Ozempic and bupropion/naltrexone (Contrave) work differently and are approved to treat different conditions, so there is no “best” option for everyone. These medications also have different dosage forms, mechanisms of action, and side effects:

• Ozempic: This once-weekly injectable GLP-1 medication is FDA-approved to treat type 2 diabetes, though it is sometimes prescribed off-label for weight loss. It slows your digestion and mimics fullness hormones to significantly reduce your appetite.
• Contrave: This daily oral pill is approved specifically for chronic weight management. It combines two medicines (bupropion and naltrexone) to target your brain’s reward system, helping to curb cravings and control overeating.

A provider on Sesame can evaluate your health history, preferences, and budget to determine the safest and most effective option, if either is suitable for you.

Take bupropion/naltrexone as directed by your provider. Swallow the tablets whole. Do not crush, split, or chew them.

Avoid taking bupropion/naltrexone with high-fat meals, as this can increase the amount of medication absorbed into your bloodstream and raise your risk of seizures.

Before starting bupropion/naltrexone, tell your provider about all medications, supplements, and other substances you use. If you drink alcohol, let them know how much and how often, including any plans to stop drinking. Check with your provider before starting or stopping any medications, especially benzodiazepines, sedatives, or anti-seizure medications.

Take Contrave exactly as prescribed, and swallow the tablets whole. Avoid taking it with high-fat meals, which can increase seizure risk. Limit or avoid alcohol, and talk with your provider before suddenly stopping heavy alcohol use.

Tell your healthcare providers you're taking Contrave before surgery or if you need opioid pain medication. Naltrexone can block the effects of opioids, including pain relievers such as codeine, oxycodone, and tramadol. Taking extra opioids to overcome this effect can cause a life-threatening overdose. Your provider can help you plan safe pain management.

Naltrexone, one of the ingredients in Contrave, blocks the effects of opioids. Starting Contrave while you're physically dependent on opioids can trigger sudden, potentially severe withdrawal symptoms.

Taking large amounts of opioids to overcome this blocking effect can cause a life-threatening overdose. The risk of overdose may also increase after missing doses or stopping Contrave.

Tell your provider if you take any opioid medications, including prescription pain relievers or medications such as methadone or buprenorphine. Do not stop opioid treatment on your own. Your provider can determine whether Contrave is appropriate or recommend another weight-loss medication.

If you develop signs of an opioid overdose, such as slow or shallow breathing or extreme drowsiness, call 911 immediately.

It's recommended that you avoid or limit alcohol while taking bupropion/naltrexone (Contrave). Drinking alcohol may increase the risk of certain side effects.

Before starting treatment, tell your provider how much and how often you drink, including any plans to stop. Suddenly stopping alcohol can cause withdrawal symptoms, including seizures, in people who have developed alcohol dependence. Your provider can help you assess this risk and make a safe plan.

Taking bupropion/naltrexone (Contrave) with a high-fat meal can increase the amount of medication absorbed into your bloodstream, raising your risk of seizures.

Avoid taking Contrave with high-fat meals. If you're eating around the time you take it, choose lower-fat options like oatmeal, fruit, whole-grain toast, or lean protein with vegetables.