Compare Contrave vs. Orlistat
Contrave and Orlistat are the only two oral weight loss medications available in Australia. Contrave is a prescription tablet targeting brain appetite and reward pathways ($150-200/month, ~5-8% weight loss). Orlistat is available over-the-counter and blocks fat absorption ($50-80/month, ~3-5% weight loss). Neither requires injections.
Compare Contrave vs Orlistat at a Glance
Compare Contrave vs Orlistat Cost in Australia
Private prescription cost per month in AUD.
Compare Contrave vs Orlistat Weight Loss Efficacy
Contrave Clinical Trials
COR-I
6.1% weight loss vs 1.3% placebo
COR-II
6.4% weight loss maintained
COR-BMOD
9.3% with intensive behaviour modification
Orlistat Clinical Trials
XENDOS
5.8kg loss vs 3kg placebo
Multiple Phase 3
~3-5% body weight reduction
Clinical trial data at highest approved doses. Individual results vary.
Compare Contrave vs Orlistat Side Effects
Contrave
Very common
- Nausea (32%)
- Constipation (18%)
- Headache (14%)
Common
- Vomiting
- Dizziness
- Insomnia
- Dry mouth
- Diarrhoea
Serious (rare)
- Seizures (contraindicated in seizure disorders)
- Increased blood pressure
- Hepatotoxicity
- Suicidal thoughts (bupropion, young adults)
- Cannot be used with opioids
Orlistat
Very common
- Oily/fatty stools
- Oily spotting
- Increased flatulence
- Faecal urgency
Common
- Abdominal discomfort
- Liquid stools
- Frequent bowel movements
- Headache
Serious (rare)
- Liver injury (very rare)
- Kidney stones (rare)
- Reduced fat-soluble vitamin absorption (A,D,E,K)
- May affect absorption of some medications
Compare How Contrave and Orlistat Work
Contrave
Opioid antagonist + NDRI combination
Targets two brain pathways. Naltrexone (opioid antagonist) blocks reward/craving pathways in the mesolimbic dopamine circuit. Bupropion (NDRI) acts on the hypothalamic appetite centre to reduce hunger. The combination addresses both biological hunger drive and reward-based food cravings.
Orlistat
Lipase inhibitor
Completely different mechanism to GLP-1 drugs. Inhibits gastric and pancreatic lipase enzymes, preventing approximately 30% of dietary fat from being absorbed. Unabsorbed fat passes through the digestive system. Does not affect appetite or the brain. Most effective with a reduced-fat diet.
Compare Contrave vs Orlistat Dosing Schedule
Contrave
Daily oral tablets
| Dose | Period | Note |
|---|---|---|
| 1 tab morning | Week 1 | Starting dose |
| 1 AM + 1 PM | Week 2 | Escalation |
| 2 AM + 1 PM | Week 3 | Escalation |
| 2 AM + 2 PM | Week 4+ | Maintenance (4 tablets/day) |
Orlistat
Oral capsule with meals (up to 3x daily)
| Dose | Period | Note |
|---|---|---|
| 60mg OTC | With each meal | Up to 3 capsules/day |
| 120mg Rx | With each meal | Up to 3 capsules/day |
Compare Contrave vs Orlistat Australian Regulatory Status
Contrave
- TGA Status
- Registered on ARTG for chronic weight management
- PBS Listed
- No PBS listing
- Supply Status
- No supply issues
- Key Advantage
- Only combination oral weight loss drug in AU; no injections needed
- UK Name
- Marketed as Mysimba in the UK
Orlistat
- TGA Status
- Registered (OTC and prescription strengths)
- PBS Listed
- No PBS listing
- OTC Availability
- 60mg available without prescription at pharmacies
- Key Advantage
- No needles, no Rx for lower dose, cheapest option, longest safety record
- Limitation
- Modest weight loss vs GLP-1 drugs; GI side effects related to fat intake
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Medication Cost CalculatorThis website is for informational and research purposes only.
We are not medical professionals and nothing on this page constitutes medical advice, diagnosis, or treatment. Always consult a qualified doctor or specialist before making any decisions about medication.
The weight loss medication landscape in Australia is changing rapidly. Information on this page may become outdated without notice. Data sourced from the TGA, FDA, MHRA, NICE, PBAC, Australian Prescriber, Obesity Evidence Hub, and clinical trial publications. Last reviewed March 2026.