Has anyone compared Zepbound and Contrave in the same trial?

No head-to-head trial has compared these two drugs. Zepbound's figures come from SURMOUNT-1 (72 weeks) and Contrave's from COR-BMOD (56 weeks), which enrolled different people for different lengths of time. Numbers from separate trials can be read side by side, but they are not a measured difference.

What does each one cost per month?

Zepbound is listed at $299–$1,086/month (with the manufacturer savings programme; list ~$1,086). Contrave is listed at $100–$400/month. The full price note for each is set out in the cost section above. What you pay depends on your insurance, your dose and your pharmacy.

Can I switch from Zepbound to Contrave?

Switching between weight-loss medicines is a decision for the prescriber who knows your history, your other medicines and how you have responded so far — this site cannot make it for you. What switching involves in practice, including dose steps and the gap between drugs, is set out on the switching page.

Which side effects were reported most often?

In SURMOUNT-1 (72 weeks), the reaction reported most often with tirzepatide was nausea — 31% of participants. In COR-I (56 weeks), the reaction reported most often with naltrexone / bupropion ER was nausea — 33% of participants. Rates come from different trials with different participants, and a rate is not a prediction for any one person.

Zepbound vs Contrave: trials compared

At a glance

Zepbound and Contrave compared on form, trial results, cost and reported side effects
	Zepbound	Contrave
Form	Weekly injection	Twice-daily tablet
How often	Once-weekly injection	Twice-daily oral tablet — no injection
Weight loss in trials	Up to 20.9% — SURMOUNT-1 (72 weeks)	Up to 9.3% — COR-BMOD (56 weeks)
FDA approved	2023	2014
Made by	Eli Lilly	Currax Pharmaceuticals
How it works	A single molecule that activates two hunger-regulating signals in the brain — GIP and GLP-1 (both natural hormones released after eating).	Bupropion activates appetite-suppressing nerve cells in the brain's hunger control centre (the hypothalamus).
Monthly cost, self-pay	$299–$1,086/mowith the manufacturer savings programme; list ~$1,086	$100–$400/mo
Most reported reaction	Nausea 31% (SURMOUNT-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.

Zepbound(tirzepatide)20.9%

SURMOUNT-1 (72 weeks)

Contrave(naltrexone / bupropion ER)9.3%

COR-BMOD (56 weeks)

In clinical trials, participants taking tirzepatide lost on average up to 20.9% 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: SURMOUNT-1 enrolled 2,539 adults with obesity or overweight with comorbidities, no type 2 diabetes over 72 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.

Zepbound$299–$1,086/mo

with the manufacturer savings programme; list ~$1,086

Self-pay vials via LillyDirect from $299/month (2.5 mg) to $699/month (10–15 mg), per zepbound.lilly.com on 4 September 2026; list price ~$1,086/month; $25/month copay card for eligible commercial insurance.

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. Zepbound: $299–$1,086/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

Zepbound · SURMOUNT-131%

Contrave · COR-I33%

Constipation

Zepbound · SURMOUNT-112%

Contrave · COR-I19%

Vomiting

Zepbound · SURMOUNT-118%

Contrave · COR-I11%

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

Zepbound — Once-weekly subcutaneous injection (2.5, 5, 7.5, 10, 12.5, 15 mg)
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

Zepbound — Noticeable appetite reduction typically within 4–8 weeks; 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

Zepbound — Improvements in systolic/diastolic blood pressure, triglycerides, LDL, and HbA1c across SURMOUNT trials.
Contrave — The LIGHT cardiovascular outcomes trial was terminated early due to a protocol violation and did not provide a definitive answer on CV outcomes.

As stated in each drug’s trial record — not a claim about which drug protects the heart more.

Other findings recorded

Zepbound — Reduced progression to type 2 diabetes; improved sleep apnoea (SURMOUNT-OSA 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

Zepbound — In SURMOUNT-4, participants who switched to placebo regained an average of 14.0% body weight over 52 weeks.
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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Last reviewed: September 2026

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.