Contrave (naltrexone/bupropion) vs Zepbound (tirzepatide)
Contrave comes out ahead on this table, winning on entry price. Zepbound scores higher on the published halfrx formula, 7.3 against 6.3; the formula takes in more than this table does.
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 Zepbound (tirzepatide)?
Contrave (naltrexone/bupropion) is $99 a month all-in, read from its own page on 2026-09-22; Zepbound (tirzepatide) is $299–$699, read from its own page on 2026-08-19. At the maintenance dose the gap is $350 a month, which is $4,649 across a year, counting 12 fills for Contrave (naltrexone/bupropion) and 13 for Zepbound (tirzepatide). Trial weight loss was 5.4% against 20.9%, 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. They were last checked on 2026-09-22 and 2026-08-19. 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 7.3 out of 10, arithmetic over the same stored fields rather than an editor's preference.
Head to head
| What decides it | Contrave $99/mo | Zepbound $299–$699/mo |
|---|---|---|
| Entry priceContrave (naltrexone/bupropion) is $200/mo cheaper to start — $99 against $299. | ✓ 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 Zepbound (tirzepatide) 20.9%, 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 | Zepbound |
|---|---|---|
| Mean weight loss in the cited trial | 5.4% | 20.9% |
| 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. | SURMOUNT-1, Study 1 on the label, 72 weeks: 20.9% mean weight loss at 15 mg against 3.1% on placebo, intention-to-treat. |
| Maintenance dose | 2 tablets twice a day | 5 mg, 10 mg or 15 mg once weekly |
| Earliest week you reach it | week 4 | week 5 |
| Year one at the published price of every step | $1,188 | $5,637 |
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 walk each titration step at its published price — Contrave has one price at every dose, so there is no step to walk — and count the fills each manufacturer bills a year: 12 for Contrave, 13 for Zepbound. 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 tirzepatide — 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 Zepbound (tirzepatide) the 8th — the cheapest of them all is $75.
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]
Zepbound (tirzepatide)
Pros
- +Highest average weight loss of any approved medication — around 20.9% at the 15 mg dose in SURMOUNT-1.[2]
- +Dual GIP/GLP-1 agonist, a different mechanism from semaglutide, so it often works for people semaglutide failed.[2]
- +$299/mo at the starting dose direct from Lilly against a $1,086 list price, with home delivery of vials or pens at the same price.[1]
- +Also approved for obstructive sleep apnea, which can unlock insurance coverage that a weight indication alone would not.[2]
- +If you are commercially insured with coverage, Lilly's card can bring it to as little as $25 a month.[1]
Cons
- −Weekly injection with the usual GI side effects — nausea, vomiting, diarrhea and constipation are the common discontinuation reasons.[2]
- −The advertised $449 ceiling is conditional. It holds only while you refill within 45 days; lapse once and 10 mg and above cost $699 — 56% more than the number in the advert.[1]
- −Lilly defines a month as 28 days, so a year is 13 fills, not 12. At $449 that is $5,837 a year against the $5,388 that 'per month' implies — $449 of hidden annual cost.[1]
- −$1,086 list price if you have no coverage and do not use LillyDirect self-pay.[1]
- −Weight regain after stopping is the documented norm, so the cost is ongoing rather than a course.[2]
- −2.5 mg is a starting dose and is not approved for maintenance, so the $299 headline is a price nobody stays on.[1]
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 Zepbound
- Zepbound price and terms →
- What is Zepbound? →
- Zepbound cost without insurance →
- Alternatives to Zepbound →
- Zepbound coupons and savings cards →
- Medicare GLP-1 Bridge →
- Zepbound Journey Program →
- Zepbound savings card →
- Zepbound side effects →
- Does Zepbound make you feel sick? →
- Does Zepbound make you tired? →
- Does Zepbound cause constipation? →
- Does Zepbound cause diarrhea? →
- Does Zepbound make you throw up? →
- Does Zepbound cause hair loss? →
- Does Zepbound cause injection site reactions? →
- Does Zepbound cause stomach pain? →
- Does Zepbound cause indigestion? →
- Does Zepbound cause acid reflux? →
- Does Zepbound make you burp? →
- Zepbound dose schedule →
- Can you stay on a lower dose of Zepbound? →
- How to inject Zepbound →
- How long Zepbound takes to work →
- What happens if you stop Zepbound →
- Hair loss: which of the labels name it →
- Alcohol: what the labels say, and what they do not →
- tirzepatide at LillyDirect: the price →
- tirzepatide: every product and price →
- LillyDirect: the seller →
- Mochi Health: the seller →
- Henry Meds: the seller →
- Noom Med: the seller →
- PlushCare: the seller →
- Compounded tirzepatide: the drug →
- Eden: the seller →
- GoodRx for Weight Loss: the seller →
Contrave against Zepbound, answered
- What happens if you stop Contrave or Zepbound?
- Zepbound's label includes a trial that stopped the drug on purpose; Contrave's does not, which is a difference in what is known rather than in what happens. On Zepbound's label, the people randomly assigned to stop gained 14% of body weight over the following 12 months while those who carried on lost 5.5% more. That figure belongs to Zepbound's trial, so this page does not apply it to Contrave.
- Is Contrave or Zepbound better for weight loss?
- Contrave reports 5.4% average weight loss and Zepbound 20.9%, 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 Zepbound?
- Contrave, at $99 a month against $449 — a difference of $350 a month, or $4,649 over a year counting 12 fills a year for Contrave and 13 for Zepbound. Both figures are the maintenance price rather than an introductory rate.
- Can you switch between Contrave and Zepbound?
- 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.