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Contrave vs Weight-Loss Alternatives Comparison Tool
- 1Effectiveness varies by individual - GLP-1 drugs show highest weight loss
- 2Side effects range from mild (nausea) to serious (seizures, mood changes)
- 3Cost differences are significant - $30/month vs $1,500/month
- 4Insurance coverage varies - check with your provider
- 5Prescription requirements and monitoring needs differ by medication
TL;DR
- Contrave mixes naltrexone and bupropion to curb cravings and boost metabolism.
- On average it delivers 5‑10% body‑weight loss after a year, a bit lower than GLP‑1 drugs like Wegovy.
- Common side effects include nausea, headache, and insomnia; rare but serious risks are high blood pressure and mood changes.
- Monthly cost ranges from $150‑$250 in the US, often covered partially by insurance with a prior‑auth.
- Top alternatives - Saxenda, Wegovy, Qsymia, Orlistat - differ in mechanism, efficacy, and safety; your health profile decides which fits best.
What is Contrave and how does it work?
When it comes to prescription appetite suppressants, Contrave is a fixed‑dose combo of two older drugs: naltrexone and an opioid‑receptor blocker that also modulates reward pathways and bupropion, a norepinephrine‑dopamine reuptake inhibitor originally marketed for depression and smoking cessation. The idea is simple: bupropion sparks the hypothalamus to increase calorie burning, while naltrexone tampers down the brain’s reward response to food. Together they aim to reduce cravings and modestly raise energy expenditure.
Clinical trials (the 2011 COR‑I and COR‑II studies) showed participants lost about 5‑10% of their baseline weight after 56 weeks, provided they paired the drug with diet and exercise. That’s enough to move many people from the "obese" to the "overweight" category, which can improve blood‑pressure and cholesterol numbers.
Safety profile and side‑effects you should know
Every medication has a trade‑off. For Contrave, the most common complaints are nausea (up to 30% of users), headache, dry mouth, and insomnia. Because bupropion can raise blood pressure, doctors usually monitor systolic numbers every few weeks, especially in patients with pre‑existing hypertension.
Rare but serious concerns include:
- Seizure risk - bupropion lowers the seizure threshold; the FDA caps the dose at 400mg per day for this reason.
- Suicidal thoughts - the drug class carries a black‑box warning for mood disorders.
- Liver toxicity - naltrexone is processed by the liver, so patients with severe hepatic impairment are excluded.
If you have a history of seizures, uncontrolled high blood pressure, or are pregnant, Contrave is likely off the table.
Cost, insurance, and access considerations
The 2025 retail price for a 30‑day supply of Contrave sits around $180 in the United States, though Medicare Part D and many private plans require prior authorization. In Australia, the PBS does not list Contrave, so you’d need a private prescription and the out‑of‑pocket cost could be 250AUD per month.
Pharmacies often offer mail‑order discounts that shave 15‑20% off the sticker price, but be wary of "online pharmacies" promising ultra‑low rates - if the price looks too good to be true, the product probably is.
Quick glance at the main alternatives
Other prescription weight‑loss drugs target the same goal-reduce calories-but they use very different pathways. Below is a snapshot of the most commonly prescribed options.
| Medication | Mechanism | Avg weight loss % (12mo) | Common side‑effects | Contraindications | Approx. monthly cost (USD) |
|---|---|---|---|---|---|
| Contrave | Naltrexone+Bupropion (reward & metabolism) | 5‑10% | Nausea, headache, insomnia | Seizure disorder, uncontrolled HTN, pregnancy | $150‑$250 |
| Saxenda | Liraglutide (GLP‑1 receptor agonist) | 8‑12% | GI upset, pancreatitis, gallbladder disease | Personal/family history of medullary thyroid cancer, MEN2 | $1,200‑$1,500 (injectable) |
| Wegovy | Semaglutide (weekly GLP‑1 agonist) | 12‑15% | Nausea, vomiting, constipation | Same as Saxenda plus severe GI disease | $1,300‑$1,600 |
| Qsymia | Phentermine+Topiramate (stimulates & satiety) | 9‑13% | Tingling, insomnia, metabolic acidosis | Pregnancy, glaucoma, hyperthyroidism | $100‑$200 |
| Orlistat | Lipase inhibitor (blocks fat absorption) | 3‑5% | Oily stools, fecal urgency, vitamin‑D deficiency | Chronic malabsorption, pregnancy | $30‑$50 (OTC) |
Notice the pattern: GLP‑1 drugs (Saxenda, Wegovy) deliver the biggest drops but come with a higher price tag and a different injection routine. Qsymia sits in the middle with solid efficacy and a lower cost, yet it carries a pregnancy warning because phentermine is a stimulant.
When Contrave makes sense - the right patient profile
If you’re:
- Between 18‑65 years old, BMI≥27 with at least one weight‑related condition (type2 diabetes, hypertension, dyslipidemia),
- Looking for a pill rather than an injection,
- Free of seizure disorders, uncontrolled hypertension, or active mood‑disorder medication,
- Comfortable with a modest (5‑10%) weight‑loss expectation,
Contrave could be a practical first line before stepping up to a GLP‑1 agent. It also pairs nicely with a structured lifestyle program-most insurers require proof of dietitian visits before approving the prescription.
Which alternative might be better for you?
GLP‑1 injectables (Saxenda, Wegovy) shine for people who need rapid, larger weight reductions and are okay with weekly or daily injections. They also improve blood‑sugar control, making them a go‑to for diabetics.
Qsymia works well for patients who tolerate stimulants and want a once‑daily oral option that can deliver double‑digit loss. However, it’s off‑limits for anyone trying to conceive.
Orlistat is the budget‑friendly, over‑the‑counter route, but you’ll have to handle oily stools and ensure you take a multivitamin. It’s best for mild‑to‑moderate overweight folks who can stick to a low‑fat diet.
In short, the "best" drug is the one that aligns with your health status, lifestyle, and willingness to manage side‑effects.
Talking to your healthcare provider
Preparation helps you get the prescription you need without endless back‑and‑forth:
- Bring recent lab results (lipids, liver panel, fasting glucose).
- List every medication you take, including over‑the‑counter supplements.
- Know your BMI and any comorbidities you’ve been diagnosed with.
- Ask about insurance coverage and prior‑authorization steps.
- Discuss the target weight‑loss goal and timeline-most doctors aim for at least a 5% reduction in the first 6 months.
Don’t hesitate to ask about switching agents if you experience intolerable side‑effects; many physicians are comfortable rotating between Contrave and Qsymia before moving to a GLP‑1 drug.
Quick decision checklist
- Do you need a pill vs. injection? → Contrave or Qsymia.
- Is a 12‑15% weight loss target realistic for you? → Consider Wegovy or Saxenda.
- Are you pregnant, planning pregnancy, or have a seizure disorder? → Avoid Contrave, Qsymia, Orlistat.
- Is cost a major barrier? → Orlistat (OTC) or Qsymia (generic).
- Do you have type2 diabetes? → GLP‑1 agents give added glycemic benefit.
Frequently Asked Questions
How long does it take to see results with Contrave?
Most users notice a reduction in cravings within the first two weeks, but measurable weight loss typically appears after 8‑12 weeks of consistent use combined with diet and exercise.
Can I take Contrave with other weight‑loss pills?
No. Mixing appetite suppressants raises the risk of high blood pressure, heart palpitations, and severe mood changes. Your doctor should review any other medications before adding Contrave.
Is Contrave approved for use in Australia?
As of 2025, Contrave is not listed on the Australian Pharmaceutical Benefits Scheme, so it must be sourced via a private prescription and paid out‑of‑pocket.
What should I do if I experience severe nausea?
Start with a low dose (8mg/90mg) and increase slowly. If nausea persists after one week, contact your prescriber; they may switch you to a GLP‑1 agent, which many patients tolerate better.
How does the effectiveness of Contrave compare to Wegovy?
Wegovy typically yields 12‑15% weight loss after a year, roughly double the average loss with Contrave. However, Wegovy requires a weekly injection and costs about eight times more per month.
Michael Friend
Contrave is just a fancy name for two old drugs thrown together because Big Pharma ran out of new molecules. The 5-10% weight loss? That’s not a miracle, that’s a polite nudge. Meanwhile, Wegovy gives you 15% and a weekly injection you can’t even hide from your dog.
Kristy Sanchez
Oh sweet mercy, another post pretending this is science and not a corporate marketing brochure wrapped in a lab coat.
Let’s be real - if you’re counting on a pill to fix your relationship with food, you’re already halfway to the ER.
Contrave doesn’t change behavior, it just makes you nauseous enough to forget about pizza.
And don’t get me started on the ‘insurance prior auth’ dance - it’s like applying for a visa to your own body.
Meanwhile, Wegovy costs more than my rent, but at least when I cry in the bathroom after my injection, I can tell myself I’m investing in my future.
Orlistat? That’s just a fancy laxative with a side of oily regret.
And yes, I’ve tried all of them.
Turns out the only thing that works is showing up at the gym when you hate yourself and the world.
But hey, at least we can all feel superior about our chosen poison, right?
Also, if you’re taking Contrave and still scrolling Reddit at 2am eating peanut butter out of the jar - you’re not sick, you’re just bad at life.
Jerrod Davis
While the pharmacological mechanisms of Contrave are adequately described, the comparative efficacy data presented lacks statistical granularity. The absence of confidence intervals, p-values, and effect size reporting renders the weight loss percentages potentially misleading. Furthermore, the cost analysis fails to account for long-term healthcare expenditures associated with comorbidities. A more rigorous framework is warranted.
Dominic Fuchs
So we’re paying $1500 a month for a shot that makes you throw up but you lose 15% of your body weight and suddenly your knees don’t scream when you walk
Or we pay $180 for a pill that makes you feel like a zombie and lose 7%
And people wonder why we’re all so tired
It’s not the food it’s the system
Asbury (Ash) Taylor
This is a really well-structured breakdown - thank you for taking the time to lay this out so clearly.
For anyone considering these options, remember: the goal isn’t to find the most powerful drug, it’s to find the one you can live with.
Some people can handle injections. Others can’t. Some can manage nausea. Others can’t.
There’s no shame in starting small. Even 5% loss improves insulin sensitivity, reduces joint pain, and lowers blood pressure.
Progress over perfection. Always.
Kenneth Lewis
contrave is just bupropion with a side of naltrexone lol
so if you already take wellbutrin for depression and you’re kinda hungry all the time... yeah you’re kinda already on contrave
also why is orlistat even still a thing? i mean i get it’s cheap but like... oily butt is not a lifestyle
Jim Daly
all these drugs are just scamming people who wanna be skinny fast
you wanna lose weight eat less move more
no pill fixes your laziness
also why is everyone so mad about the cost
you want magic pills but you dont want to do the work
also who even has time for all these injections
Tionne Myles-Smith
I started Contrave last month and honestly? I’m surprised.
My cravings for carbs just… faded. Like, I walked past a bakery the other day and didn’t even think about it.
Yeah I got a little nauseous at first, but I lowered the dose and now it’s fine.
And I’m not saying this is magic - I’m still walking 30 mins a day and drinking water like my life depends on it.
But for the first time in years, I feel like I’m not fighting my brain every second.
You guys aren’t weak for trying this. You’re brave.
Leigh Guerra-Paz
Oh my goodness, thank you so much for this incredibly thorough and compassionate breakdown!
I’ve been researching this for months and I feel like I finally understand the differences between all these medications - and more importantly, I feel less alone.
It’s so easy to feel like a failure when you’ve tried diets, apps, juice cleanses, and gym memberships that you never use - and then someone tells you to just ‘eat less’ like it’s that simple.
But this? This is science. This is empathy. This is real.
Please, if you’re reading this and you’re scared to talk to your doctor - go. Bring this list. Bring your questions. You deserve to feel better. You deserve to be heard.
And if you’re on Contrave and you’re having a hard day? It’s okay. You’re doing better than you think.
Love you all.
- Leigh, who’s been here too.
Jordyn Holland
It’s hilarious how Americans treat weight loss like a luxury product you can buy at CVS.
Meanwhile, in the rest of the world, people eat real food and move their bodies - and they don’t need a $1,300 injection to stop eating bread.
This isn’t medicine. It’s capitalism with a stethoscope.
Jasper Arboladura
The clinical data cited is methodologically flawed. The COR-I and COR-II trials were industry-funded, had high dropout rates, and employed suboptimal dietary controls. Furthermore, the 5–10% weight loss metric is statistically insignificant when contextualized against baseline BMI distributions. A true meta-analysis would require adjustment for confounding variables including sleep architecture, circadian rhythm disruption, and gut microbiome composition - none of which are addressed here. This is not evidence. It’s marketing.
Joanne Beriña
Why are we letting foreign drug companies profit off our obesity crisis?
Contrave? Made in Germany. Wegovy? Made in Switzerland.
Where’s the American-made solution?
We got the smartest scientists in the world - why are we importing weight loss pills like we’re importing coffee beans?
Buy American. Eat real food. Stop paying for foreign pharmaceuticals to fix what our culture broke.
ABHISHEK NAHARIA
In India, we do not have access to these drugs. We have roti, dal, and walking to the market.
Our grandparents didn’t need pills. They didn’t have calories to count. They had hunger.
Now we want to inject ourselves with expensive hormones to lose weight while sitting on sofas.
Progress is a lie.
What we need is discipline. Not drugs.
Hardik Malhan
The GLP-1 agonists demonstrate superior efficacy in modulating appetite via central satiety pathways and delaying gastric emptying. However, the cost-benefit ratio remains suboptimal for population-level implementation. Contrave offers a pharmacokinetically favorable oral alternative with lower systemic burden, albeit with narrower therapeutic window. Prior authorization protocols should be streamlined to reduce administrative friction.
Casey Nicole
Wow, so we’re supposed to be grateful that Big Pharma gives us pills that make us feel like zombies so we can fit into a dress?
And you call that progress?
My mom lost 40 pounds in the 80s by eating rice and beans and dancing to disco.
Now we pay $1,600 to cry in the bathroom because our stomach hates us.
This isn’t medicine. This is torture with a prescription.
Asbury (Ash) Taylor
Thank you for sharing your perspective, Tionne - your honesty about the emotional side of this journey means a lot.
I’ve been on Contrave for six months. I didn’t lose 10% - I lost 6%. But I haven’t had a panic attack in 4 months.
That’s not just weight. That’s peace.
And if that’s what it takes to get there? I’ll take the nausea.
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