Contrave® vs. Ozempic® for weight loss: Which one works best in 2025?

What you’ll learn:

• Ozempic^® is a weekly injection that mimics a natural hormone to help control appetite, while Contrave^® is a daily pill that combines two medications to reduce cravings.  
• Ozempic^® typically results in greater weight loss than Contrave^®, but both can be very effective.
• Both medications work best when paired with healthy eating habits and regular exercise.

It can feel like Ozempic^® is everywhere right now—and it’s definitely top of mind for many people exploring weight loss medications. Originally developed to treat type 2 diabetes, Ozempic^® has become a popular off-label option for weight management thanks to its impressive results. But it’s not the only choice out there.

Contrave^® is another FDA-approved weight loss medication that takes a very different approach. While both can support weight loss, they work differently in the body and come in different forms—Ozempic^® is a once-weekly injection, while Contrave^® is a pill you take twice a day. They also have very different costs associated with them, which can be a big part of choosing one or the other for some people.

Let’s break down the key differences between Contrave^® and Ozempic^®, including how they work, how much they cost, what side effects to expect, and how much weight people typically lose. Use this info to start a conversation with your doctor about which option could be the best fit for you.

Ozempic^® vs. Contrave^®: How do they work?

Both Ozempic® and Contrave^® can support healthy weight loss, but they work in very different ways. Let’s take a closer look at their active ingredients and what they do:

Semaglutide (Ozempic^®)

Semaglutide is the active ingredient in Ozempic^®. It belongs to a class of medications called GLP-1 receptor agonists, which means they mimic the hormone GLP-1. This hormone plays a key role in regulating appetite, slowing digestion, and helping your body maintain stable blood sugar levels after eating. By enhancing this process, semaglutide helps you feel fuller longer on less food, making it easier to make healthier choices and lower your calorie intake. 

Naltrexone and bupropion (Contrave^®)

Contrave^® is a combination of two medications—bupropion and naltrexone—that work together to target the areas of the brain involved in appetite and impulse control. Here’s a closer look:

• Bupropion: This medication is often used alone as an antidepressant and off-label for ADHD. In Contrave^®, it helps curb appetite.
• Naltrexone: This medication is commonly used to treat addiction when used alone. In Contrave^®, its role is to help control cravings and impulsive eating behaviors.
  

Ozempic^® vs. Contrave^®: What are the differences?

As we’ve said, Contrave^® and Ozempic^® are two very different medications. Each comes with its own characteristics, costs, side effects, and potential benefits. Which one is right for you will depend on your preferences, budget, health history, and weight loss goals. Here’s a breakdown of their key differences—and a few helpful talking points for your doctor’s appointment.

They have different FDA approvals

Contrave^® is FDA-approved for weight loss, while Ozempic^® is frequently prescribed off-label, though it’s approved for type 2 diabetes. 

That doesn’t necessarily mean one is better than the other—it really comes down to what your goals are and how your body responds. FDA approval means a medication has been specifically studied and cleared for a certain use, like weight management in the case of Contrave^®.

With off-label use, like Ozempic^® for weight loss, doctors are prescribing a medication based on strong clinical evidence, even if the official FDA approval is for something else. Many weight loss specialists use Ozempic^® off-label because research and real-world results show it can be highly effective. 

If you’re looking for the FDA-approved version, Ozempic^®’s sister medication Wegovy^® has the same active ingredient and is FDA-approved for weight loss. 

They are both unlikely to be covered by insurance

Don’t expect either to be covered by insurance. Weight loss medications, in general, are unlikely to be covered by insurance. Ozempic^® might be covered if prescribed for type 2 diabetes, but coverage is unlikely for weight loss. The same holds true for Wegovy^®. Even though it is FDA-approved for weight loss, coverage is unlikely. 

They are taken differently

Ozempic^® is a once-weekly injection, self-administered using a pre-filled pen. Contrave^® is a twice-daily oral medication taken as a pill. For both, a person will start on the lowest dose, and it will be increased gradually over several weeks to minimize side effects.

Ozempic^® is likely to be more effective for weight loss

Both medications can help you lose weight, especially when combined with lifestyle changes, but Ozempic^® tends to produce more dramatic results. We’ll go into the specifics and what the studies show. 

Ozempic^® vs. Contrave^®: What are the similarities?

Ozempic^® and Contrave^® work differently, but they occasionally share the common goal of helping people lose weight. Here’s how they’re alike:

Both help reduce appetite 

Whether it’s through hormone regulation (Ozempic^®) or targeting brain signals (Contrave^®), both medications work to curb hunger and help you feel satisfied with less food.

Both are prescription-only medications 

Neither of these medications is available over the counter. A healthcare provider must evaluate your health history and determine if Ozempic^® or Contrave^® is the right fit for you.

They can both be expensive without insurance

Ozempic^® and Contrave^® can be expensive medications, and coverage for weight loss is unlikely. With both, you have options that can help you save, which we’ll go through below.

Ozempic^® vs. Contrave^®: Which is better for weight loss?

Both medications can be effective, but their weight loss potential differs significantly.

• Ozempic^® (semaglutide): People using semaglutide for weight loss lost an average of 15% of their body weight over 68 weeks in one study. Nearly one-third lost 20% or more of their body weight. The study also emphasized that semaglutide, when combined with lifestyle changes, consistently outperformed the placebo in both weight loss and improvements in cardiovascular risk factors, including waist circumference, blood pressure, and cholesterol. 
• Contrave^® (naltrexone and bupropion): In a study, Contrave^® resulted in a modest weight loss of approximately 5 to 10% of body weight over a period of about a year. The medication was also shown to help sustain weight loss over time and improve control over eating behavior, like cravings and emotional eating. 

While Ozempic^® generally leads to more significant weight loss, Contrave^® can still be effective, especially for people struggling with food cravings and emotional eating. Regardless of which medication you choose, lifestyle changes—like healthier eating and regular movement—can improve your results.

How long does it take to see results?

These medications are designed to help people lose steady weight over time. Most people notice progress within the first few weeks. Here’s what people can expect to lose in terms of average body weight percentage with both:

After 3 months

• Ozempic^®: 6%
• Contrave^®: About 5%

After 1 year

• Ozempic^®: 15% to 20%
• Contrave^®: 5% to 10%

Everyone’s body responds differently, depending on the lifestyle changes they make while taking the medication.

Who can take Ozempic^® or Contrave^® for weight loss?

If you’re considering Ozempic^® or Contrave^® for weight loss, your BMI and overall health will play a key role in determining your eligibility. Here’s a breakdown of who may qualify for each medication (again for Ozempic^® this will be an off-label use):

• Adults with a BMI of 30 or higher

or

• Adults with a BMI of 27 or higher and at least one weight-related condition, such as high blood pressure or high cholesterol.

Who shouldn’t take Ozempic^® or Contrave^®?

While Ozempic^® and Contrave^® can aid in weight loss, they are not suitable for everyone. Below are the groups who should avoid these medications due to safety concerns.

Ozempic

If you have any of the following conditions, Ozempic^® may not be a safe option for you:

• A personal or family history of medullary thyroid carcinoma (MTC)
• Multiple endocrine neoplasia syndrome type 2 (MEN2)
• A severe allergic reaction to semaglutide or any of its ingredients

Ask your doctor if Ozempic^® is right for you if you have a history of:

• Pancreatitis (acute or chronic)
• Severe gastrointestinal conditions, such as gastroparesis
• Kidney disease or kidney failure, as this medication may worsen kidney function
• Severe diabetic retinopathy, since GLP-1 medications could increase the risk of complications

If you are pregnant, planning to become pregnant, or breastfeeding, you shouldn’t take Ozempic^®.

Contrave^®

Contrave^® may not be safe for people with certain health conditions. You should avoid Contrave^® if you:

• Have a history of seizures, since bupropion can lower the seizure threshold
• Are dependent on opioids or in opioid withdrawal, as the naltrexone component can trigger withdrawal symptoms
• Have uncontrolled high blood pressure, because bupropion can further increase blood pressure
• Have or have had an eating disorder like bulimia or anorexia
• Are taking monoamine oxidase inhibitors (MAOIs), or have used them in the last 14 days
• Have severe liver or kidney disease, which may impair how your body processes the medication
• Have a history of bipolar disorder, since bupropion may trigger manic episodes
• Are pregnant or breastfeeding

Before starting either of these medications, it’s important to talk to your doctor about your medical history. They can help you determine if Ozempic^® or Contrave^® is the right fit for you or if another weight-loss option might be safer and more effective.

Can you switch between Ozempic^® and Contrave^®?

You can switch between Ozempic^® and Contrave^®, but it’s important to understand that these medications work differently to support weight loss. Ozempic^® mimics the GLP-1 hormone, which helps control appetite and regulate blood sugar, while Contrave^® targets the brain’s reward system to reduce cravings and emotional eating. Because of this, you may experience the following changes:

• Appetite control – You might notice a shift in how you feel hunger and fullness.
• Differences in weight loss results – You may find that weight loss slows down or speeds up with one or the other, especially in the early stages.
• New side effects – While Ozempic^® is more likely to cause nausea and gastrointestinal discomfort, Contrave^® can sometimes lead to insomnia, dizziness, or an increased heart rate. If you experience trouble sleeping, taking Contrave^® earlier in the day may help.
• Adjusting to a new routine – Ozempic^® is a once-weekly injection, while Contrave^® requires twice-a-day dosing. This change in routine may take some time to get used to.

How to manage the transition

• Always talk to your doctor first – A healthcare provider can guide you through the best approach to switching.
• Stay hydrated & eat small meals – This can help reduce nausea and keep your digestion steady as your body adjusts.
• Focus on healthy lifestyle habits – Making mindful food choices and staying active can help you maintain progress with both medications.
• Be patient with your body – Adjusting to a new medication takes time. Give yourself a few weeks to see how your body responds.

If you take Contrave^® or Ozempic^® to lose weight, will you need to keep taking them forever?

Weight-loss medications like Ozempic^® and Contrave^® aren’t quick fixes—they’re designed for long-term use to help people maintain weight loss. These medications work by altering appetite regulation and metabolism, which means their benefits only last as long as you continue taking them.

So, what happens when you stop taking them? Here’s what you can expect.

• Potential weight regain
• Slower metabolism
• Increased hunger and cravings

Ozempic^®

• How long will I take it? Ozempic^® is typically used as a long-term treatment, often for a year or more for weight loss. 
• Will I have to taper off of it? Tapering off Ozempic^® is recommended to preserve weight loss and lower appetite rebound. A study found that people who tapered off semaglutide over nine weeks were able to maintain their weight for six months. 

Contrave^®

• How long will I take it? Most studies have looked at the results of Contrave^® over a one-year period. Some people stay on it longer if it continues to help with weight management.
• Will I have to taper off of it? Tapering off Contrave^® is also recommended because it contains bupropion, an antidepressant that can lead to withdrawal symptoms if discontinued suddenly. 

Follow your doctor’s instructions for both medications.

What’s the best way to maintain weight loss?

The best way to make weight loss sustainable and to stop taking medications safely is by making lasting lifestyle changes while taking them. Studies consistently show that people who combine GLP-1 medications with healthy lifestyle changes lose more weight and keep it off longer than those who rely on medication alone. 

While drugs like Ozempic^® and Contrave^® can be incredibly effective tools, they work best as part of a comprehensive plan that includes healthy eating, physical activity, and behavioral support, not as a stand-alone solution. 

Noom can help you develop healthier eating habits and a better relationship with food, which can make a big difference in long-term weight management. Regular exercise also plays a crucial role, not just in maintaining weight loss but in boosting metabolism and improving overall health.

Ozempic^® vs. Contrave^®: Dosage and administration

Ozempic^® is a once-a-week injection, while Contrave^® comes as a pill that you take twice a day. With both, you’ll start at a lower dose and slowly increase it over time. This step-up approach helps your body adjust and can make side effects easier to manage.

Here’s what you need to know about how each one is taken.

Ozempic^®

To take Ozempic^®, you give yourself a once-weekly injection with a pre-filled pen. 

• How to take it: Inject yourself on the same day every week. The time of day doesn’t matter. You will give yourself the injection in the abdomen, thigh, or upper arm. Be sure to rotate spots with each injection to limit irritation. Let your doctor know if you notice redness or swelling that doesn’t go away.
• Doses: 0.25 mg, 0.5 mg, 1 mg, 2 mg
• Dosing: Your doctor will start you on the lowest dose (0.25 mg) and will increase it gradually to minimize side effects. If you need more than 2 mg to continue losing weight, your doctor will switch you to Wegovy^®, which goes up to 2.4 mg.
• What to do if I miss a dose: If you miss a dose, you have up to 5 days to take it—after that, it’s best to skip and resume your next scheduled injection. If you take the injection on a different day, make that your new day to take Ozempic^® the following week.
• Storage: Ozempic^® should be stored in the refrigerator before it’s opened, ideally between 36°F and 46°F (2°C to 8°C). Once you’ve started using the pen, it can be stored either in the refrigerator or at room temperature, as long as the temperature doesn’t exceed 86°F (30°C). Make sure to always keep the cap on when not in use and avoid exposing it to direct sunlight or heat.

Contrave^® 

Contrave^® is taken by mouth as a tablet, typically twice a day. 

• How to take it: It’s important to take Contrave√ at the same time every day, but not with a high-fat meal, as this can increase the risk of side effects.
• Doses: One tablet of Contrave^® contains 8 mg of naltrexone and 90 mg of bupropion.
• Dosing: Contrave^® begins at a low dose to minimize side effects, typically starting with one tablet per day. Most people end up taking two tablets in the morning and two in the evening, for a maximum of four tablets per day.
• What to do if you miss a dose: If you miss a dose, skip it and take your next scheduled dose at the usual time. Don’t double up or take extra tablets to make up for a missed dose.
• Storage: There are no special storage requirements for Contrave^®, but it’s important to keep it in its original container and out of reach of children.

Contrave^® vs. Ozempic^®: Costs and insurance

When it comes to weight-loss medications, cost is often a big deciding factor. Understanding the differences in pricing can help you weigh your options, so let’s break down the costs and insurance coverage for Ozempic^® and Contrave^® to see how they compare.

Ozempic^®

Without insurance, Ozempic^® typically costs around $998 per month. 

• Insurance considerations: Most insurance providers don’t cover Ozempic^® for weight loss. 
• How to save: Wegovy^® contains the same active ingredient as Ozempic^® but can be prescribed at a higher maximum dosage (2.4 mg). Without insurance, it can cost more than Ozempic^®, $1,350 per month. If you get it through NovoNordisk’s NovoCare Pharmacy, the price is $499 per month for all doses. 

Learn more about the cost of Ozempic^®. 

Contrave^®

Contrave^®’s list price ranges from $500 to $700 per month without insurance. 

• Insurance considerations: Contrave^® is also rarely covered by insurance for weight loss.  
• How to save: The manufacturer’s CurAccess™ Patient Support Program allows people who don’t have insurance coverage to get it for $99 per month.

Learn more about the cost of Contrave^®.

Ozempic^® vs. Contrave^®: Side effects

If you’re considering Ozempic^® or Contrave^® for weight management, it’s important to know the potential side effects. While both medications can be effective tools for weight loss, side effects vary from person to person. Here’s what you should be aware of, from more common, mild effects to more serious reactions that need to be checked out by a doctor:

Common side effects

Both medications are more likely to cause side effects when you first start them or when your doctor ups your dose. Here’s what you can expect:

Ozempic^®

• Nausea
• Vomiting
• Diarrhea or constipation
• Fatigue
• Stomach pain

Contrave^®

• Nausea
• Constipation
• Anxiety
• Headache
• Dizziness
• Trouble sleeping
• Dry mouth

Serious side effects and warnings

While Ozempic^® and Contrave^® are generally well-tolerated, they can come with rare but serious risks that shouldn’t be overlooked. Though most people experience only mild side effects, some people may develop more severe reactions. Here’s what to look out for:

Boxed warning for Ozempic^®

Ozempic^® carries an FDA-boxed warning for the potential risk of thyroid C-cell tumors. This warning is based on findings from animal studies, but it has not yet been confirmed whether this risk applies to humans. Do not take these medications if you or a family member has a history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2). Get immediate medical help for unexplained lumps in the throat.

Boxed warning for Contrave^® 

Contrave^® carries an FDA-boxed warning for an increased risk of suicidal thoughts and behaviors, particularly in adolescents and young adults. This warning is due to the bupropion component, which affects neurotransmitters in the brain and has been associated with mood changes, depression, and suicidal ideation in some people. Get immediate medical help for concerning mental changes.

Get immediate medical help if you experience any of the following:

Ozempic^®:

• Pancreatitis: Symptoms include severe abdominal pain, nausea, and vomiting, along with tenderness when touching the stomach
• Kidney problems: Side effects of Ozempic^® could lead to dehydration and worsen kidney function, particularly in those with preexisting kidney disease. Symptoms may include swelling in the legs or ankles, decreased urination, and fatigue.
• Low blood sugar (hypoglycemia): Symptoms include dizziness, shakiness, blurred vision, fast heartbeat, and feeling jittery. This is much more common in people who are taking other medications for diabetes.
• Vision changes: If you notice any sudden changes in your vision while taking Ozempic^®, including blurriness, dark spots, or difficulty focusing, get immediate medical attention.
• Gallbladder disease: Symptoms include sudden right-sided abdominal pain, nausea, vomiting, fever, or yellowing of the skin or eyes (jaundice).
• Severe allergic reactions: If you have symptoms like swelling of the face, throat, or difficulty breathing, get immediate medical attention.

For a full breakdown of potential risks, see the Ozempic^® safety information.

Contrave^®:

• Seizures: Bupropion, one of the ingredients in Contrave^®, lowers the seizure threshold, increasing the risk in those prone to seizures. Symptoms include sudden convulsions, loss of consciousness, stiffening of muscles, or jerking movements.
• Mood changes and suicidal thoughts: Symptoms to watch for include sudden mood swings and changes in behavior.
• Increased blood pressure and heart rate: Symptoms include persistent headaches, chest discomfort, and shortness of breath.
• Liver toxicity: Rare cases of liver damage have been reported. Be alert for symptoms like jaundice, fatigue, and abdominal pain.
• Severe allergic reactions: Go to the nearest emergency room for any unusual swelling, difficulty breathing, or signs of anaphylaxis.

For a complete list of ingredients and safety details, refer to the Contrave^® Medication Guide. 

Which is safer: Ozempic^® or Contrave^®?

Ozempic^® and Contrave^® are both generally safe when used as directed, but which one is right for you really depends on your overall health. While each medication comes with its own set of potential risks, most people tolerate them well under the guidance of a healthcare provider.

Which is right for me when choosing between Contrave^® or Ozempic^®?

Contrave^® and Ozempic^® are very different medications that can help a person lose weight when needed. Let’s break down the key factors to help you understand which one might work best for you.

Medication	Ozempic® (without insurance)	Contrave (without insurance)
Pricing per month (without insurance)	$998 per month Wegovy® (2.4mg) is available for $499 per month through the NovoCare Pharmacy.	$600 to $800 per month CurAccess™ Patient Support Program: $99 per month
Dosing	Starting dose: 0.25 mg per week Escalation doses: 0.5 mg, 1 mg, 2 mg per week Wegovy®: 0.25 mg, 0.5 mg, 1.0 mg, 1.7 mg, 2 mg per week	Starting dose: One 8 mg naltrexone/90 mg bupropion pill once per day Escalation dose: Up to 2 tablets twice a day
Effectiveness	Average weight loss of 15% of body weight over one year.	Average weight loss of about 5% to 10% of body weight over one year.
Insurance coverage	Rarely covered for weight loss; may be covered for type 2 diabetes	Rarely covered for weight loss
Side effects	Common side effects include nausea, vomiting, diarrhea, and reduced appetite.	Common side effects include nausea, constipation, headaches, dizziness, and dry mouth.

Alternatives to Ozempic^® and Contrave^® 

While Ozempic^® and Contrave^® are popular options for weight loss, they aren’t the only choices available. Whether you’re looking for a different semaglutide-based medication, another type of GLP-1 receptor agonist, or a non-GLP-1 weight-loss drug, there are several alternatives that may better suit your needs. Some options may be more affordable, easier to access, or better suited to your specific health conditions.

Medication	Brand names and uses	Cost per month (without insurance)	Effectiveness	How it’s taken
Semaglutide – GLP-1 receptor agonist – Same active ingredient as Ozempic®.	Wegovy®: weight loss and heart disease Rybelsus®: type 2 diabetes, off-label weight loss	Wegovy®: $1,350 $499 (NovoCare Pharmacy)  Learn more Rybelsus®: $998 Learn more	Ozempic®/Wegovy®: People lost an average of 15% of body weight in 68 weeks with injectable semaglutide Rybelsus®: People lost about 4% of their body weight	Ozempic®/Wegovy®: Weekly injection Rybelsus®: Daily pill
Tirzepatide – GLP-1/GIP receptor agonist	Mounjaro®: type 2 diabetes, off-label weight loss  Zepbound®: weight loss and obstructive sleep apnea (OSA)	Mounjaro®: $1,080 Learn more Zepbound®: Pens: $1,087 Vials: $349 (2.5 mg) $499 (5 mg, 7.5 mg, 10 mg) Learn more	People lost an average of 21% of body weight at 72 weeks.	Weekly injection
Liraglutide – GLP-1 receptor agonist	Victoza®: type 2 diabetes, off-label weight loss Saxenda®: weight loss and heart disease Generic liraglutide: type 2 diabetes, off-label weight loss	Victoza®: $800 to $1,400 Saxenda®: $1,350 Learn more. Generic liraglutide: $470 – $700	People lost an average of 5-6% of body weight in one year.	Daily injection

Other medications

GLP-1s aren’t the only options. These medications work in different ways and can be prescribed to help people lose weight if needed. 

Medication	Brand names	Cost per month (without insurance)	Effectiveness	How it’s taken
Metformin (off-label weight loss)	Glucophage®, Fortamet®, Glumetza®	Generic: $4–$15 Brand name: $100–$500+ Learn more.	People lost an average of about 6% of their body weight over six months while taking metformin.	Pill taken up to two times daily
Phentermine	Lomaira®, Adipex-P®	$27-$100	About 80% of people with a BMI of 30 or more lost at least 5% of their body weight in 6 months.	Daily pill
Diethylpropion	Tenuate®, Tenuate Dospan®	$40-$85	People lost an average of 10% of their body weight in 6 months.	Pill taken one to three times daily
Orlistat	Xenical®, Alli®	$50-$800	People in a study lost about 10% of body weight after taking Orlistat for 1 year	Pill taken three times daily with meals

Ozempic^® vs. Contrave^®: Finding the right approach

Choosing between Ozempic^® and Contrave^® comes down to your individual health needs, budget, lifestyle preferences, and long-term goals. Ozempic^® is often more effective for weight loss, but it requires weekly injections, while Contrave^® is an oral medication that helps control cravings and emotional eating. That said, while medications can be powerful tools, they work best when combined with sustainable lifestyle changes, including nutrition, exercise, and behavioral support.

Long-term weight management depends on building habits that continue even after stopping medication. That’s where Noom Med comes in—offering a science-backed approach that supports you every step of the way, whether you’re using Ozempic^®, Contrave^®, or exploring other treatments. With personalized coaching, structured guidance, and practical tools, Noom helps you not only lose weight but also maintain your progress for life.

Ultimately, the best approach is one that works for you—a plan that fits your lifestyle, medical needs, and long-term health goals. Whether you’re considering GLP-1 medications like Ozempic^® and Wegovy^®, alternatives like Contrave, or non-prescription solutions, having the right support system is key. If you’re ready to take control of your weight-loss journey, let’s explore how Noom can help you build sustainable habits and achieve lasting success.

Note: Ozempic^®, Mounjaro^®, Victoza^®, and metformin are not FDA-approved to treat obesity or for weight loss.