Contrave (naltrexone/bupropion) vs Qsymia (phentermine/topiramate)
Verdict
Qsymia is the better choice of the two, winning on entry price (halfrx score 7.1 against 6.3).
Computed from the stored fields, so it moves when a price does. Nothing here is written by hand or by a model.
Which is cheaper, Contrave (naltrexone/bupropion) or Qsymia (phentermine/topiramate)?
Contrave (naltrexone/bupropion) is $99 a month all-in, read from its own page on 2026-09-22; Qsymia (phentermine/topiramate) is $66–$75, read from its own page on 2026-09-22. At the maintenance dose the gap is $24 a month, which is $288 across a year, counting 12 fills. Trial weight loss was 5.4% against 9.8%, from separate trials with different populations, so the gap is not a measured difference between the two. Every axis below is computed from stored fields rather than written by hand, so the comparison moves when a price does. Both were last checked on 2026-09-22. Neither carries an FTC action, a state action, a BBB F grade or an FDA warning letter. The published formula scores them 6.3 and 7.1 out of 10, arithmetic over the same stored fields rather than an editor's preference.
Head to head
| What decides it | Contrave $99/mo | Qsymia $66–$75/mo |
|---|---|---|
| Entry priceQsymia (phentermine/topiramate) is $33/mo cheaper to start — $66 against $99. | — | ✓ better here |
| Regulatory and complaint riskNeither carries a lawsuit, an FDA warning letter or a supply-risk flag. | tied | tied |
| Average weight loss in trialsContrave (naltrexone/bupropion) reports 5.4% and Qsymia (phentermine/topiramate) 9.8%, each from its own trial. They were not compared against each other, and the populations, durations and endpoints differ, so the higher number is not a better result — it is a different study. | not comparable | not comparable |
What the trials, the titration and a year actually say
| Axis | Contrave | Qsymia |
|---|---|---|
| Mean weight loss in the cited trial | 5.4% | 9.8% |
| The trial that figure comes from | COR-I on the label, 56 weeks: 5.4% mean weight loss on 32 mg/360 mg against 1.3% on placebo, intention-to-treat. | CONQUER, Study 2 on the label, 56 weeks: 9.8% mean weight loss at the 15 mg/92 mg dose against 1.2% on placebo, intention-to-treat. |
| Maintenance dose | 2 tablets twice a day | 7.5 mg / 46 mg daily |
| Earliest week you reach it | week 4 | week 3 |
| Year one at the published price of every step | $1,188 | No titration prices recorded |
Trial percentages are quoted from the label or the named trial beside them. They are not a head-to-head result: different populations, different durations, different endpoints. That is why the comparison above scores this axis as not comparable rather than awarding it to the higher number. The year-one figures are one price at every dose, times the twelve 30-day bottles a year holds. The full arithmetic is published.
Read the price gap carefully: these two are not the same purchase
- These are different molecules — naltrexone and bupropion against phentermine and topiramate — so this is a comparison of two treatments, not of two prices for one.
- Against every medication on this site with a verified maintenance price, Contrave (naltrexone/bupropion) is the 2nd cheapest of 9 and Qsymia (phentermine/topiramate) the 1st — the cheapest of them all is $75.
Currax Pharmaceuticals
Contrave (naltrexone/bupropion)6.3
$99/mo all-in
verified 2026-09-22
Weaker moleculeBoxed warning
7.1
$66–$75/mo all-in
verified 2026-09-22
Weaker moleculeREMS restrictedControlled substance
Contrave (naltrexone/bupropion)
Pros
- +$99 a month direct from the manufacturer's CurAccess program — below every branded GLP-1 on this site, and tied with the cheapest compounded route.[1]
- +Oral, no injections, no refrigeration, no titration involving needles.[2]
- +Works on appetite and reward pathways rather than gut hormones, so it is an option for people who cannot tolerate GLP-1 side effects.[3]
- +The bupropion component may help if you also want to stop smoking or have low mood.[3]
Cons
- −5.4% mean weight loss at 56 weeks in COR-I, the trial on its label — about a third of semaglutide and a quarter of tirzepatide.[4]
- −Boxed warning for suicidal thoughts and behaviors from the bupropion component.[3]
- −Contraindicated with uncontrolled hypertension, seizure disorders and opioid use — the opioid interaction matters, because naltrexone blocks opioid pain relief in an emergency.[3]
- −Placebo arm lost 1.3%, so the drug-attributable effect is about four points rather than the headline figure.[4]
Qsymia (phentermine/topiramate)
Pros
- +9.8% mean weight loss at the top dose in CONQUER, intention-to-treat — the strongest result available from an oral non-GLP-1 drug.[2]
- +$74.99/mo through Qsymia Engage home delivery for anyone, $65.99 for Costco members, and generic phentermine/topiramate ER runs roughly $50–$100 — an order of magnitude under branded GLP-1 list prices.[1]
- +Approved down to age 12, as Wegovy and Saxenda are; Zepbound is for adults only.[2]
Cons
- −Topiramate raises the risk of oral clefts when taken in the first trimester. The label recommends a negative pregnancy test before starting and every month during treatment, with effective contraception, and Qsymia is dispensed only through pharmacies certified under an FDA REMS.[6]
- −Phentermine is a controlled substance with cardiovascular contraindications.[2]
- −Cognitive side effects — word-finding difficulty and trouble concentrating — are common enough to be a frequent reason people stop.[2]
- −Its 9.8% in CONQUER is under half the 20.9% tirzepatide reached in SURMOUNT-1 on Zepbound's label, a separate trial in a different population, so this is not a head-to-head result.[7]
Sources
- [1] Qsymia Engage home delivery pricing, qsymia.com
- [2] Qsymia REMS: pregnancy testing and contraception requirements (FDA)
- [3] CONQUER: phentermine plus topiramate, phase 3 (The Lancet)
- [4] Qsymia CONQUER trial results (manufacturer HCP site)
- [5] Assessment of the REMS for phentermine–topiramate (Annals of Internal Medicine)
- [6] FDA prescribing information for QSYMIA
- [7] FDA prescribing information for ZEPBOUND
Comparisons are computed from the fields on each card, not written by hand or by a model, so they change when the data does. Information only, not medical advice. halfrx may earn a commission from some links, which never changes what a comparison says.
Everything on Contrave
- Contrave price and terms →
- What is Contrave? →
- Contrave cost without insurance →
- Alternatives to Contrave →
- Contrave coupons and savings cards →
- Contrave Home Delivery →
- Contrave side effects →
- Does Contrave make you feel sick? →
- Does Contrave cause constipation? →
- Does Contrave cause diarrhea? →
- Does Contrave make you throw up? →
- Does Contrave make you dizzy? →
- Does Contrave cause headaches? →
- Does Contrave keep you awake? →
- Does Contrave cause dry mouth? →
- Contrave dose schedule →
- How to take Contrave →
- How long Contrave takes to work →
- Which labels record what happens when you stop →
- Hair loss: which of the labels name it →
- Alcohol: what the labels say, and what they do not →
Everything on Qsymia
- Qsymia price and terms →
- What is Qsymia? →
- Qsymia cost without insurance →
- Alternatives to Qsymia →
- Qsymia coupons and savings cards →
- Qsymia Engage →
- Qsymia side effects →
- Does Qsymia cause constipation? →
- Does Qsymia make you dizzy? →
- Does Qsymia keep you awake? →
- Does Qsymia cause dry mouth? →
- Qsymia dose schedule →
- How to take Qsymia →
- How long Qsymia takes to work →
- Which labels record what happens when you stop →
- Hair loss: which of the labels name it →
- Alcohol: what the labels say, and what they do not →
- phentermine: every product and price →
- Phentermine: the drug →
Contrave against Qsymia, answered
- Is Contrave or Qsymia better for weight loss?
- Contrave reports 5.4% average weight loss and Qsymia 9.8%, each from its own trial. The two were not compared against each other, so the higher figure is not a result of a head-to-head and this page does not present it as one. What is comparable is what each costs, below.
- Which is cheaper, Contrave or Qsymia?
- Qsymia, at $75 a month against $99 — a difference of $24 a month, or $288 over a year counting the twelve 30-day bottles a year holds. Both figures are the maintenance price rather than an introductory rate.
- Can you switch between Contrave and Qsymia?
- They are different molecules, so this is a change of medication rather than of brand, and the one you move to is started on its own dosing schedule.