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Wegovy vs Contrave

Last reviewed: September 2026Based on 2 clinical trials

Wegovy (semaglutide, weekly injection) and Contrave (naltrexone / bupropion ER, twice-daily tablet) are both approved for weight loss in the United States. No head-to-head trial has compared these two drugs. The figures below come from separate trials, each with its own participants, length and comparison group.

At a glance

Wegovy and Contrave compared on form, trial results, cost and reported side effects
AttributeWegovyContrave
FormWeekly injectionTwice-daily tablet
How oftenInjection: once-weeklyTwice-daily oral tablet — no injection
Weight loss in trialsUp to 14.9% — STEP 1 (68 weeks)Up to 9.3% — COR-BMOD (56 weeks)
FDA approved20212014
Made byNovo NordiskCurrax Pharmaceuticals
How it worksA GLP-1 analogue with an extended half-life of approximately one week.Bupropion activates appetite-suppressing nerve cells in the brain's hunger control centre (the hypothalamus).
Monthly cost, self-pay$349–$399/mowith the manufacturer savings programme; list price ~$1,349$100–$400/mo
Most reported reactionNausea 44% (STEP 1)Nausea 33% (COR-I)
Every figure in this table is read from the same trial and label records used everywhere else on this site.

Weight loss in each drug's main trial

No head-to-head trial has compared these two drugs.

Wegovy(semaglutide)14.9%

STEP 1 (68 weeks)

Contrave(naltrexone / bupropion ER)9.3%

COR-BMOD (56 weeks)

In clinical trials, participants taking semaglutide lost on average up to 14.9% 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: STEP 1 enrolled 1,961 adults with obesity or overweight with comorbidities, no type 2 diabetes over 68 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.

Wegovy$349–$399/mo

with the manufacturer savings programme; list price ~$1,349

Self-pay via NovoCare Pharmacy: $349/month for the 0.25–2.4 mg pens, $399/month for the Wegovy HD 7.2 mg pen. New patients pay a $199/month introductory price for the first two months on the 0.25 mg or 0.5 mg starting doses (offer runs through December 31, 2026, then the regular price applies). ~$25/month with eligible commercial insurance, capped at $100/month in savings. List price ~$1,349/month. The Wegovy pill is priced separately (see the oral pill entry). Per wegovy.com and novocare.com on 17 September 2026.

Contrave$100–$400/mo

~$100–$400/month (brand). Generic available in some markets.

Self-pay prices are what the manufacturer or the pharmacy lists, not what most people end up paying. Wegovy: $349–$399/month. Contrave: $100–$400/month. Insurance, dose and pharmacy all change both figures.

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.

Nausea
Wegovy · STEP 144%
Contrave · COR-I33%
Vomiting
Wegovy · STEP 124%
Contrave · COR-I11%
Constipation
Wegovy · STEP 124%
Contrave · COR-I19%
A rate is the share of trial participants who reported that reaction, not a prediction for any one person.

How they differ in practice

How you take it

  • Wegovy — Two forms: once-weekly injection (2.4 mg) OR once-daily pill (25 mg). Same drug, similar results, very different cost and convenience.
  • Contrave — Oral extended-release tablet, twice daily

Dose build-up

  • 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

  • Wegovy — Noticeable effects within 4–8 weeks; maximum weight loss typically reached by 60–68 weeks
  • Contrave — Appetite and craving changes typically within 4–8 weeks; significant weight loss by 16–24 weeks

Heart and metabolic findings

  • Wegovy — The SELECT trial (n=17,604) showed a 20% reduction in major adverse cardiovascular events against placebo.
  • 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

  • Wegovy — 20% reduction in heart attacks and strokes (SELECT trial, established CVD); improved blood pressure and cholesterol across STEP trials
  • 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

  • Wegovy — In STEP 4, stopping semaglutide after a 20-week run-in led to significant weight regain.
  • 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

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Medical disclaimer: This website is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider before starting, stopping, or changing any treatment. Prices shown are United States self-pay or list prices and vary by insurance and country.