Contrave vs Ozempic 2026: Weight Loss, Cost & Side Effects Comparison

Contrave and Ozempic are both prescription weight loss medications but they work through very different mechanisms and produce notably different results. Ozempic (semaglutide) typically delivers 10 to 15% body weight loss over 68 weeks while Contrave produces an average of 5 to 8% weight loss over 56 weeks. However, the right choice depends on your individual health history, budget and lifestyle preferences.

Both medications are designed for long term weight management and require combining them with healthy eating and regular physical activity for optimal results. Neither is a quick fix as sustainable weight loss requires making lasting lifestyle changes while using these medications.

TL;DR

• Ozempic wins for weight loss results (15% vs 5 to 8% body weight) but both medications serve different purposes. Ozempic (semaglutide) is a GLP 1 receptor agonist injection delivering superior weight loss through appetite suppression and blood sugar control
• Contrave (naltrexone/bupropion) is an oral medication targeting the brain’s reward system to control cravings and emotional eating 
• Contrave costs $444.58 monthly versus Ozempic’s $419.95. Ozempic is slightly cheaper and more effective for weight loss and blood sugar control while Contrave focuses on appetite suppression with modest results
• Both require a healthcare provider’s prescription and work best with healthy lifestyle changes
• Choose Ozempic for maximum weight loss; choose Contrave if you prefer pills over injections or struggle primarily with emotional eating and food cravings

Contrave vs Ozempic: How They Work

Contrave and Ozempic are very different medications that target distinct biological pathways to help you lose weight. Understanding these mechanisms can help you determine which aligns better with your weight loss journey.

Contrave (Naltrexone/Bupropion)

Contrave is a combination medication containing two active ingredients: naltrexone (an opioid blocker) and bupropion (which affects dopamine and norepinephrine). The bupropion component is same active ingredient found in antidepressant medications like Wellbutrin.

This dual action formula targets brain’s reward system and appetite control center to reduce cravings and help control emotional eating. Contrave is particularly effective for individuals who struggle with impulsive eating behaviors and food cravings rather than simple hunger.

In the COR-I clinical trial, participants taking the maximum dose of Contrave lost an average of 5 to 6% of their body weight over 56 weeks compared to placebo group. Participants who stayed on Contrave for entire 56 weeks saw even better results with completers achieving approximately 8% body weight loss.

Ozempic (Semaglutide)

Ozempic contains semaglutide, a GLP 1 receptor agonist that mimics a natural hormone your body naturally produces called glucagon like peptide 1. This hormone regulates appetite and blood sugar levels by slowing stomach emptying and signaling fullness to the brain.

Originally approved for type 2 diabetes and blood sugar control, Ozempic is frequently prescribed off label for weight loss due to its impressive results. According to the STEP 1 trial published in the New England Journal of Medicine, patients taking semaglutide 2.4 mg weekly lost an average of 14.9% of their body weight over 68 weeks when combined with healthy lifestyle changes.

Contrave vs Ozempic – Weight Loss Results

When comparing weight loss effectiveness, Ozempic generally leads to more significant weight loss than Contrave. Here’s how the clinical data compares:

Why Ozempic Beats Contrave for Weight Loss

Weight loss with Ozempic can typically reach between 10% and 15% of total body weight over 68 weeks with some studies showing losses up to 20%. The STEP 5 trial demonstrated sustained weight loss of 15.2% over 104 weeks (2 years).

In clinical trials, people taking Contrave lost an average of approximately 8.1% of their total body weight over 56 weeks at the maximum dose. Participants who stayed on Contrave for the entire study period lost an average of 11.5% of their total body weight – still significant, but less than Ozempic’s average results.

In a study of people with overweight or obesity and type 2 diabetes, Ozempic 2 mg weekly produced an average weight loss of 14.1 pounds over 40 weeks – demonstrating effectiveness even in populations that often have more difficulty losing weight.

Important note: Weight loss results for Ozempic and Contrave can vary widely among individuals and can be affected by many factors including lifestyle changes, adherence to the medication and individual metabolism.

When Contrave May Be Preferred

Contrave is often preferred for individuals struggling with craving control especially emotional eating. If your weight gain is driven primarily by cravings, impulsive eating or using food as an emotional coping mechanism, Contrave’s action on the brain’s reward system may be particularly beneficial.

Contrave vs Ozempic Cost 2026

Cost is often a deciding factor when choosing between weight loss medications.

Contrave costs $444.58 versus Ozempic’s $419.95. Ozempic is slightly cheaper and more effective for weight loss and blood sugar control while Contrave focuses on appetite suppression with modest results.

Contrave vs Ozempic Side Effects

Both Contrave and Ozempic can cause gastrointestinal side effects such as nausea, vomiting, and constipation. However, each medication has unique risks based on its mechanism of action.

Contrave Serious Risks

Contrave carries a boxed warning for an increased risk of suicidal thoughts and behaviors, particularly in adolescents and young adults. This warning applies due to the bupropion component, which is also used in antidepressant medications.

Contrave should NOT be used if you:

•  Have uncontrolled high blood pressure
• Have a seizure disorder or history of seizures
• Are taking monoamine oxidase inhibitors (MAOIs)
• Have an eating disorder (bulimia or anorexia)
• Are dependent on opioids or going through opioid withdrawal
•  Are taking other medications containing bupropion

Contrave can also cause increased blood pressure so regular monitoring is recommended. Drug interactions are possible with prescription pain medications and other medications.

Ozempic Serious Risks 

Ozempic has a boxed warning from the FDA for the potential risk of thyroid C-cell tumors based on animal studies. In rodent studies, semaglutide caused thyroid tumors including medullary thyroid carcinoma.

Ozempic should NOT be used if you have:

• A personal or family history of medullary thyroid cancer
• Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
• A history of pancreatitis
• Severe kidney problems

Ozempic is linked to risks of pancreatitis, kidney problems and potential thyroid tumors (specifically medullary thyroid carcinoma). Other potential risks include gallbladder disease, low blood sugar (especially when combined with other diabetes medications) and diabetic retinopathy complications.

Contrave vs Ozempic: Dosage & Administration

The administration method is key difference between these medications and may influence your choice.

Why Ozempic Wins for Compliance

Studies show significantly better adherence rates with weekly injections compared to medications requiring multiple daily doses. The convenience of one injection per week versus remembering 4 pills daily makes Ozempic easier for many people to maintain long term.

Contrave vs Ozempic: Which Is Better For You?

Choosing between Contrave and Ozempic depends on individual health needs, budget and lifestyle preferences. Both medications are prescription only and require a healthcare provider’s evaluation to determine suitability.

Cardiovascular Considerations

Ozempic has cardiovascular benefits, reducing the risk of heart attack and stroke in patients with Type 2 diabetes. The SELECT trial demonstrated a 20% reduction in major cardiovascular events (cardiovascular death, heart attack, stroke) in people with overweight or obesity and established cardiovascular disease.

Contrave’s effect on cardiovascular morbidity and mortality has not been established. People with uncontrolled high blood pressure should not take Contrave.

Can You Take Contrave and Ozempic Together?

Taking Contrave and Ozempic together is possible under close doctor supervision but this combination has not been extensively studied. Some healthcare providers may prescribe both for patients who need additional craving control alongside appetite suppression. Always consult your healthcare provider before combining any weight loss medications.

Conclusion

Both Contrave and Ozempic can help reduce appetite and cravings contributing to weight loss when combined with healthy lifestyle changes. Semaglutide (Ozempic) generally offers superior weight loss results compared to Contrave but best choice depends on your individual circumstances.

Consult with your healthcare provider to review your medical history, health history, family history and current medications to determine which weight loss medication is right for your weight management goals. Both medications require ongoing monitoring and should be part of a comprehensive weight loss journey that includes healthy lifestyle changes.

References & Resources

Ozempic Prescribing Information 

Contrave Prescribing Information