At a glance
| Attribute | Qsymia | Contrave |
|---|---|---|
| Form | Daily capsule | Twice-daily tablet |
| How often | Daily oral capsule — no injection | Twice-daily oral tablet — no injection |
| Weight loss in trials | Up to 9.8% — CONQUER (56 weeks) | Up to 9.3% — COR-BMOD (56 weeks) |
| FDA approved | 2012 | 2014 |
| Made by | Vivus | Currax Pharmaceuticals |
| How it works | Phentermine suppresses appetite by triggering the release of adrenaline-like chemicals in the brain's hunger control centre. | Bupropion activates appetite-suppressing nerve cells in the brain's hunger control centre (the hypothalamus). |
| Monthly cost, self-pay | $30–$400/mogeneric; brand runs to $400 | $100–$400/mo |
| Most reported reaction | Dry mouth 21% (CONQUER) | Nausea 33% (COR-I) |
Weight loss in each drug's main trial
No head-to-head trial has compared these two drugs.
CONQUER (56 weeks)
COR-BMOD (56 weeks)
In clinical trials, participants taking phentermine / topiramate ER lost on average up to 9.8% of their starting body weight, and participants taking naltrexone / bupropion ER lost on average up to 9.3%. Those numbers come from two different studies: CONQUER enrolled 2,487 adults with obesity and at least 2 weight-related health conditions over 56 weeks against placebo, while COR-BMOD enrolled adults with obesity, with intensive behaviour therapy over 56 weeks against placebo + intensive behaviour therapy. Who took part, how long each trial ran and what each drug was measured against all move the percentage, so the two figures are not a measured difference between the drugs.
Monthly cost, self-pay
The bar spans the range in each drug's price record — lowest listed price to highest.
generic; brand runs to $400
~$30–$80/month generic; ~$200–$400/month brand (Qsymia).
~$100–$400/month (brand). Generic available in some markets.
Side effects reported in the trials
Both trials reported 3 reactions in common. Each rate is the percentage of participants who reported it in the trial named beside it, so the two columns are not from the same study.
How they differ in practice
How you take it
- Qsymia — Once-daily extended-release capsule
- Contrave — Oral extended-release tablet, twice daily
Dose build-up
- Qsymia — 3.75/23 mg → 15/92 mg, titrated over 14 weeks
- Contrave — titrated to 32/360 mg/day over 4 weeks
Where a drug is not listed here, its prescribing information sets out its own dose steps.
How soon it acts
- Qsymia — Appetite suppression typically begins within the first week; significant weight loss by 12–16 weeks
- Contrave — Appetite and craving changes typically within 4–8 weeks; significant weight loss by 16–24 weeks
Heart and metabolic findings
- Qsymia — In CONQUER, there were significant reductions in blood pressure, waist circumference, triglycerides and blood glucose.
- Contrave — The LIGHT cardiovascular outcomes trial was stopped early, because of a protocol violation.
As stated in each drug’s trial record — not a claim about which drug protects the heart more.
Other findings recorded
- Qsymia — Generic now available (from 2025) — significantly lower cost than GLP-1 drugs; improved blood pressure and triglycerides in CONQUER trial
- Contrave — May help specifically with emotional eating and food cravings; bupropion's antidepressant effect may be beneficial if low mood contributes to overeating
If you stop taking it
- Qsymia — Weight regain after stopping is expected.
- Contrave — Weight regain after stopping is expected.
Common questions
Written and maintained by one person · Built with agentic AI tools · Every number checked against the cited trial · Not medical advice
Clinical evidence — Phentermine / Topiramate ER and Naltrexone / Bupropion ER
No head-to-head trial has compared these two drugs.
- CONQUER — Phentermine / Topiramate: 2,487 adults with obesity and at least 2 weight-related health conditions, 56 weeks. The Lancet, 2011. View source ↗
- COR-BMOD — Naltrexone / Bupropion: Adults with obesity, with intensive behaviour therapy, 56 weeks. Obesity, 2011. View source ↗
- COR-I — Naltrexone / Bupropion: 1,742 adults with obesity or overweight with comorbidities, 56 weeks. The Lancet, 2010. View source ↗
- Qsymia (phentermine and topiramate extended-release) — FDA prescribing information — DailyMed View source ↗
- Contrave (naltrexone and bupropion extended-release) — FDA prescribing information — DailyMed View source ↗
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Built with agentic AI tools and not a substitute for medical advice
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