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Contrave® vs. Ozempic® — A Comparison

Written on September 27, 2023 by Sendra Yang, PharmD, MBA. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

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Obesity and diabetes are conditions that have substantial prevalence worldwide.[1,2] More than 1.9 billion adults were overweight, and 650 million were obese in 2016.[1] Diabetes has been increasing, from a reported 108 million cases in 1980 to 422 million in 2014.[2] Two medications that have been talked about as part of the treatment of obesity and diabetes are Contrave® and Ozempic®.[3,4] This article will further discuss Contrave® vs. Ozempic®, exploring the similarities and differences between the two drugs.

What Is Contrave®?

Contrave® is a prescription medication approved to help people struggling to lose weight. It is an extended-release product with a fixed dose of naltrexone, an opioid antagonist, and bupropion, an antidepressant.[3,5]

The exact way Contrave® works is not fully understood.[5] Bupropion and naltrexone are proposed to work by changing how your brain responds to food. The antidepressant component, bupropion, makes you feel fewer cravings for food, making it easier to control your appetite [3,5]. The other active medication, naltrexone, works by changing your brain's response to the pleasure of eating [3,5]. By reducing your brain's craving for food pleasure, the medication helps you eat less.

Contrave® is effective in helping people lose weight in combination with physical activity and reduced caloric intake [3]. In a clinical study, researchers observed that after 12 weeks of Contrave® treatment, participants achieved at least a 5% weight loss [5]. Patients should discontinue therapy if a 5% weight loss is not achieved after 12 weeks of treatment.[3]

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What Is Ozempic®?

Ozempic® is a marketed brand medication of the generic semaglutide that is approved for treating type 2 diabetes.[4] However, Ozempic® is also being used off-label for weight loss. The generic semaglutide is approved under a different brand name, Wegovy®, for chronic weight maintenance.[6] The medication belongs to a class of drugs known as GLP1s or glucagon-like peptide 1 receptor agonists.[4]

Ozempic® works by mimicking the human GLP1 hormones in the body and binding to the corresponding receptor. The receptor binding stimulates insulin secretion and lowers glucagon secretion. The primary function of glucagon is to increase glucose release from the liver.[7] Ozempic® also delays gastric emptying right after a meal to increase satiety and decrease appetite.

Studies investigated the effects of semaglutide in obese and overweight patients with at least one comorbidity.[8,9] The average change in body weight from baseline to week 68 was a reduction of 14.9% in the semaglutide group compared to 2.4% with placebo.[8] The semaglutide dose in these studies is higher than the doses used to treat type 2 diabetes.[4]

Similarities And Differences Between Contrave® vs Ozempic®

Contrave® and Ozempic® are both being used for weight loss, even though Ozempic® is used off-label. Both medications are available only by prescription.[3,4] They contribute to weight loss partly by suppressing the appetite. The common adverse effects are gastrointestinal-related for both Contrave® and Ozempic®, including nausea, vomiting, diarrhea, and constipation.

Contrave® was approved in 2014 for weight loss, while Ozempic® gained approval in 2017 for type 2 diabetes.[5,6] Wegovy®was approved in the United States in 2021 for weight management.[6]

The dosing intervals and administration between Contrave® and Ozempic® also differ.[3,4] Contrave® is available as an extended-release oral tablet, taken once in the morning and once in the evening.[3] Ozempic® is available as a subcutaneous injection, administered once a week.[4] However, the generic semaglutide is also marketed in the U.S. as an oral tablet under the name Rybelsus.[10]

Here is a chart that helps to display the differences and similarities between Contrave® and Ozempic®.

Comparison of Contrave® vs Ozempic®

Characteristic Contrave® Ozempic®
U.S. Food and Drug Administration Approval Date and Indication 2014 (obesity and overweight) 2017 (type 2 diabetes) 2021 (Wegovy® obesity and overweight)
Active Ingredient/s Naltrexone and Bupropion Semaglutide
Administration/Dosage Form Extended-release oral tablet Subcutaneous injection
Dosing Schedule Twice a day Once a week
Top Common Adverse Effects Nausea, constipation, headache, vomiting, dizziness, insomnia, dry mouth, diarrhea Nausea, vomiting, diarrhea, abdominal pain, constipation

Next Steps With Everlywell

If you want to know more about ways to help you manage your weight, consider Everlywell's comprehensive Weight Care+ program. You can get regular one-on-one virtual visits with a licensed clinician, access to GLP1 prescriptions if you qualify, quarterly at-home lab tests or supplements, and lifestyle content and support for health conditions.

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  1. Obesity and overweight. World Health Organization. Accessed September 19, 2023. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight.
  2. Diabetes. World Health Organization. Accessed September 19, 2023. https://www.who.int/news-room/fact-sheets/detail/diabetes.
  3. DailyMed - CONTRAVE EXTENDED-RELEASE- naltrexone hydrochloride and bupropion hydrochloride tablet, extended release. U.S. National Library of Medicine. Accessed September 19, 2023. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=485ff360-32c8-11df-928b-0002a5d5c51b.
  4. DailyMed - OZEMPIC- semaglutide injection, solution. U.S. National Library of Medicine. Accessed September 19, 2023. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=adec4fd2-6858-4c99-91d4-531f5f2a2d79.
  5. Sherman MM, Ungureanu S, Rey JA. Naltrexone/Bupropion ER (Contrave): Newly approved treatment option for chronic weight management in obese adults. P T. 2016;41(3):164-172. https://pubmed.ncbi.nlm.nih.gov/26957883/.
  6. FDA approves new drug treatment for chronic weight management, first since 2014. U.S. Food and Drug Administration. Accessed September 19, 2023. https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014.
  7. Glucagon: What it is, Function & Symptoms. Cleveland Clinic. Accessed September 19, 2023. https://my.clevelandclinic.org/health/articles/22283-glucagon.
  8. Wilding JPH, Batterham RL, Calanna S, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021;384(11):989-1002. doi:10.1056/NEJMoa2032183.
  9. Wadden TA, Bailey TS, Billings LK, et al. Effect of subcutaneous semaglutide vs placebo as an adjunct to intensive behavioral therapy on body weight in adults with overweight or obesity: The STEP 3 randomized clinical trial. JAMA. 2021;325(14):1403-1413. doi:10.1001/jama.2021.1831.
  10. DailyMed - Rybelsus- oral Semaglutide Tablet. U.S. National Library of Medicine. Accessed September 19, 2023. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=27f15fac-7d98-4114-a2ec-92494a91da98.
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