| Obesity
Zepbound vs Contrave
Side-by-side clinical, coverage, and cost comparison for obesity.Deep comparison between: Zepbound vs Contrave with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsContrave has a higher rate of injection site reactions vs Zepbound based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Contrave but not Zepbound, including UnitedHealthcare
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Category
Zepbound
Contrave
At A Glance
SC injection
Once weekly
GIP/GLP-1 receptor agonist
Oral
Twice daily
Opioid antagonist / NDRI combination
Indications
- Obesity
- Sleep Apnea, Obstructive
- Obesity
Dosing
Obesity Starting dose 2.5 mg SC once weekly for 4 weeks, escalating in 2.5 mg increments every 4 weeks; maintenance 5 mg, 10 mg, or 15 mg SC once weekly.
Sleep Apnea, Obstructive Starting dose 2.5 mg SC once weekly for 4 weeks, escalating in 2.5 mg increments every 4 weeks; maintenance 10 mg or 15 mg SC once weekly.
Obesity Dose escalation over 4 weeks to maintenance of 32 mg naltrexone/360 mg bupropion (two 8 mg/90 mg tablets twice daily) taken orally in morning and evening; not taken with high-fat meal; evaluate response after 12 weeks and discontinue if <5% weight loss.
Contraindications
- Personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2)
- Known serious hypersensitivity to tirzepatide or any excipient in ZEPBOUND
- Uncontrolled hypertension
- Seizure disorder or history of seizures
- Concomitant use of other bupropion-containing products
- Bulimia or anorexia nervosa
- Chronic opioid or opiate agonist (e.g., methadone) or partial agonist (e.g., buprenorphine) use, or acute opiate withdrawal
- Abrupt discontinuation of alcohol, benzodiazepines, barbiturates, or antiepileptic drugs
- Concomitant use of MAOIs, including reversible MAOIs such as linezolid or intravenous methylene blue
- Known allergy to bupropion, naltrexone, or any other component of CONTRAVE
Adverse Reactions
Most common (>=2%) Nausea, diarrhea, vomiting, constipation, abdominal pain, dyspepsia, injection site reactions, fatigue, hypersensitivity reactions, eructation, hair loss, gastroesophageal reflux disease, flatulence, abdominal distension, dizziness
Serious Risk of thyroid C-cell tumors, severe gastrointestinal reactions, acute kidney injury, acute gallbladder disease, acute pancreatitis, hypersensitivity reactions including anaphylaxis and angioedema, hypoglycemia, diabetic retinopathy complications, pulmonary aspiration
Postmarketing Acute pancreatitis, hemorrhagic and necrotizing pancreatitis, ileus, intestinal obstruction, severe constipation including fecal impaction, anaphylaxis, angioedema, pulmonary aspiration, acute renal failure or worsening of chronic renal failure
Most common (>=2%) Nausea, constipation, headache, vomiting, dizziness, insomnia, dry mouth, diarrhea, anxiety, hot flush, fatigue, tremor, upper abdominal pain, viral gastroenteritis, influenza, tinnitus, urinary tract infection, hypertension, abdominal pain, hyperhidrosis, irritability, blood pressure increased, dysgeusia, rash, muscle strain, palpitations
Serious Suicidal behavior and ideation, neuropsychiatric adverse events, seizures, increase in blood pressure and heart rate, allergic reactions, angle-closure glaucoma
Postmarketing Loss of consciousness, malaise, Brugada pattern/syndrome, drug reaction with eosinophilia and systemic symptoms (DRESS), acute generalized exanthematous pustulosis (AGEP), aseptic meningitis
Pharmacology
Tirzepatide is a dual GIP receptor and GLP-1 receptor agonist that selectively binds and activates both receptors, reducing body weight by decreasing caloric intake and affecting appetite regulation, stimulating glucose-dependent insulin secretion, reducing glucagon secretion, and delaying gastric emptying.
CONTRAVE combines naltrexone, an opioid antagonist, and bupropion, a relatively weak inhibitor of the neuronal reuptake of dopamine and norepinephrine; together they act on the hypothalamus (appetite regulatory center) and the mesolimbic dopamine circuit (reward system) to reduce food intake and body weight, though the exact neurochemical effects are not fully understood.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Zepbound
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (9/12)
Contrave
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (9/12)
UnitedHealthcare
Zepbound
- Covered on 4 commercial plans
- PA (5/8) · Step Therapy (4/8) · Qty limit (1/8)
Contrave
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Zepbound
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (0/3)
Contrave
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
$25/fillfill
Zepbound Savings Card - Covered benefitCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
Final cost depends on formulary coverage
No savings programs available for Contrave.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.