Introduction

When it comes to prescription weight loss medications, Zepbound and Contrave offer two very different approaches.

Zepbound is a cutting-edge weekly injection that targets gut and appetite hormones, while Contrave is an oral pill that affects the brain’s reward system.

So which one is better? That depends on your health profile, preferences, and goals. This guide compares Zepbound vs Contrave to help you choose the right path.

Quick Comparison: Zepbound vs Contrave

Feature	Zepbound	Contrave
Active Ingredient	Tirzepatide	Naltrexone + Bupropion
FDA-Approved For	Obesity / Overweight (2023)	Obesity / Overweight (2014)
Delivery	Weekly injection	Daily oral tablet (2x/day)
Average Weight Loss	Up to 22.5% of body weight	~5–10% of body weight
Mechanism	GLP-1 + GIP hormone receptor agonist	Appetite and reward center modulation

Learn more: What Is Tirzepatide? Zepbound for Weight Loss

How They Work

Zepbound

• Mimics GLP-1 and GIP hormones

• Suppresses appetite

• Slows digestion

• Improves insulin sensitivity

• Helps reduce visceral (belly) fat

Contrave

• Combines bupropion (used in depression/smoking cessation) and naltrexone (used in addiction treatment)

• Targets the hypothalamus (hunger center) and reward system of the brain

• Aims to reduce cravings and emotional eating

Weight Loss Results

Measure	Zepbound	Contrave
Average % Lost	15–22.5%	5–10%
Timeframe	3–6 months	3–6 months
Typical Weight Loss	25–50+ lbs	10–20 lbs

Clinical trials show Zepbound has the most significant weight loss of any FDA-approved treatment to date.

Side Effect Comparison

Side Effect	Zepbound	Contrave
Nausea	Common	Common
Headache / Dizziness	Sometimes	Common
GI issues (bloating, gas)	Mild	Mild
Mood or sleep changes	Rare	More common
Black box warning	None	Yes – Suicidal thoughts (young adults)

Contrave is not recommended for people with seizure history, eating disorders, or uncontrolled hypertension.

Learn more: Side Effects of Weight Loss Medications

Convenience & Dosing

Feature	Zepbound	Contrave
Frequency	Weekly	Twice daily pills
Ease of Use	Injection only	Oral tablet
Onboarding	Weekly dose titration	4-week pill ramp-up
Missed dose protocol	Flexible	Rigid dosing window

Zepbound offers fewer doses and better compliance for busy individuals.

Cost & Coverage

Factor	Zepbound	Contrave
U.S. Retail Price	~$1,060/month	~$99–$150/month
With Savings Card	As low as $25/month	~$99 via discount programs
Insurance Coverage	Requires prior authorization	Less likely, often excluded

Apply:

• Zepbound Savings Card 
• Contrave Savings Program 

When to Choose Zepbound

You have moderate to severe obesity (BMI ≥30)
You want the highest weight loss results available
You’re insulin resistant, prediabetic, or have PCOS
You’re comfortable with weekly injections

When to Choose Contrave

You prefer a daily oral medication
You have mild to moderate weight to lose
You struggle with emotional eating or food reward issues
You want a lower-cost, pill-based option

Final Thoughts

Both Zepbound and Contrave are legitimate tools for weight loss—but they’re built for different users.

Zepbound delivers more weight loss and better metabolic support, while Contrave may be a good fit for those who prefer pills and focus on cravings and emotional eating.

Zepbound = Best for significant weight loss, metabolic reset
Contrave = Best for cost-conscious users with mild weight struggles

Not sure which fits your lifestyle? Visit our Weight Loss Medication Match Tool to find your best-fit prescription.