Contrave may interfere with antidepressants, seizure medications, or drugs used to treat substance abuse.
- Semaglutide may interact with insulin or other diabetes medications, increasing the risk of low blood sugar.
Before starting either medication, a full review of medical history, current prescriptions, and any over-the-counter drugs is needed. Regular follow-up appointments help ensure the medication remains safe and effective.
Understanding who should avoid these medications helps reduce the risk of serious side effects. Both Contrave and Semaglutide can be effective tools for weight loss, but they are not suitable for everyone. Healthcare professionals must carefully evaluate each patient’s health conditions, medications, and risks before starting treatment.
Which Is Easier to Use: Contrave or Semaglutide?
When comparing Contrave and Semaglutide, it is important to understand how each medication is taken and how simple or difficult it may be to use. This includes looking at how often each drug needs to be taken, the method of taking it (by mouth or injection), and what might affect someone’s ability to keep using it over time.
Route of Administration
Contrave is taken by mouth as a pill. It combines two medicines, bupropion and naltrexone, into a single tablet. This makes it convenient for people who prefer oral medications and are used to taking pills.
Semaglutide is given as a once-weekly injection. It comes in a pre-filled pen that delivers the medicine under the skin, usually in the stomach, thigh, or upper arm. While the idea of injecting medication may seem difficult or uncomfortable, many people find that the weekly schedule makes it easier to manage than taking pills every day. The needle is small, and the injection is usually not painful, but it does require learning the correct technique and storing the pen properly.
For individuals who dislike injections or have a fear of needles, taking a daily pill like Contrave may feel more manageable. On the other hand, some people may prefer not to take a medication every day and find the weekly injection of Semaglutide more convenient once they get used to it.
Dosing Frequency and Schedule
Contrave is taken twice per day. The dosing schedule starts low and slowly increases over several weeks. Patients begin with one pill in the morning and work up to two pills in the morning and two pills in the evening. This four-week schedule helps the body adjust and reduces the risk of side effects, especially nausea and headache. However, this gradual increase means patients need to remember to follow the schedule carefully at the beginning. After reaching the full dose, it must be taken consistently every day at the same times with food.
Semaglutide is taken once a week. It also uses a step-up schedule, but the steps are spaced out over months. Patients start with a lower dose and increase it every four weeks until reaching the target dose. This helps reduce side effects such as nausea. Once at the full dose, the patient continues injecting the same amount every week. The once-weekly schedule can be easier for people who struggle with taking daily medications or have busy routines.
Ease of Adherence
Adherence means how well someone is able to stick to their medication plan. Medications that are hard to remember or unpleasant to take can lead to missed doses, which may reduce effectiveness.
Taking Contrave twice a day may be a challenge for people who already take many other pills, work irregular hours, or have trouble remembering morning and evening doses. It also needs to be taken with food, which may be an issue for people who skip meals or have unpredictable meal schedules. Missing doses or not following the food requirement may increase side effects or reduce the benefits of the medication.
Semaglutide’s once-weekly injection may support better adherence in some people. It is easier to remember one dose each week than two doses every day. The injection can be taken with or without food and does not depend on meals. However, storage requirements (such as refrigeration for some formulations) and comfort with self-injection can affect ease of use.
Training and Support
Starting either medication often involves guidance from a healthcare provider. With Contrave, most people are already familiar with how to take pills, so less training is needed. Patients may need instructions on the titration schedule and managing common side effects.
Semaglutide requires learning how to use the injection pen. Most manufacturers provide training materials and demonstration videos. Pharmacists and nurses may also offer support. Once patients are comfortable with the injection process, many report it becomes routine. The pens are designed to be user-friendly and do not require drawing up medicine from a vial or handling needles directly.
Monitoring and Follow-Up
Both medications may require regular follow-up with a doctor to check progress and manage side effects. Contrave may need more frequent monitoring at first, especially in people with a history of mood disorders or high blood pressure. Blood pressure and mental health should be checked regularly.
Semaglutide requires monitoring for gastrointestinal side effects, as well as blood sugar levels in people with diabetes. Follow-up appointments often include checking for signs of pancreatitis, gallbladder issues, or thyroid problems.
Contrave is a twice-daily pill that needs to be taken with food. It may feel more familiar but requires regular daily effort and meal planning. Semaglutide is a once-weekly injection, which may seem more complex at first but can be easier for long-term use after proper training. The best choice depends on what fits better with a person’s lifestyle, comfort level, and ability to stay on track with the medication schedule.
Cost, Insurance Coverage, and Accessibility
Cost, insurance coverage, and how easy it is to get a medication are important parts of choosing a treatment. Contrave and Semaglutide can both help with weight loss, but their prices and how they are covered by insurance can be very different. Patients and healthcare providers need to understand these differences to make the best choice.
Average Retail Prices
Contrave is usually taken as a pill, and its retail price is often lower than Semaglutide. The average cost of Contrave without insurance can range from $500 to $700 per month. However, this can vary based on the pharmacy and location. Some pharmacies may offer it at a lower cost through savings programs or discount cards.
Semaglutide for weight loss is sold under the brand name Wegovy. Wegovy is an injectable medication taken once a week. The retail price for Wegovy is typically $1,300 to $1,500 per month if there is no insurance. Another form of Semaglutide, Ozempic, is used mainly for type 2 diabetes but is sometimes prescribed off-label for weight loss. Its price is similar to Wegovy, though insurance coverage may differ because of the approved use.
The cost difference between Contrave and Semaglutide is clear: Wegovy is often twice as expensive as Contrave when paying out of pocket.
Insurance Coverage and Prior Authorization
Whether a health insurance plan will cover a medication depends on the plan and the approved use of the drug. Contrave is approved by the U.S. Food and Drug Administration (FDA) for chronic weight management in adults with obesity or overweight with certain health conditions. Because of this, some insurance plans include it in their drug list, also known as a formulary. However, even if it is on the list, prior authorization may still be required. That means the doctor must first prove the patient meets certain conditions, like having a specific body mass index (BMI) or having tried other methods of weight loss.
Wegovy is also FDA-approved for chronic weight management. But many insurance plans do not cover weight loss drugs at all. If they do, coverage may be limited to certain patients or require multiple steps before approval. Prior authorization is very common for Semaglutide. Patients may need to provide past weight loss attempts, current BMI, and health history before the medication is approved.
Some Medicaid plans cover weight loss medications like Contrave or Wegovy, but this varies by state. Medicare usually does not cover weight loss drugs unless the patient has another condition, like diabetes, and the drug is approved for that purpose.
If Semaglutide is prescribed for diabetes under the brand name Ozempic, insurance may be more likely to cover it. This is because Ozempic is FDA-approved for treating type 2 diabetes. However, using Ozempic off-label for weight loss is less likely to be covered by insurance.
Manufacturer Discount Programs
Both manufacturers offer discount or savings programs to help patients lower their out-of-pocket costs. Contrave has a savings card that can reduce the monthly cost to as low as $99 per month for eligible patients. This program is often available to those with commercial insurance or those who are uninsured but not on government insurance like Medicare or Medicaid.
Wegovy’s manufacturer, Novo Nordisk, also offers a savings program, but it is usually only available for those with commercial insurance. The discount can reduce the cost by a few hundred dollars per month, but it rarely brings the total cost below $500. These programs often have limits, including a set number of months or yearly savings caps.
Patients should check each drug’s website or ask their doctor or pharmacist about current savings options. These programs can change over time.
Pharmacy Access and Supply Issues
Contrave is widely available at most retail pharmacies across the United States. It is stocked regularly and does not often face supply problems.
Semaglutide, especially Wegovy, has had supply shortages in recent years. These shortages have been caused by high demand and manufacturing delays. This means some patients may have trouble getting their prescription filled, even if they have insurance coverage.
Wegovy is also more likely to be found in specialty pharmacies, which may require extra steps to fill prescriptions. Some pharmacies may ask for extra paperwork, and delivery may take longer.
Long-Term Costs
Because weight loss treatments are often used for many months or even years, long-term costs are important. Even small price differences each month can add up. For patients paying out of pocket, Contrave may be more affordable over time. However, if insurance covers Semaglutide, the cost may become more manageable.
Patients should consider the total cost over time, not just the monthly price. Regular doctor visits, lab tests, and follow-up care may also affect the overall cost of treatment.
Contrave is often less expensive than Semaglutide, especially when not covered by insurance. However, both drugs may require insurance approval and prior authorization. Savings programs may help lower the cost, but they have limits. Availability at pharmacies and possible supply issues are also important to consider. Choosing between these medications should include a full look at cost, coverage, and how easy it is to start and continue treatment.
How Do These Medications Affect Other Conditions Like Diabetes or Mental Health?
Contrave and semaglutide are mainly used for weight loss, but they can also affect other health conditions. These include type 2 diabetes, mental health problems like depression and anxiety, and even heart-related issues. Understanding how each medication works beyond just weight loss is important for people who have more than one health concern.
Contrave and Its Effects on Mental Health and Cravings
Contrave is a combination of two drugs—bupropion and naltrexone. Bupropion is a medicine often used to treat depression and to help people stop smoking. It works on certain chemicals in the brain that affect mood and energy. Naltrexone is usually used to treat people who are addicted to alcohol or opioids. When used together in Contrave, these drugs can help reduce hunger and food cravings, especially cravings triggered by emotions or stress.
Some people may notice that Contrave helps them manage emotional eating, or eating when feeling sad, anxious, or bored. Because bupropion can affect mood, some users report improvements in feelings of well-being while using Contrave. However, Contrave is not meant to treat depression on its own, and it should not be taken in place of regular mental health medications.
There are also important risks to consider. Contrave carries a warning for suicidal thoughts and behaviors, especially in young adults and teenagers. While this is rare, people who take Contrave should be watched for any sudden changes in mood, behavior, or thoughts. This is particularly important for people who have a history of depression, anxiety, or other mental health conditions. If someone begins to feel more depressed or starts having thoughts of harming themselves, they should speak with a doctor immediately.
People who have or had an eating disorder, such as bulimia or anorexia, should not take Contrave. This is because bupropion can increase the risk of seizures in people with these conditions. Contrave is also not safe for people who take certain drugs for depression, like MAOIs, or for people who have a history of seizures.
In some cases, Contrave may also help people who are trying to quit smoking. This is because the bupropion part is the same as the drug used in smoking treatment, called Zyban. Still, doctors usually decide this based on each person’s needs.
Semaglutide and Its Effects on Type 2 Diabetes and Blood Sugar
Semaglutide works in a very different way. It copies a natural hormone in the body that helps control blood sugar, hunger, and digestion. This makes it helpful not only for weight loss but also for people who have type 2 diabetes.
People with type 2 diabetes often benefit from semaglutide because it helps lower blood sugar levels. It also helps the body use insulin more effectively and slows down how fast food leaves the stomach. This leads to better control of blood sugar, especially after meals. Doctors often see improvements in a person’s A1C level, which is a test that shows average blood sugar over a few months.
In addition to helping with blood sugar, semaglutide has also been shown to lower the risk of serious problems like heart attack and stroke in people with type 2 diabetes. This makes it a very useful option for people who are overweight or obese and also have diabetes or a history of heart problems.
It is important to note that semaglutide is not used to treat type 1 diabetes. It should also not be used in people with a personal or family history of a rare type of thyroid cancer called medullary thyroid carcinoma. People with a condition called multiple endocrine neoplasia syndrome type 2 should also avoid this drug.
Mental and Emotional Effects of Semaglutide
Semaglutide does not treat depression or anxiety directly. However, some people feel better emotionally as they lose weight and improve their overall health. Weight loss can lead to increased energy, better sleep, improved self-esteem, and even a more active social life. These changes can support better mental health in many people.
Still, semaglutide can cause side effects like nausea, fatigue, or reduced appetite, especially in the beginning. If someone feels unwell for a long time, it may affect their mood or cause irritability. Although serious mood changes are uncommon, it is still a good idea to monitor how someone feels emotionally while taking this medication, especially if they already have a mental health condition.
In some cases, semaglutide can lower appetite too much. If someone eats too little, it may lead to a lack of energy, weakness, or changes in mood. It is important to follow a balanced eating plan and talk with a doctor or dietitian if these issues come up.
Overall Impact on Health
Both medications offer benefits beyond weight loss, but they do so in different ways. Contrave may help people with emotional eating or those who also struggle with depression, though it comes with risks for those with a history of certain mental health or neurological conditions. Semaglutide is especially helpful for people with type 2 diabetes or heart risk, and it often improves overall metabolic health. However, it may not be the right choice for people with thyroid risks or those sensitive to appetite-related side effects.
Choosing between the two depends on the person’s full health picture, including medical history, current conditions, and treatment goals. Healthcare providers can help decide which option fits best based on these factors.
Which One to Choose? Clinical Scenarios and Guidance
Choosing between Contrave and Semaglutide depends on several important factors. These include how much weight needs to be lost, other health problems like diabetes or high blood pressure, how the medication is taken, and each person’s medical history. Some people may also have preferences about pills versus injections or how often they need to take the medicine. Each of these things can affect which drug might be a better fit.
When the Main Goal Is Weight Loss
Semaglutide usually leads to more weight loss than Contrave. Studies have shown that many people who use Semaglutide lose around 15 percent or more of their body weight. With Contrave, the average weight loss is smaller—around 5 to 9 percent. This means that for people who want to lose a large amount of weight, or for those who have tried other weight loss options without success, Semaglutide might offer better results.
However, not everyone wants or needs that level of weight loss. For those who are overweight but not severely obese, and who prefer to take a pill instead of getting an injection, Contrave might still be a good choice.
If the Person Has Type 2 Diabetes
Semaglutide has special benefits for people who have type 2 diabetes. It lowers blood sugar while also helping with weight loss. It has also been shown to protect the heart in people with diabetes. This can reduce the risk of heart attacks and strokes. Contrave does not have the same strong effects on blood sugar or heart health.
So, for people with both extra weight and type 2 diabetes, Semaglutide may be the better option. It treats both conditions at the same time and helps lower the risk of other serious health problems.
Preference for Pills or Injections
Another difference between these two medicines is how they are taken. Semaglutide is given as an injection under the skin once a week. Some people may feel uncomfortable with needles or may not want to give themselves a shot. In those cases, Semaglutide might not be the right fit.
Contrave comes as a pill taken by mouth. It starts with a small dose and increases over a few weeks. Some people find pills easier to take than injections. But Contrave must be taken every day, sometimes more than once, which can be hard for people who forget to take medicine regularly.
For people who don’t mind injections and want a once-a-week routine, Semaglutide may be easier to manage. For others who dislike injections or prefer a daily pill, Contrave may feel more comfortable.
If There Is a History of Mental Health Conditions
Contrave includes a medicine called bupropion, which can affect brain chemicals. This may help with cravings and may also improve mood in some people. It is also used to help people stop smoking. But this medicine can raise the risk of seizures in people who have certain health conditions. It also has a warning about possible suicidal thoughts, especially in younger adults.
Because of this, Contrave is not safe for people who have had seizures, certain eating disorders like bulimia, or a history of drug or alcohol withdrawal. In those cases, Semaglutide may be safer. Semaglutide does not act on the brain in the same way and is not known to increase the risk of mood changes or seizures.
Other Health Conditions
People with high blood pressure may need to be careful with Contrave, since it can raise heart rate and blood pressure. Semaglutide usually has the opposite effect and may slightly lower blood pressure and cholesterol levels. On the other hand, Semaglutide is not a good choice for people who have had a certain kind of thyroid cancer or a condition called Multiple Endocrine Neoplasia type 2 (MEN2). It should also be avoided by those with a history of pancreatitis or gallbladder problems.
Because both drugs have risks in certain medical conditions, a full review of someone’s health history is very important before starting either one.
Lifestyle and Medication Schedule
Some people have busy lives and may find it easier to take a medicine once a week rather than every day. In this case, Semaglutide may be a better match. Others are used to taking pills and would rather avoid injections. These people may do better with Contrave.
Also, Contrave requires slowly increasing the dose over several weeks, and it may take time for the body to get used to it. Some people may stop using it because of side effects like nausea, headache, or trouble sleeping. Semaglutide also causes nausea in many people, but the dose is also increased slowly, which can help the body adjust.
Each medication has its own strengths. Semaglutide tends to help people lose more weight and is especially helpful for people who also have type 2 diabetes. It is taken once a week, which many people find convenient. However, it does require giving an injection and may cause stomach problems in the beginning. Contrave comes as a daily pill and might be a better option for those who prefer not to use injections or who may benefit from the added effects of bupropion, such as mood support or help with quitting smoking.
However, Contrave is not right for people with certain medical conditions, such as seizures or eating disorders. And it may not be as effective for those who need to lose a large amount of weight or who have diabetes.
The decision between Contrave and Semaglutide should always be made with a healthcare provider. A doctor or specialist can review a person’s health conditions, treatment goals, and lifestyle to help choose the safest and most effective option.
Conclusion
Choosing the right weight loss medication can be difficult, especially when comparing two very different drugs like Contrave and Semaglutide. Both are approved by the U.S. Food and Drug Administration (FDA) for helping people lose weight, but they work in different ways and come with different benefits and risks. Understanding these differences is important for making a safe and effective decision that fits a person’s health needs and lifestyle.
Contrave is a tablet that combines two medicines—bupropion and naltrexone. It works mainly in the brain to reduce hunger and control cravings. Bupropion is also used to treat depression and help people stop smoking, while naltrexone is often used to treat alcohol and drug addiction. Together, they help reduce appetite and may help with emotional eating. Semaglutide, on the other hand, is a once-weekly injection. It belongs to a class of drugs called GLP-1 receptor agonists. It works by copying a natural hormone in the body that helps control blood sugar, slows digestion, and reduces hunger.
Both medications have been shown to help people lose weight, but Semaglutide generally leads to greater weight loss than Contrave. In clinical studies, people taking Semaglutide often lost around 15% of their body weight, while those on Contrave usually lost around 5% to 9%. Semaglutide tends to produce faster and more significant results. However, these results can vary depending on the person’s body, other health conditions, and how well the medication is taken as prescribed.
Side effects are also an important part of the decision. Contrave may cause nausea, headache, trouble sleeping, dry mouth, and in some cases, raised blood pressure or heart rate. It is not recommended for people with uncontrolled high blood pressure, a history of seizures, or certain mental health conditions. There is also a warning about the risk of suicidal thoughts, especially in young adults. Semaglutide often causes nausea, vomiting, or diarrhea, especially when first starting the medication. There is also a risk of more serious issues such as pancreatitis, gallbladder problems, or thyroid tumors, though these are rare. People with a family history of medullary thyroid cancer or a condition called Multiple Endocrine Neoplasia Syndrome Type 2 (MEN2) should not use Semaglutide.
Some people may also consider how the medication is taken. Contrave is a pill taken every day and may be easier for people who prefer oral medications. Semaglutide is given as an injection once a week, which may not appeal to those who are afraid of needles. However, the once-weekly dosing could be more convenient for some. Adherence and ease of use can affect how well the medicine works over time.
Cost is another factor. Both medications can be expensive without insurance. Semaglutide is often more costly than Contrave. Insurance coverage varies, and some health plans may not cover one or both drugs. Drug companies sometimes offer savings programs or coupons to help reduce the cost.
Other health conditions may also guide the decision. For people with type 2 diabetes, Semaglutide may be more useful because it also helps lower blood sugar and improve heart health. Contrave may be a better choice for those who are overweight and also trying to quit smoking or manage depression, since bupropion has benefits for those conditions. But both drugs have specific risks that must be carefully weighed by a healthcare provider.
In summary, both Contrave and Semaglutide offer benefits for weight loss but work in very different ways. Semaglutide often results in greater weight loss, but it is more expensive and requires injections. Contrave is less costly and taken as a pill, but the side effects and mental health warnings require attention. Choosing the right medication depends on individual health conditions, comfort with the form of treatment, cost, and possible risks. The best decision is made with help from a healthcare provider who can consider all these factors and help guide safe and effective treatment.
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Questions and Answers: Contrave vs Semaglutide
Both Contrave and Semaglutide are used for weight management in adults who are overweight or obese, often with other related health conditions.
Contrave is a combination of bupropion and naltrexone, which affect the brain’s appetite and reward systems. Semaglutide is a GLP-1 receptor agonist that mimics a gut hormone to regulate appetite and blood sugar.
Clinical studies suggest that Semaglutide (e.g., Wegovy) leads to greater weight loss than Contrave, with average weight loss often exceeding 15% of body weight, compared to 5–9% with Contrave.
Contrave is taken orally as a pill, usually twice daily. Semaglutide is typically administered once weekly as a subcutaneous injection (e.g., Wegovy).
Common side effects of Contrave include nausea, constipation, headache, dizziness, dry mouth, and insomnia.
Semaglutide may cause nausea, vomiting, diarrhea, constipation, and abdominal pain, especially when first starting the medication.
Yes. Semaglutide (especially Ozempic) is also FDA-approved for type 2 diabetes, while Contrave is not approved specifically for diabetes but may be used off-label with caution.
Semaglutide has shown cardiovascular risk reduction in patients with type 2 diabetes and existing cardiovascular disease. Contrave has not shown definitive cardiovascular benefit.
Contrave should not be used in people with seizure disorders, uncontrolled hypertension, or those on chronic opioid therapy. Semaglutide is contraindicated in people with a history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2.
Semaglutide (Wegovy) is more expensive and may have more insurance restrictions. Contrave is often less expensive but still may require prior authorization.
Dr. Judith Germaine
Dr. Jude (Germaine-Munoz) Germaine, MD is a family physician in Springfield, New Jersey. She is currently licensed to practice medicine in New Jersey, New York, and Florida. She is affiliated with Saint Josephs Wayne Hospital.