Zepbound vs Contrave: Roughly Five Times the Effect, Five Times the Price
Zepbound (tirzepatide, Eli Lilly) vs Contrave (naltrexone-bupropion, Currax Pharmaceuticals)
Last verified May 2026
The verdict
SURMOUNT-1 reported −20.9% at 72 weeks for Zepbound; COR-I reported −6.1% at 56 weeks for Contrave at full dose. The cost runs the other way — about $99 a month through Currax against $349–$499 through LillyDirect. Contrave is oral, cheap, and frequently the step-therapy hurdle standing in front of the drug you asked for, which is the practical reason to understand what it does before dismissing it.
Side-by-side comparison
| Field | Zepbound | Contrave |
|---|---|---|
| Drug class | Dual GIP/GLP-1 receptor agonist | Opioid antagonist + aminoketone antidepressant |
| Route & frequency | Subcutaneous injection, once weekly | Oral tablet, twice daily |
| Pivotal trial weight loss | -20.9% at 72 weeks (SURMOUNT-1, 15 mg) | -6.1% at 56 weeks (COR-I, full dose) |
| FDA approval (chronic weight management) | November 2023 | September 2014 |
| Additional FDA-approved indications | Moderate-to-severe OSA in adults with obesity (Dec 2024, per SURMOUNT-OSA) | None beyond chronic weight management |
| Typical US cash price | $349-$499/month via LillyDirect vials (dose-dependent) | ~$99/month via Currax cash-pay program |
| Most common adverse events | Nausea (~29%), diarrhea, constipation, vomiting | Nausea, constipation, headache, insomnia, dry mouth |
| Boxed warning | Thyroid C-cell tumors (rodent finding) | Suicidal thoughts and behaviors in young adults (bupropion class) |
| Notable contraindications | Personal/family history of medullary thyroid carcinoma or MEN 2 | Uncontrolled hypertension, seizure disorders, chronic opioid use, MAOI use |
What each one costs in the compounded market
Standing monthly cash prices from the 556 sellers on this register. These are compounded preparations, not the approved products compared above.
Zepbound — tirzepatide
from $99 /mo
253 sellers publish a standing price; the median is $240 a month.
Contrave — naltrexone-bupropion
No seller on this register publishes a compounded price for it. For a drug still in trials that is expected — and anyone selling it anyway is doing so outside the system this register covers.
⚠ 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 when the shortages closed. The price gap is real, and so is the difference in oversight. Every seller, with its price record.
Frequently asked questions
Which works better for weight loss, Zepbound or Contrave?
Zepbound recorded -20.9% at 72 weeks (SURMOUNT-1, 15 mg); Contrave recorded -6.1% at 56 weeks (COR-I, full dose). ⚠ 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.
Are Zepbound and Contrave the same drug?
No. Zepbound is tirzepatide and Contrave is naltrexone-bupropion — different molecules. Results with one do not predict results with the other.
Is Zepbound or Contrave cheaper?
On the manufacturers' own cash pricing: Zepbound at $349-$499/month via LillyDirect vials (dose-dependent), Contrave at ~$99/month via Currax cash-pay program. ⚠ 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.
Which has worse side effects, Zepbound or Contrave?
The most common adverse event reported was Nausea (~29%), diarrhea, constipation, vomiting for Zepbound and Nausea, constipation, headache, insomnia, dry mouth 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.
What does a compounded version of each actually cost?
Across the 556 sellers in this register, the cheapest standing monthly cash prices we hold are tirzepatide from $99 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.
Can I switch from Zepbound to Contrave?
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.
Which one should I ask for?
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.
References
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See the full drug-vs-drug verdict index or provider rankings.