At a glance
| Attribute | Wegovy | Contrave |
|---|---|---|
| Form | Weekly injection | Twice-daily tablet |
| How often | Injection: once-weekly | Twice-daily oral tablet — no injection |
| Weight loss in trials | Up to 14.9% — STEP 1 (68 weeks) | Up to 9.3% — COR-BMOD (56 weeks) |
| FDA approved | 2021 | 2014 |
| Made by | Novo Nordisk | Currax Pharmaceuticals |
| How it works | A 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 reaction | Nausea 44% (STEP 1) | Nausea 33% (COR-I) |
Weight loss in each drug's main trial
No head-to-head trial has compared these two drugs.
STEP 1 (68 weeks)
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.
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.
~$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
- 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
Clinical evidence — Semaglutide and Naltrexone / Bupropion ER
No head-to-head trial has compared these two drugs.
- STEP 1 — Semaglutide (injection): 1,961 adults with obesity or overweight with comorbidities, no type 2 diabetes, 68 weeks. New England Journal of Medicine, 2021. 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 ↗
- Wegovy (semaglutide) injection and tablets — FDA prescribing information — DailyMed View source ↗
- Contrave (naltrexone and bupropion extended-release) — FDA prescribing information — DailyMed View source ↗
Next step most people take
Built with agentic AI tools and not a substitute for medical advice
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