Key Differences Between Contrave vs Semaglutide for Weight Loss (Compared)

Contrave vs semaglutide is a popular, yet difficult, topic online for weight-loss prescription treatments. 

Contrave offers convenient oral dosing with moderate weight reduction via changes in brain chemistry, while Semaglutide provides superior weight loss via weekly injections that mimic your natural gut hormones. 

This guide breaks down the mechanisms, results, costs, and side effects of both medications so you may make an informed choice based on your goals, budget, and lifestyle preferences.

What is Contrave

Contrave is an FDA-approved oral weight-loss medication that combines two existing drugs: naltrexone hydrochloride (8 mg) and bupropion hydrochloride (90 mg) in each extended-release tablet.

How Does it Work?

Contrave works in your brain.

• Bupropion activates POMC (Pro-opiomelanocortin) neurons that help reduce appetite.
• Naltrexone blocks opioid signals that usually shut down this hunger control.
  
  

The result is fewer cravings and better portion control. 

What is Semaglutide (Ozempic, Wegovy)

Semaglutide is a GLP-1 receptor agonist approved for weight management at 2.4 mg weekly (Wegovy) and type 2 diabetes at lower doses (Ozempic). 

It mimics glucagon-like peptide-1, a hormone your intestines naturally release after eating to signal fullness and regulate blood sugar.

How Does it Work?

Semaglutide works by calming your appetite and helping you stay full for longer. 

It activates GLP-1 receptors in the brain and gut, slows stomach emptying, and stabilizes blood sugar levels. These effects help you eat less without feeling forced to restrict your food intake.

Semaglutide helps your body release more insulin when blood sugar goes up, and it lowers glucagon, which is the signal that tells your liver to release stored sugar.

Key Differences Between Contrave vs Semaglutide

Comparison Table

Mechanisms

Contrave

Contrave alters neurotransmitter activity in brain regions that control appetite and reward. 

Bupropion increases norepinephrine and dopamine levels while activating POMC neurons that suppress hunger. 

Naltrexone blocks opioid-mediated negative feedback that would stop this appetite suppression. This combination reduces food cravings by changing how your brain responds to eating.

Semaglutide

Semaglutide mimics the GLP-1 hormone by binding to receptors in your gut, pancreas, and brain. 

It delays gastric emptying so food stays in your stomach 3-4 hours longer than usual. 

In the brain, it activates appetite control centers to reduce hunger. It also enhances insulin secretion and reduces glucagon release, stabilizing blood sugar levels.

Weight Loss Results

Contrave

Clinical trials showed that people taking Contrave lost 3.7-8.1% of body weight over 56 weeks, compared with 1.3-4.9% with placebo. 

Between 36% and 57% achieved at least 5% weight loss. And the principal weight-loss reduction occurs in the first six months.

Semaglutide

Clinical trials show consistent results that adults with obesity lost 14.9% of body weight over 68 weeks, 12.4 percentage points more than placebo. 

And weight loss from Semaglutide was sustained for up to four years, averaging 10.2% at 208 weeks.

Semaglutide weight loss reviews from real-world use confirm these clinical outcomes.

Benefits

Contrave

Contrave benefits include:

• Doesn't cause severe gastrointestinal effects common with GLP-1s
• Good option for people with needle phobia or who prefer daily pills
• Reduces food cravings and emotional eating patterns
• Oral convenience without injections required

Semaglutide

Semaglutide benefits extend beyond weight loss:

• Improves blood sugar control and helps manage type 2 diabetes
• Reduces blood pressure and favorably changes cholesterol levels
• Reduces food cravings and enhances appetite control for long-term maintenance
• Reduces heart attack, stroke, and cardiovascular death in people with heart disease

Side Effects

Contrave

Common side effects include:

• Nausea
• Insomnia
• Vomiting
• Dizziness
• Headache
• Constipation 

Contrave carries a black box warning for suicidal thoughts in young adults. It may also raise blood pressure and heart rate. Seizure risk increases to 0.1%. About 6.3% discontinued due to nausea.

Semaglutide

Common side effects of Semaglutide include:

• Injection site reaction
• Abdominal pain
• Mild vomiting
• Constipation
• Diarrhea
• Nausea

Dosage

Contrave

• Week 1: One tablet in the morning
• Week 2: One tablet in the morning + one in the evening
• Week 3: Two tablets in the morning + one in the evening
• Week 4 onward (maintenance): Two tablets in the morning + two in the evening (32 mg naltrexone / 360 mg bupropion per day)

Check our detailed Semaglutide dosage information for comparison.

Semaglutide

• Weeks 1–4: 0.25 mg weekly
• Weeks 5–8: 0.5 mg weekly
• Weeks 9–12: 1.0 mg weekly
• Weeks 13–16: 1.7 mg weekly
• Week 17 onward: 2.4 mg weekly 

Important note: Inject subcutaneously in your abdomen, thigh, or upper arm once weekly for better results. 

The maximum dose of semaglutide for weight loss is 2.4 mg weekly.

Who It's Best For

Contrave

Contrave suits people who deal with intense cravings or emotional eating, prefer a pill over a shot, aim for 5–10% weight loss, want a lower-cost option than GLP-1 drugs, and have tried diet and exercise without enough success. 

Semaglutide

Semaglutide fits people who want a proven, evidence-based option, have obesity or weight-related health issues, need firm appetite control, and may handle weekly shots or daily oral doses.

Cost and Insurance Coverage

Contrave

Contrave retails for $500- $840 per month without insurance. 

The CurAccess Patient Support Program offers it for $99/month, with free shipping, to eligible patients regardless of insurance status. 

A savings coupon card can reduce costs to $20-$199/month for commercially insured patients. Most insurance plans don't cover weight loss medications.

Semaglutide

Semaglutide costs $1,300- $1,600 per month at retail prices. Some insurance plans cover it when prescribed for obesity-related conditions. 

Manufacturer savings programs can significantly reduce costs for eligible patients. Compounded semaglutide costs $179-$300 monthly but may vary in quality. 

Find the cheapest semaglutide options without insurance. Or explore Semaglutide tablets as an alternative to injections. 

Ready to start your weight loss journey? Explore personalized GLP-1 injections tailored to your needs.

Similarities Between Contrave and Semaglutide

Despite different mechanisms, both medications share essential characteristics, which include:

• Requires ongoing use to maintain weight loss; weight regain occurs after discontinuation.
• Works best when combined with a reduced-calorie diet and increased physical activity for optimal results.
• Need gradual dose escalation over several weeks to minimize side effects and improve tolerance.
• Not approved for cosmetic weight loss in people without obesity or weight-related health conditions.
• Carry cardiovascular considerations requiring blood pressure and heart rate monitoring during treatment.
• May interact with diabetes medications, necessitating dose adjustments to prevent hypoglycemia.

Read genuine semaglutide weight loss reviews from people who've achieved results.

Semaglutide and Contrave Safety Precautions Before You Begin

Before starting either medication, discuss these important safety considerations with your doctor:

• Medical history screening for thyroid cancer, pancreatitis, gallbladder disease, kidney problems, or eating disorders.
• Medication interactions, including insulin, sulfonylureas, MAO inhibitors, other bupropion products, and opioid medications.
• Mental health evaluation for depression, bipolar disorder, or a history of suicidal thoughts, especially with Contrave.
• Pregnancy planning, as both medications should be discontinued if you become pregnant or plan to conceive.
• Baseline health markers, including blood pressure, heart rate, liver function, kidney function, and blood sugar levels.
• Seizure risk assessment, particularly for Contrave, in people with eating disorders or those abruptly stopping alcohol.

Have a look at our semaglutide pills vs Injection to help you discover a preferred treatment option. 

You can also find out some of the reasons that semaglutide treatment isn’t working for you and fix the issues with our in-depth guide.  

Can You Take Contrave and Semaglutide Together?

No clinical trials have evaluated the safety and efficacy of using both medications simultaneously. 

So the combination could potentially increase side effects, particularly nausea and gastrointestinal distress. 

Always consult your healthcare provider before combining weight loss medications. And better still, you can access our personalized GLP-1 injections with medical supervision.

Can You Switch Between Contrave and Semaglutide?

Yes, switching between medications is possible under medical supervision. 

If Contrave isn't producing adequate results after 12 weeks, your doctor may recommend transitioning to semaglutide. 

Conversely, people who can't tolerate semaglutide's gastrointestinal effects might switch to Contrave. 

How to Choose the Right One for Your Goals?

Step 1: Define Your Weight Loss Target

Determine whether you need modest weight loss (5-10% of body weight) or substantial reduction (10%+). 

Contrave suits smaller goals while semaglutide delivers rapid results. So calculate your target weight and timeline to guide medication selection based on clinical trial outcomes.

Step 2: Evaluate Your Budget and Insurance

Always review your insurance coverage for weight-loss medications and calculate your out-of-pocket costs, including available savings programs. 

Contrave costs less upfront but delivers smaller results, while semaglutide requires a higher investment for superior outcomes. 

Step 3: Consider Your Medical History and Preferences

Discuss medication interactions with your doctor. Choose based on side effect tolerance and lifestyle compatibility for long-term adherence.

Pro Tip:  IvyRx makes this choice easier with a consult that reviews your health record, goals, and budget, then guides you to the proper treatment with steady support.

So start your transformation today. Get a personalized GLP-1 treatment with expert guidance every step of the way.

You can also compare other options in our guides: 

• Contrave vs Mounjaro
• semaglutide vs tirzepatide
• semaglutide vs metformin for weight loss. 

Get Personalized GLP-1 Weight Loss Treatment & Support at IvyRx

Ivy Rx offers direct access to licensed providers who build a treatment plan around your health record, goals, and daily needs. You get prescription GLP-1 care, home delivery, steady progress checks, and clear medical support.

So if you’re ready for real, supervised weight control? You can start your personalized GLP-1 treatment today.