Contrave vs Semaglutide Comparison: Differences, Pros and Cons

When considering options for achieving weight loss goals, two prescription medications, Contrave® and semaglutide, have gained significant attention. As people search for fast and effective methods to lose weight, comparing Contrave^® and semaglutide has raised questions about their different mechanisms of action in managing weight and how well they work.

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Knowing the differences between these two drugs is key for people thinking about using prescription medication to lose weight. Contrave^®, which combines two medicines and semaglutide, was first made to treat diabetes and has shown it can help people drop extra pounds. This article aims to provide information regarding both drugs and look at how they work, possible side effects, and overall performance.

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Key Takeaways

• Contrave^® and semaglutide (Ozempic^® /Wegovy^®) are prescription medications for weight management in adults with obesity or weight-related conditions ^[1].

• Semaglutide acts as a GLP-1 receptor agonist, mimicking gut hormones to reduce appetite and signal fullness to the brain ^[2].

• Contrave^® combines naltrexone and bupropion to curb hunger and cravings ^[2].

• In clinical studies, semaglutide (Wegovy®) demonstrated an average weight loss of 14.9% over 68 weeks, while Contrave® showed an average weight loss of 8.1% over 56 weeks. Individual results may vary, and these medications should be selected based on a healthcare provider's evaluation of each patient’s specific needs and health conditions.

• Side effects: Semaglutide (Wegovy^®) may cause gastrointestinal issues, while Contrave's^® common side effects include nausea and constipation ^[2].

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What Is Contrave^®?

Contrave^®, a prescription drug, was approved for use by the U.S. Food and Drug Administration in 2014 to help adults who are obese or overweight with weight-related health issues to lose weight [4]. This medicine has an influence on weight loss through two main components: bupropion and naltrexone [4].

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Bupropion, also sold as Wellbutrin^®, belongs to the antidepressant category. It has an impact on the brain by stopping dopamine and norepinephrine from being reabsorbed, which can boost mood and turn on reward systems [4]. Naltrexone marketed as ReVia^®, is an opioid blocker used to help people stay away from substance use after they quit alcohol or drugs [4].

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The special mix of these two medicines in Contrave^® has an influence on brain pathways in two ways, leading to less hunger and better control over cravings [4]. People should use it along with a workout plan approved by their doctor, changes in behavior, and a healthy diet that also cuts down on calories [5].

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Contrave^® comes in the form of an oral extended-release (ER) tablet that releases its active ingredients over a period of time. You'll find 8 milligrams (mg) of naltrexone and 90 mg of bupropion in each tablet [6]. Doctors generally prescribe that patients take two tablets twice a day [6]. Talk with your healthcare provider about your specific needs and available options. 

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Contrave® has been shown to assist in weight management, but it is also associated with potential side effects, ranging from mild to serious, including an increased risk of suicidal thoughts and behaviors, particularly in individuals with a history of depression or other mental health conditions. It is essential to use Contrave® under the guidance of a healthcare provider who can monitor for these and other potential side effects.

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Also, some people who use it have reported hot flashes and liver problems [6]. Like all prescription drugs, you should take Contrave^® as prescribed by a doctor.

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If you're considering semaglutide alternatives, options like Contrave^® or other GLP-1 receptor agonists might be effective for weight management and blood sugar control. It's important to discuss these alternatives with your healthcare provider to determine the best fit for your needs and health goals.

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How Does Contrave^® Work?

Contrave^® works to help people lose weight by combining two key ingredients: naltrexone and bupropion. Scientists don't understand the exact brain chemistry behind it, but studies have shown how these components team up to affect hunger and food cravings [7].

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The medicine acts on two crucial brain regions: the hypothalamus and the mesolimbic dopamine circuit. It has an influence on the pro-opiomelanocortin (POMC) cells in the arcuate nucleus of the hypothalamus. These cells make alpha-melanocyte-stimulating hormone (alpha-MSH) and beta-endorphin [7].

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Bupropion, a mild blocker of dopamine and norepinephrine reuptake, boosts the making and release of alpha-MSH and beta-endorphin from POMC cells. Alpha-MSH turns on the melanocortin-4 receptor (MC4R), which results in less food intake and more energy use [7].

Naltrexone, an opioid antagonist, has an impact on the mu-opioid receptor (MOP-R). This blocks it. This action stops the inhibitory feedback of beta-endorphin on POMC cells. As a result, it boosts POMC signaling [7]. When you combine naltrexone and bupropion, it affects POMC signaling more than each drug on its own [7].

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Besides its effect on the hypothalamus, Contrave^® also influences the mesolimbic reward system. A study on mice showed that injecting naltrexone and bupropion into the ventral tegmental area led to a bigger drop in food intake than using either drug alone [7]. This points to the combo having separate yet complementary actions in the mesolimbic dopamine circuit, changing reward values and behaviors aimed at eating [8].

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By focusing on these brain pathways, Contrave^® can impact appetite reduction, craving control, and weight loss promotion when combined with a lower-calorie diet and increased physical activity [4].

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What Is Semaglutide?

Semaglutide copies the hormone glucagon-like peptide-1 (GLP-1) that occurs in the body [9]. It's part of a group of drugs called GLP-1 receptor agonists, which aim to do what the natural GLP-1 hormone does [11]. 

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To get compounded semaglutide, for both the injectable form and oral forms, you need a medical consultation with a qualified healthcare provider to determine if you’re a good candidate for semaglutide treatment. Your doctor will decide if semaglutide is right for you and which type: either the injectable form of semaglutide (Wegovy^®, Ozempic^®) or one of the oral forms of semaglutide (Rybelsus^®, SubMagna™).

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The FDA approved semaglutide for use in 2017 as part of the process to approve Ozempic^®, a shot adults can take to treat type 2 diabetes [9]. In 2019, Rybelsus^® got the FDA's okay as the first GLP-1 receptor agonist you can take by mouth [9]. Just two years later, in 2021, the FDA approved a stronger dose of injectable semaglutide, which goes by the brand name Wegovy^® [9].

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Semaglutide has an influence on the GLP-1 receptor in the brain, which controls appetite [12]. It assists people to lose weight in three main ways:

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1. It affects brain areas that manage appetite after eating, which might help to reduce food intake.

2. It makes the stomach empty more, making people feel full for longer.

3. It has an influence on insulin production and blood glucose level control [10] [12].

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Research shows that people who continue using semaglutide can lose weight and keep the weight off for more than a year when paired with a healthy diet and exercise [12]. People shouldn't mix semaglutide with other products containing the drug or other GLP-1 receptor agonist medicines [12].

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How Does Semaglutide Work?

Semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1 RA), copies the GLP-1 hormone that your gut releases after you eat [11]. This drug matches 94% with human GLP-1 and has 31 amino acids with two main changes that make it work better [13].

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Compounded semaglutide can be used when tailored dosing or specific formulations are needed that aren’t available in standard prescriptions, offering more flexibility for individual patient needs. It’s important to consult with a healthcare provider to ensure the compounded version is safe, effective, and sourced from a reputable source like Eden.

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Semaglutide typically begins to suppress appetite within a few days to a week of starting the medication, with more noticeable effects developing over the first few weeks. Sticking to semaglutide safety guidelines will help you cut down on possible side effects and get the best results as you work to manage your weight.

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Semaglutide works by binding to GLP-1 receptors, which triggers cAMP and PKA signaling [13]. This binding has an impact on several key processes:

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1. Boosted insulin production: Semaglutide prompts pancreatic β-cells to make more insulin, which helps to lower blood sugar levels [11].

2. Glucagon release suppression: Semaglutide stops glucagon secretion, which helps control glucose levels [13].

3. Gastric emptying delay: This effect makes people feel full, leading to less food intake [14].

4. Appetite suppression: Semaglutide has an impact on brain areas that control appetite, which results in less hunger and fewer food cravings [11].

5. Modulation of food preferences: Studies show that this drug lowers people's liking for fatty, high-calorie foods [14].

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These effects work together to improve how the body handles glucose and lead to weight loss. Studies show that people taking 2.4 mg of semaglutide lost about 6% of their weight by week 12 and 12% by week 28 [15].

By mimicking a natural hormone that controls hunger and blood sugar, semaglutide tablets work by helping people manage their weight by reducing food cravings. Semaglutide comes in pill form, as a sublingual suspension, and as an injection. Each type has its pros and cons, and there are several factors to consider when deciding between semaglutide tablets vs injections.

Semaglutide's special structure, which includes changes that make it more resistant to breakdown by enzymes like DPP-4, has an influence on its long half-life of 11 to 13 hours [13]. This means patients need fewer doses compared to other GLP-1 RAs, making it a handy choice for managing weight over time [14].

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Semaglutide And Contrave^® Compared

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Contrave^®: Weight Loss Effectiveness

Contrave^® has an influence on weight management, as shown by promising results in clinical trials. One study revealed that people taking Contrave^® lost 4% to 5% more weight than those on a placebo. Also, 39% to 48% of Contrave^® users cut their body weight by 5% or more, while 16% in the placebo group hit this target [16].

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Semaglutide: Weight Loss Effectiveness

Semaglutide has demonstrated significant weight loss in clinical trials, such as the STEP 1 trial, where participants taking a 2.4 mg dose of semaglutide lost an average of 14.9% of their body weight over 68 weeks. These results highlight the potential of semaglutide as part of a comprehensive weight management plan, though individual results may vary. What's more, 69% of patients shed over 10% of their body weight [17]. 

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Contrave^®: Safety

Contrave^® has an impact on patients with side effects like nausea, constipation, headaches, and sleep problems. To reduce these issues, doctors start with a low dose and increase it. Other possible side effects include dry mouth, dizziness, and higher blood pressure. In rare cases, people have reported liver damage, so regular check-ups are needed [18]. The FDA has put a black box warning on Contrave^® because it might cause suicidal thoughts. This is due to bupropion, one of the main ingredients in the drug [16].

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Semaglutide: Safety

Semaglutide's most frequent side effects affect the gut. These include feeling sick, having loose stools, and having trouble going to the bathroom. Most people find these problems mild and see them go away in a few weeks. It's crucial to keep an eye on heart rate and blood pressure because semaglutide might make them go up [18]. 

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Semaglutide carries a black box warning for the potential risk of thyroid C-cell tumors, as observed in rodent studies. It is important to discuss all potential risks, including gastrointestinal issues, with your healthcare provider before starting treatment.

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If you’re wondering how long semaglutide stays in your system, it has a half-life of about a week. This means it can linger in your system for several weeks after you take your final dose. Sticking to semaglutide safety guidelines will help you cut down on possible side effects and get the best results as you work to manage your weight.

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Contrave^®: Cost

The cost of Contrave^®, a prescription medication used for weight management, can vary depending on factors like insurance coverage, pharmacy, and whether you purchase a generic version. Without insurance, the retail price can range from about $100 to $300 for a 30-day supply [18]. With insurance or discount programs, the out-of-pocket cost may be significantly lower, sometimes around $20 to $60 per month [18]. Contrave^® might be cheaper for some people since it comes in a generic form [18].

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Semaglutide: Cost

The Ozempic injection price can vary depending on factors such as insurance coverage, dosage, and the pharmacy you use. Without insurance, the retail price for a one-month supply (typically one pen) can range from $800 to $1,200.

With insurance, out-of-pocket costs may be significantly lower, sometimes ranging from $25 to $100 per month, depending on your plan.

The semaglutide costs can add up quickly if your insurance doesn't cover it. Prices can change based on your insurance plan, where you buy the semaglutide, and other factors. Research shows patients might pay up to 68% of the cost themselves for weight loss drugs.

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Semaglutide vs Contrave^®: Pros And Cons

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Semaglutide Pros

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• Weight reduction: Research studies show that people who take semaglutide lose about 15% of their body weight on average [10].

• Hunger management: Semaglutide copies what GLP-1 does in the body, which helps to control appetite and make you feel less hungry [10].

• Blood sugar control: Has a positive impact on people with type 2 diabetes [10].

• Non-surgical option: Offers a way to lose weight without surgery [10].

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Semaglutide Cons

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• Side effects: Users often experience nausea, diarrhea, constipation, and stomach pain [10].

• Administration method: Requires shots every week, which some users might find inconvenient [10].

• Cost: Can be pricey, and insurance coverage varies [10].

• Long-term effects: We don't yet grasp the long-term impacts of using it for a long time [10].

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Contrave^® Pros

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• Positive results: Studies show 39% to 48% of people lost 5% or more of their body weight [16].

• Two-pronged approach: Uses bupropion and naltrexone to target both hunger and food cravings [16].

• Oral medication: Comes as a tablet, which some patients might like better than injections [16].

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Contrave^® Cons

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• Side effects: Can lead to nausea, constipation, headaches, and sleep problems [18].

• Safety concerns: Has a black box warning because it might cause suicidal thoughts linked to bupropion [16].

• Gradual dosage increase: Needs a slow uptick in dosage to cut down side effects [18].

• Monitoring: Calls for regular liver function checks due to rare instances of liver damage [18].

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Contrave^® vs Semaglutide Overall

Contrave^® and semaglutide differ in several important ways. Contrave^® combines naltrexone and bupropion in a pill form. People take it once or twice a day to treat long-term obesity [16]. Semaglutide goes by two brand names: Ozempic^® for diabetes and Wegovy^® for weight loss. Patients receive it as a shot every week [16].

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The two medications differ in how well they work. Contrave^® shows promise, with 39% to 48% of people who take it losing 5% or more of their body weight [3]. Semaglutide, on the other hand, leads to more significant weight loss. People in clinical trials who took semaglutide lost an average of 15% of their body weight [16].

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The two drugs share similar side effects concerning stomach problems like feeling sick, having trouble passing stool, and diarrhea [16]. But Contrave^® might make your blood pressure go up and leave your mouth feeling dry. On the other hand, semaglutide can affect eyesight and cause the pancreas to swell up in some people [16].

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It's essential to understand semaglutide dosages and guidelines. Many individuals have successfully lost weight while using semaglutide as part of a medically supervised treatment plan. These semaglutide success stories show how semaglutide can help people shed weight and boost their overall health. Always talk to your doctor to figure out the best way to treat your condition.

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Final Thoughts on Contrave^® and Semaglutide

Contrave® and semaglutide provide different approaches to weight management, each with specific benefits and potential risks. The choice between these medications should be made in consultation with a healthcare provider, who can consider individual health conditions, goals, and potential side effects. You should work with your doctor to figure out which option suits your weight loss goals best.

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These drugs work best when you use them as part of a full weight management plan. This means eating a balanced diet, working out, and changing your lifestyle.  One of the most effective semaglutide tips for weight loss is to pair the medication with a balanced diet and regular exercise to enhance results. Maintaining consistent dosing and tracking your progress is crucial for achieving and sustaining your weight loss goals. If you're looking for a reputable semaglutide program, Eden offers personalized plans designed to optimize weight loss and overall health. Combining expert guidance with customized dosing, Eden helps you achieve the best results with semaglutide.

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FAQ

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Can you take semaglutide and Contrave^® together?

There is limited clinical evidence on the safety of combining semaglutide and Contrave®. Because both medications have different mechanisms of action and potential side effects, it is crucial to consult with a healthcare provider before considering the use of both drugs simultaneously.

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Contrave^® has more drug interactions than semaglutide. It can interact with monoamine oxidase inhibitors (MAOIs), which may cause a big jump in blood pressure if you take them together or within 14 days of stopping an MAOI [1]. Because of its naltrexone part, Contrave^® can stop opioid pain medications from working [1]. It might also interact with medications that the liver processes, including some antidepressants, antipsychotics, and antivirals [1].

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Is Contrave^® more effective than Ozempic^®?

The effectiveness of Contrave® versus Ozempic® (semaglutide) can vary based on individual patient factors, including their overall health, weight loss goals, and any underlying conditions such as type 2 diabetes. Clinical trials indicate that semaglutide may lead to greater average weight loss compared to Contrave®, but the best choice depends on personalized medical advice.

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References

1. Sison G. Contrave vs. Wegovy: Differences, similarities & side effects. The Checkup. Published June 19, 2024. Accessed August 18, 2024. https://www.singlecare.com/blog/contrave-vs-wegovy/

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2. Dr. V Medical and Aesthetics. Semaglutide vs Contrave. Dr. V Medical Aesthetics. Published December 25, 2023. Accessed August 18, 2024. https://www.drvaesthetics.com/semaglutide-vs-contrave/

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3. Drugs.com. Contrave vs Semaglutide Comparison - Drugs.com. Drugs.com. Published 2014. Accessed August 18, 2024. https://www.drugs.com/compare/contrave-vs-semaglutide

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4. Weiman E, Suero Salvador, MD T. Contrave for Weight Loss: Uses, Side Effects, and Precautions. Sesame Care. Published December 22, 2023. Accessed August 18, 2024. https://sesamecare.com/blog/contrave-for-weight-loss

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5. WebMD. Drugs & Medications. webmd.com. Published 2024. Accessed August 18, 2024. https://www.webmd.com/drugs/2/drug-166975/contrave-oral/details

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6. Medical News Today. Contrave: Side effects, for weight loss, dosage, and more. medicalnewstoday.com. Published September 26, 2021. Accessed August 18, 2024. https://www.medicalnewstoday.com/articles/drugs-contrave

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7. Sherman MM, Ungureanu S, Rey JA. Naltrexone/Bupropion ER (Contrave). Pharmacy and Therapeutics. 2016;41(3):164-172. Accessed August 18, 2024. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4771085/

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8. Ornellas T, Chavez B. Naltrexone SR/Bupropion SR (Contrave). Pharmacy and Therapeutics. 2011;36(5):255-262. Accessed August 18, 2024. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3138366/

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9. Weiman E, Suero Salvador, MD T. Semaglutide for Weight Loss: Benefits, Side Effects, and More. Sesame Care. Published December 19, 2023. Accessed August 18, 2024. https://sesamecare.com/blog/semaglutide-for-weight-loss

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10. Southwest Family Medical. The Pros and Cons of Semaglutide for Weight Loss - Dr. Taylor. swfamilymedical.com. Published September 7, 2023. Accessed August 18, 2024. https://swfamilymedical.com/pros-cons-semaglutide-for-weight-loss/

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11. UCLA Health. Semaglutide, also known as Ozempic, for weight loss - what you need to know. uclahealth.org. Published January 12, 2023. Accessed August 18, 2024. https://www.uclahealth.org/news/article/semaglutide-weight-loss-what-you-need-know

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12. Anderson LA. How does semaglutide work for weight loss? Drugs.com. Published March 9, 2024. Accessed August 18, 2024. https://www.drugs.com/medical-answers/semaglutide-work-weight-loss-3573689/

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13. Tamayo-Trujillo R, Ruiz-Pozo VA, Cadena-Ullauri S, Paz-Cruz E. Molecular mechanisms of semaglutide and liraglutide as a therapeutic option for obesity. Frontiers. Published April 28, 2024. Accessed August 18, 2024. https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2024.1398059/full

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14. Alorfi NM, Algarni AS. Clinical Impact of Semaglutide, a Glucagon-Like Peptide-1 Receptor Agonist, on Obesity Management: A Review. Clinical Pharmacology: Advances and Applications. 2022;Volume 14:61-67. doi: https://doi.org/10.2147/cpaa.s374741

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15. Ghusn W, De la Rosa A, Sacoto D, et al. Weight Loss Outcomes Associated With Semaglutide Treatment for Patients With Overweight or Obesity. JAMA Network Open. 2022;5(9):e2231982. doi: https://doi.org/10.1001/jamanetworkopen.2022.31982

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16. Recovery Delivered. Contrave vs. Ozempic: A Side-By-Side Comparison. Recovery Delivered - Online Suboxone Treatment. Published December 11, 2023. Accessed August 18, 2024. https://www.recoverydelivered.com/addiction-blog/contrave-vs-ozempic-a-side-by-side-comparison/

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17. Kim N, Wang J, Burudpakdee C, et al. Cost-effectiveness analysis of semaglutide 2.4 mg for the treatment of adult patients with overweight and obesity in the United States. Journal of Managed Care & Specialty Pharmacy. 2022;28(7):740-752. doi: https://doi.org/10.18553/jmcp.2022.28.7.740

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18. Madison Wellness & Aesthetic Center. CONTRAVE VS. SEMAGLUTIDE FOR WEIGHT MANAGEMENT. madisonfamilycare.com. Published February 15, 2024. Accessed August 18, 2024. https://madisonfamilycare.com/blog/contrave-vs-semaglutide-for-weight-management/

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19. Pauley C. Contrave vs Ozempic for Weight Loss - What’s the Difference? Form Health. Published October 17, 2023. Accessed August 18, 2024. https://www.formhealth.co/blog/contrave-vs-ozempic/

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20. The Sleeve Clinic. Ozempic vs. Contrave For Weight Loss: A Comparision. sleeveclinic.com. Published December 2023. Accessed August 18, 2024. https://sleeveclinic.ca/blog/ozempic-vs-contrave/

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‌Disclaimer: The FDA does not approve compounded medications for safety, quality, or manufacturing. Prescriptions and a medical evaluation are required for certain products. The information provided on this blog is for general informational purposes only. It is not intended as a substitute for professional advice from a qualified healthcare professional and should not be relied upon as personal health advice. The information contained in this blog is not meant to diagnose, treat, cure, or prevent any disease. Readers are advised to consult with a qualified healthcare professional for any medical concerns, including side effects. Use of this blog's information is at your own risk. The blog owner is not responsible for any adverse effects or consequences resulting from the use of any suggestions or information provided in this blog.

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