Question 1

Which works better for weight loss, Wegovy or Contrave?

Accepted Answer

Wegovy recorded -14.9% at 68 weeks (STEP-1); Contrave recorded -6.1% at 56 weeks (COR-I). ⚠ These come from separate trials with different protocols and populations, so the gap between two numbers from two studies is weaker evidence than it looks. No head-to-head trial of this pair is on record here.

Question 2

Are Wegovy and Contrave the same drug?

Accepted Answer

No. Wegovy is semaglutide and Contrave is naltrexone-bupropion — different molecules, and they work differently: GLP-1 receptor agonist (appetite + satiety) against Opioid antagonist + dopamine/norepinephrine reuptake inhibitor (reward + craving pathway). Results with one do not predict results with the other.

Question 3

Is Wegovy or Contrave cheaper?

Accepted Answer

On the manufacturers' own cash pricing: Wegovy at About $349/mo first 2 months then $499/mo via NovoCare; $1,349/mo list, Contrave at About $99/mo via Currave Currax Direct savings card; about $700/mo list. ⚠ That is the list-price comparison, and it is not what most people pay. What you actually pay depends on whether your plan covers it, which formulary tier it sits in, and whether you have met your deductible — and for many people the honest comparison is between an insured copay and a cash-pay compounded alternative rather than between these two figures.

Question 4

Does either one have better cardiovascular evidence?

Accepted Answer

Wegovy does. Wegovy: SELECT: 20% relative reduction in MACE in adults with CVD + overweight/obesity without diabetes. Contrave: No outcome trial; LIGHT was terminated early without showing CV benefit. This matters more than it first appears — a drug with a completed outcomes trial has evidence about events that matter, not only about weight, and that is often what decides coverage.

Question 5

Which has worse side effects, Wegovy or Contrave?

Accepted Answer

The most common adverse event reported was Nausea (about 44%), diarrhea, vomiting, constipation for Wegovy and Nausea (about 32%), constipation (about 19%), headache (about 18%), insomnia for Contrave. ⚠ Rates come from separate trial populations and are not a like-for-like comparison. In practice how fast the dose is escalated affects tolerability at least as much as which drug it is, which is one reason a slower titration is worth asking for.

Question 6

How is each one taken?

Accepted Answer

Wegovy: Weekly subcutaneous injection, 16-week titration to 2.4 mg. Contrave: Oral tablets, 4-week titration to 2 tabs twice daily (32 mg naltrexone / 360 mg bupropion total). Worth weighing honestly against your own habits — the best drug for you is partly the one you will still be taking in eight months, and a dosing routine that does not fit a life gets abandoned.

Question 7

What does a compounded version of each actually cost?

Accepted Answer

Across the 556 sellers in this register, the cheapest standing monthly cash prices we hold are semaglutide from $79 a month. ⛔ A compounded preparation is not the approved product: no agency has reviewed that specific preparation for safety, effectiveness or manufacturing quality, and the legal ground under compounding these molecules narrowed once the shortages closed. The price gap is real and so is the difference in oversight.

Question 8

Can I switch from Wegovy to Contrave?

Accepted Answer

Yes, with a prescriber. Expect to re-titrate from the bottom of the new drug's ladder rather than starting where you left off: these are different molecules and tolerance to one does not transfer to the other. Both the old drug's washout and the new drug's schedule apply.

Question 9

Which one should I ask for?

Accepted Answer

That is a prescriber's call, and anyone answering it from a table is guessing. What a page like this can do is tell you what the trials measured, what the manufacturers charge, and where the evidence is still missing, so the conversation starts from the record rather than from an advertisement.

Field	Wegovy	Contrave
Mean weight loss (TBWL)	-14.9% at 68 weeks (STEP-1)	-6.1% at 56 weeks (COR-I)
Mechanism	GLP-1 receptor agonist (appetite + satiety)	Opioid antagonist + dopamine/norepinephrine reuptake inhibitor (reward + craving pathway)
Dosing	Weekly subcutaneous injection, 16-week titration to 2.4 mg	Oral tablets, 4-week titration to 2 tabs twice daily (32 mg naltrexone / 360 mg bupropion total)
Cash price (US, 2026)	About $349/mo first 2 months then $499/mo via NovoCare; $1,349/mo list	About $99/mo via Currave Currax Direct savings card; about $700/mo list
FDA indication	Chronic weight management (2021); cardiovascular risk reduction in adults with CVD + overweight/obesity (2024)	Chronic weight management (2014)
Most common side effect	Nausea (about 44%), diarrhea, vomiting, constipation	Nausea (about 32%), constipation (about 19%), headache (about 18%), insomnia
Boxed warning	Thyroid C-cell tumors (rodent finding); contraindicated in MTC/MEN 2	Suicidal thoughts and behaviors in young adults (bupropion class warning)
Cardiovascular outcome data	SELECT: 20% relative reduction in MACE in adults with CVD + overweight/obesity without diabetes	No outcome trial; LIGHT was terminated early without showing CV benefit
Age and BMI eligibility	Adults and adolescents 12+ with BMI ≥30, or ≥27 with a weight-related comorbidity	Adults 18+ with BMI ≥30, or ≥27 with a weight-related comorbidity
Who should avoid it	Personal/family history of medullary thyroid cancer, MEN 2, history of pancreatitis	Uncontrolled hypertension, seizure disorder, eating disorders, chronic opioid use, MAOI use within 14 days

Wegovy vs Contrave: The Price of the Efficacy Gap

The verdict

Side-by-side comparison

What each one costs in the compounded market

Frequently asked questions