Contrave vs Ozempic in Australia
Contrave is a twice-daily tablet registered by the TGA for weight management. Ozempic is a weekly injection registered for type 2 diabetes, not for weight loss, so a weight-loss script is private and off-label. No trial has compared them. On 9 November 2026 Chemist Warehouse listed a 28-day pack of Contrave at $249.99 and a one-month Ozempic pen on a private script at $144.99. Neither is PBS-subsidised for weight loss.
Short answer
Contrave is a TGA-registered weight-management tablet. Ozempic is registered and PBS-listed for type 2 diabetes only. No trial has compared them. In COR-I, Contrave produced 5.4% average loss against 1.3% on placebo over 56 weeks. Semaglutide 1 mg, a maintenance dose of Ozempic, produced 7.0% against 3.4% over 68 weeks in STEP 2, a trial in people with type 2 diabetes.
- Last updated:
- 9 November 2026
- Prices, PBS and supply checked:
- 9 November 2026
Prices at three retailers, the PBS Schedule of 1 November 2026 and the TGA shortage database were rechecked on 9 November 2026; both Australian Product Information documents, the COR trial papers, STEP 2 and the 2026 BMJ network meta-analysis on 6 October 2026.
Compare Contrave vs Ozempic at a Glance
Prices, PBS and supply rows as at 9 November 2026. Weight loss figures are trial averages at the highest dose studied; see the head-to-head section for the direct comparison.
The Evidence: What the Trials Show
No randomised trial has compared naltrexone/bupropion with semaglutide at any dose. A Europe PMC search restricted to randomised controlled trials on 6 October 2026 returned only placebo-controlled trials and post-hoc analyses.
Contrave was tested in four 56-week placebo-controlled trials with 4,536 participants, all in the United States and all funded by the developer, Orexigen. On the Australian Product Information's intention-to-treat analysis, COR-I (538 on Contrave, 536 on placebo; BMI 30 to 45, or 27 to 45 with high cholesterol or blood pressure; no diabetes) found 5.4% average loss against 1.3%. COR-BMOD, where both groups also had 28 intensive behaviour-modification sessions, found 8.1% against 4.9%; COR-Diabetes found 3.7% against 1.7% in people with type 2 diabetes. The journal papers use a modified intention-to-treat set and report larger figures: COR-I 6.1% against 1.3%, with 48% losing 5% or more against 16%. Counting dropouts as non-responders, the Product Information puts that rate at 31% against 12%.
Ozempic's doses were tested for blood sugar control in type 2 diabetes, and its Product Information reports weight only in kilograms, as a secondary outcome. The one weight-management trial that reports the 1 mg dose as a percentage is STEP 2: 1,210 adults with type 2 diabetes and a BMI of 27 or more, randomised to semaglutide 2.4 mg, 1.0 mg or placebo for 68 weeks. The 2.4 mg group lost 9.6% and the placebo group 3.4%. The 1.0 mg result, 7.0%, comes from Novo Nordisk's announcement; the published abstract reports only the 2.4 mg contrast. No trial was found that reports a percentage loss for any Ozempic dose in people without diabetes.
| Result | Contrave (naltrexone/bupropion) | Ozempic (semaglutide 1 mg) |
|---|---|---|
| Trial | COR-I, 56 weeks, 1,742 randomised | STEP 2, 68 weeks, 1,210 randomised |
| Who took part | Adults with obesity, or overweight plus high cholesterol or blood pressure; no diabetes | Adults with type 2 diabetes and a BMI of 27 or more |
| Average weight change | -5.4% vs -1.3% on placebo (Product Information analysis); -6.1% vs -1.3% (journal analysis) | -7.0% vs -3.4% on placebo (1.0 mg figure from the sponsor's announcement) |
| Lost 5% or more | 31% vs 12% (Product Information); 48% vs 16% (journal) | Not reported for the 1 mg arm; 68.8% vs 28.5% at 2.4 mg |
| Nausea | 31.8% vs 6.7% (pooled trials, Product Information) | 19.9% vs 6.3% (pooled diabetes trials, Product Information) |
| Stopped for an adverse event | 23.8% vs 11.9% (pooled trials, Product Information) | 8.7% vs 1.5% (pooled diabetes trials, Product Information) |
| Funding | Orexigen Therapeutics | Novo Nordisk |
Two trials in two populations, not a comparison. The Contrave column gives the Australian Product Information's intention-to-treat figures first and the Lancet 2010 modified intention-to-treat figures second. The Ozempic column pairs STEP 2 weight data with pooled side-effect data from the SUSTAIN diabetes trials, because STEP 2's abstract gives no per-arm side-effect figures for 1.0 mg.
The BMJ network meta-analysis of July 2026 (262 trials, 99,791 participants, Chinese government funding) estimated subcutaneous semaglutide's one-year effect against lifestyle alone at 9.8%, pooling all doses, and found naltrexone-bupropion "not convincingly different from lifestyle modification alone" at one year, with the highest gastrointestinal event rate of the 19 drugs assessed (incidence rate ratio 4.2) and a discontinuation risk ratio of 2.3. The Lancet network meta-analysis republished in April 2024 after a retraction (132 trials, searched to March 2021) did find naltrexone-bupropion lowered weight against lifestyle change alone, and gave it the highest odds of stopping for adverse events (odds ratio 2.69).
The Contrave trials lost about half their participants and carried the last recorded weight forward.
STEP 2 participants had type 2 diabetes, and people with diabetes lose less on semaglutide. STEP 1, the 2.4 mg trial in people without diabetes, found 14.9% against 2.4%; that dose is Wegovy, not Ozempic.
The 7.0% figure for 1.0 mg is sponsor-reported. The meta-analyses pool semaglutide at every dose, so their 9.8% is weighted by the Wegovy trials and isolates no Ozempic dose.
No Contrave trial ran beyond 56 weeks.
Contrave's one cardiovascular outcome trial, LIGHT (8,910 people at raised cardiovascular risk, 85% with diabetes), was stopped early after the sponsor released confidential interim data. At the 50% interim analysis major cardiovascular events were 2.0% on Contrave against 2.3% on placebo (hazard ratio 0.88), and the investigators concluded that cardiovascular safety "remains uncertain". The Contrave Product Information revised on 3 September 2026 says the cardiovascular risks of use beyond a year have not been fully determined and asks for a cardiovascular risk reassessment each year.
Contrave vs Ozempic Prices in Australia
Prices checked 9 November 2026.
Ozempic on a private script is cheaper per month than Contrave. One Ozempic 1 mg pen holds four weekly doses and cost $144.99 at Chemist Warehouse on 9 November 2026. A 112-tablet pack of Contrave lasts 28 days at the full dose of two tablets twice daily and cost $249.99 at the same retailer that day, or $8.93 a day. No price is given for Ozempic 2 mg: the 2 mg pen (ARTG 388180) is not on the PBS and was not listed by any of the three retailers, and the Product Information says the 1 mg pen delivers 1 mg doses only, so a 2 mg cost cannot be built from the 1 mg price.
Contrave's first pack lasts longer than 28 days: the titration uses one tablet a day in week 1, two in week 2 and three in week 3, so the first three weeks use 42 tablets.
| Strength | Used as | Chemist Warehouse | Your Discount Chemist | Chemist Outlet |
|---|---|---|---|---|
| Contrave 8/90 mg, 112 tablets | 28 days at full dose (two tablets twice daily from week 4) | $249.99 | $254.95; no stock shown | $250.00 |
| Contrave 8/90 mg, 28-tablet starter pack | Registered pack size for the first weeks | not listed | not listed | not listed |
| Ozempic 0.25/0.5 mg pen (3 mL) | Weeks 1 to 4 at 0.25 mg, then 0.5 mg | $144.99 private; $25.00 PBS (type 2 diabetes only) | $145.00 private; $25.00 PBS | $150.00 private |
| Ozempic 1 mg pen (3 mL) | Optional step up from week 9 | $144.99 private; $25.00 PBS (type 2 diabetes only) | $145.00 private; $25.00 PBS | $150.00 private |
| Ozempic 2 mg pen | Optional step after four weeks at 1 mg | not listed | not listed | not listed |
Read from the retailers' product pages on 9 November 2026. Private prices are what a non-PBS script costs. Chemist Warehouse sells Ozempic in store only, and its 0.25/0.5 mg page is for the 1.5 mL pen the TGA lists as deleted from 31 December 2025. Chemist Warehouse and Your Discount Chemist show the concession price as $7.10; the PBS rate from 1 January 2026 is $7.70. Your Discount Chemist's Contrave page shows $0.00 until its only option, Private, is selected, then $254.95. The 28-tablet starter pack is in the Product Information but was not found at any retailer.
What the first year costs
| Path over 52 weeks | Cost at Chemist Warehouse prices |
|---|---|
| Contrave, 13 packs at full dose | $3,250 |
| Ozempic 1 mg on a private script, 13 pens | $1,885 |
| Ozempic 2 mg on a private script | Not listed: no retailer price for the 2 mg pen, and the 1 mg pen delivers 1 mg doses only |
| Ozempic on the PBS for type 2 diabetes, 13 scripts | $325 |
Illustrative; assumes no price changes, missed doses or gaps. The Contrave figure slightly overstates the first year because the first pack lasts longer during titration; if treatment stops at the 16-week review, the spend is four packs, $1,000. The PBS line applies only to people who qualify under the diabetes criteria.
Costs on top of the medicine
- Consultations and scripts, including Contrave's 16-week and yearly reviews. An aggregator quoted Contrave telehealth consultation fees of $49 (My Weight Loss Clinic) and $59.99 (Qoctor) with program prices of $280 to $290 a month in April 2026; Weight Loss GP advertised a bulk-billed assessment and $230 to $260 a month in August 2026. None of these is a retailer price.
- Blood pressure checks for Contrave, before starting and at regular intervals, per the Product Information.
- Pen needles for Ozempic, whose packs come with or without NovoFine Plus needles. A 100-pack of NovoFine 32G 4 mm needles was $19.95 at Your Discount Chemist, and NovoFine Plus 32G 4 mm $24.99 at Chemist Outlet, on 9 November 2026.
- A sharps container for used needles.
- Blood tests or review appointments your prescriber asks for.
How these prices were checked
Prices were read from the product pages of Chemist Warehouse, Your Discount Chemist and Chemist Outlet on 9 November 2026 and will be rechecked every three months; if a figure has gone unchecked for longer, the date at the top will say so. The retailer pages show no date of last price change. For corroboration, the Australian Journal of General Practice put naltrexone/bupropion at $249 a month in 2024 and Australian Prescriber at $242 a month in 2021.
Compare Contrave vs Ozempic Cost in Australia
Private prescription cost per month in AUD.
Is Contrave or Ozempic on the PBS?
PBS status verified 9 November 2026
- Contrave
- Not on the PBS.
- The PBS Schedule effective 1 November 2026 has no naltrexone with bupropion item on the PBS or the Repatriation PBS; the naltrexone 50 mg tablet (8370M) and Zyban bupropion (8465M, 8710K) are separate products. No medicine registered for weight management is PBS-subsidised, as the Australian Journal of General Practice noted in April 2025.
- Ozempic
- Listed for type 2 diabetes only.
- Six PBS items cover the 0.25/0.5 mg and 1 mg pens; the 2 mg pen is not on the schedule. The first script needs a telephone or online authority; continuing scripts are streamlined. The criteria, in force since 1 June 2024, require that Ozempic is used with metformin, a sulfonylurea or insulin, that the diabetes responded inadequately to one of those, and that an SGLT2 inhibitor failed, was contraindicated or was not tolerated. Patients who meet them pay $25.00 a script, or $7.70 with a concession card. Nothing in the listing covers weight management; more than 1,000 PBS compliance letters went to Ozempic prescribers in March 2025.
- TGA registration
- The TGA has assessed the medicine as safe and effective for a stated use. Contrave's is weight management. Ozempic's are type 2 diabetes, and type 2 diabetes with chronic kidney disease.
- PBS listing
- The government subsidises the medicine for a defined group, who pay the co-payment. Ozempic has this for type 2 diabetes under the criteria above. Contrave has no listing for any use.
- Private prescription
- A script for a TGA-registered medicine at the pharmacy's full price. Every Contrave script works this way, as does any Ozempic script written for a reason outside the PBS criteria.
- Private health extras
- Some funds pay a benefit on non-PBS prescription medicines, and the rules on weight-loss medicines differ by fund. HCF's pharmacy cover page lists weight loss medication among its exclusions. Teachers Health says Top Extras members can claim for non-PBS medicines used for weight loss, naming Ozempic, at its standard $60 benefit rather than its high-cost benefit. Bupa says that from 1 April 2024 it pays benefits on "select" weight-loss medicines, subject to eligibility and yearly limits. None of the three pages names Contrave.
Contrave and Ozempic Supply in Australia
Supply status verified 9 November 2026
- Contrave
- No shortage notice.
- The database of current, anticipated, resolved and discontinuation entries has no row for Contrave, naltrexone or bupropion. On 9 November 2026 Chemist Outlet's 112-pack page showed both "In Stock" and an out-of-stock notice; Your Discount Chemist showed no stock in any store.
- Ozempic
- No current shortage notice.
- The TGA recorded a semaglutide shortage from 15 April 2022, which the PBAC and the TGA attributed to off-label prescribing for weight loss, and removed Ozempic from its shortage list on 18 July 2025. The only semaglutide entry now is the discontinuation of the old 1.5 mL 0.25/0.5 mg pen, deleted from 31 December 2025 and replaced by a 3 mL pen that delivers the same doses. Whether the 2 mg pen is supplied in Australia is unknown.
Different strengths of the same medicine can go short at different times. The database is the authority; this line is updated each quarter and whenever a notice appears.
Compare Contrave vs Ozempic Weight Loss Efficacy
Contrave Clinical Trials
Ozempic Clinical Trials
COR-I
6.1% weight loss vs 1.3% placebo (5.4% in the Australian PI analysis)
COR-II
6.4% vs 1.2% placebo
COR-BMOD
9.3% vs 5.1% placebo (both arms had intensive behaviour modification)
COR-Diabetes
5.0% vs 1.8% placebo; HbA1c -0.6 vs -0.1 points
SUSTAIN 1
-3.7 kg (0.5mg) and -4.5 kg (1mg) vs -1.0 kg placebo (type 2 diabetes)
SUSTAIN FORTE
-6.9 kg at 2mg vs -6.0 kg at 1mg
FLOW (chronic kidney disease)
Kidney failure, 50% eGFR fall, or kidney or CV death 24% lower vs placebo (HR 0.76)
SURPASS-2 (vs Mounjaro)
-5.7 kg at 1mg vs -7.6 to -11.2 kg with tirzepatide
STEP 2 (1mg arm)
-7.0% (sponsor-reported) vs -3.4% placebo (type 2 diabetes)
Clinical trial data at highest approved doses. Individual results vary.
Compare Contrave vs Ozempic Side Effects
Contrave
Ozempic
Very common
- Nausea (31.8% vs 6.7% placebo)
- Constipation (18.1% vs 7.2%)
- Vomiting (9.9% vs 2.9%)
Common
- Dizziness
- Tremor
- Dry mouth
- Upper abdominal pain
- Tinnitus
- Palpitations
- Hot flush
- Excessive sweating
- Stopped for side effects: 23.8% vs 11.9% placebo
Serious (rare)
- Seizures (0.06% in trials; contraindicated with any seizure history)
- Hypertensive crisis (post-marketing, during titration)
- Suicidal thoughts (post-marketing; no suicides or suicide attempts in trials to 56 weeks)
- Serotonin syndrome (with SSRIs, SNRIs or some opioids)
- Severe skin reactions, including TEN and DRESS
- Cardiovascular safety beyond one year uncertain (LIGHT trial stopped early)
- Contraindicated with opioids
Very common
- Nausea (17-20% vs 6% on comparators)
- Diarrhoea (12-13%)
- Low blood sugar when used with insulin or a sulfonylurea
Common
- Vomiting (6-8%)
- Constipation
- Abdominal pain
- Indigestion
- Gallstones
- Decreased appetite
- Fatigue
Serious
- Acute pancreatitis
- Dehydration and kidney injury
- Diabetic retinopathy complications
- Sudden vision loss (NAION)
- Severe allergic reaction (rare)
Safety: What the Australian Product Information Says
Contrave combines naltrexone, an opioid antagonist, with bupropion, an antidepressant, and its Australian Product Information lists thirteen contraindications. Ozempic is a GLP-1 receptor agonist whose only contraindication is allergy to the ingredient.
Gut effects are the most common problem with both, and more people stop Contrave for side effects. In Contrave's pooled trials 31.8% had nausea against 6.7% on placebo, 18.1% constipation against 7.2% and 9.9% vomiting against 2.9%; 23.8% stopped for an adverse event against 11.9%, most often for nausea, headache, dizziness or vomiting. Most nausea began within four weeks and almost all had resolved by week 24. In Ozempic's pooled diabetes trials nausea was 17.0% at 0.5 mg and 19.9% at 1 mg against 6.3%, diarrhoea 12.2% and 13.3% against 5.7%, and vomiting 6.4% and 8.4% against 3.3%; 6.1% at 0.5 mg and 8.7% at 1 mg stopped for an adverse event against 1.5% on placebo.
Who cannot take it: Contrave is contraindicated in uncontrolled high blood pressure, any history of seizures, a brain tumour, acute alcohol or benzodiazepine withdrawal, a history of bipolar disorder, current or past bulimia or anorexia nervosa, opioid dependence or use of opioid-containing medicines (including methadone and buprenorphine), MAOI antidepressants within 14 days, pregnancy, severe liver disease and end-stage kidney failure. It is not recommended under 18, over 75, after a recent heart attack or in unstable heart disease. Ozempic's single contraindication is hypersensitivity; it is not for type 1 diabetes and is not recommended in NYHA class IV heart failure.
Seizures: Contrave's trials recorded seizures in 0.06% of people on the drug (2 of 3,239) and none on placebo. Anyone who has a seizure on Contrave must stop and not restart. The Product Information warns about alcohol, head injury and medicines that lower the seizure threshold, including antidepressants, antipsychotics, tramadol, systemic steroids and sedating antihistamines. Ozempic carries no seizure warning.
Blood pressure: Contrave's trials showed small, transient average rises of up to 1 mmHg, and post-marketing reports include hypertensive crisis during titration. Ozempic's document lists increased heart rate as uncommon.
Opioids: Contrave blocks opioids. The Consumer Medicine Information says to stop any opioid at least 7 to 10 days before starting, and to stop Contrave at least three days before planned opioid treatment, for example surgery. Ozempic has no opioid interaction.
Mental health: both documents warn about suicidal thoughts. Contrave's says suicidality has been reported in post-marketing use at all ages, with close supervision needed early and after dose changes. Ozempic's carries the GLP-1 class statement that suicidal behaviour and ideation have been reported.
Serotonin syndrome and skin reactions: the TGA updated bupropion products in 2022 to warn of serotonin syndrome with SSRI or SNRI antidepressants, and the Contrave document lists severe skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis, DRESS, AGEP) with the instruction to stop and never restart. Neither appears in the Ozempic document.
Pregnancy: Contrave is category B3 and contraindicated in pregnancy. Ozempic is category D, must not be used in pregnancy or while breastfeeding, and must be stopped at least two months before a planned pregnancy because of its long half-life.
Pancreas, eyes, gallbladder and kidneys: Ozempic's document warns of acute pancreatitis (stop if suspected, never restart if confirmed), diabetic retinopathy complications in insulin-treated patients, gallstones, dehydration leading to acute kidney injury, aspiration under general anaesthesia, and NAION, a rare optic nerve condition some studies link to semaglutide. Hypoglycaemia is very common with insulin or a sulfonylurea. None of these appears in the Contrave document.
The stopping rule: Contrave must be stopped at 16 weeks if less than 5% of starting weight has been lost, and at one year if that loss has not been maintained. Ozempic has no weight-based rule because weight is not its indication.
Long-term data: Contrave's trials ran 56 weeks and its one cardiovascular outcome trial, LIGHT, was stopped early. Ozempic's Product Information reports two-year trials in people with diabetes (SUSTAIN 6 and FLOW).
This is not a complete list of adverse effects. The Consumer Medicine Information is.
Compare How Contrave and Ozempic Work
Contrave
Opioid antagonist + NDRI combination
The Australian Product Information says the exact neurochemical appetite suppressant effects of naltrexone/bupropion are not fully understood. Naltrexone is a mu-opioid antagonist; bupropion is a moderately weak inhibitor of dopamine and noradrenaline reuptake. The two act on the arcuate nucleus of the hypothalamus, which regulates appetite, and on the mesolimbic dopamine reward system. In laboratory and animal studies the combination increased the firing of appetite-regulating POMC neurons and reduced food intake.
Ozempic
GLP-1 receptor agonist
Mimics the natural hormone GLP-1. Slows gastric emptying, increases insulin production, reduces glucagon, and acts on appetite centres in the brain to reduce hunger. Once-weekly injection in abdomen, thigh, or upper arm.
Compare Contrave vs Ozempic 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) |
Ozempic
Weekly subcutaneous injection
| Dose | Period | Note |
|---|---|---|
| 0.25mg | Weeks 1-4 | Starting dose |
| 0.5mg | Week 5 onwards | Maintenance dose |
| 1mg | After at least 4 weeks on 0.5mg, if needed | Maintenance dose; highest dose for type 2 diabetes with chronic kidney disease |
| 2mg | After at least 4 weeks on 1mg, if needed | Maximum dose, type 2 diabetes only (2mg pen registered; not on the PBS) |
Compare Contrave vs Ozempic Australian Regulatory Status
Contrave
- TGA Status
- Registered on ARTG (AUST R 288372) for weight management in adults with BMI 30+, or 27+ with a weight-related comorbidity
- PBS Listed
- No PBS listing
- Supply Status
- No TGA shortage notice (checked 9 Nov 2026)
- Stopping Rule
- The Product Information requires stopping at 16 weeks if less than 5% of body weight has been lost, and at one year if 5% is not maintained
- UK Name
- Authorised in the UK as Mysimba (MHRA licence PLGB 50742/0001)
Ozempic
- TGA Status
- Registered for type 2 diabetes (2019) and type 2 diabetes with chronic kidney disease (Aug 2025). Not registered for weight management.
- PBS Listed
- Yes, for type 2 diabetes with authority criteria (with metformin, a sulfonylurea or insulin, after an SGLT2 inhibitor has not worked, is contraindicated or was not tolerated; first script by telephone or online authority). $25.00 a script, $7.70 concession.
- Off-label Use
- A script for weight loss is private and at the prescriber's discretion. The TGA says advertising Ozempic for weight loss is illegal, and in Mar 2025 the Department of Health and Aged Care wrote to more than 1,000 doctors who had prescribed PBS Ozempic to patients with no history of type 2 diabetes, reminding them off-label prescribing must be private.
- Supply Status
- Shortage 15 Apr 2022 to 18 Jul 2025; no shortage notice as at 9 Nov 2026. The 1.5 mL starter pen was deleted 31 Dec 2025 and replaced by a 3 mL pen.
- Compounding
- Compounded versions banned from 1 October 2024
Getting a Prescription
Both are Schedule 4 medicines and cannot be bought legally without a prescription.
Contrave's registered indication is adults with a BMI of 30 or more, or 27 to 30 with at least one weight-related condition such as type 2 diabetes, high cholesterol or controlled high blood pressure, alongside a reduced-energy diet and more physical activity. The Product Information requires every prescriber to have read iNova's physician educational material, to measure blood pressure and pulse before starting, to review at 16 weeks and stop if less than 5% has been lost, and to reassess the need for treatment and cardiovascular risk every year. Telehealth services that prescribe it include Weight Loss GP, Qoctor and My Weight Loss Clinic (fees under Other costs above).
Ozempic's registered indications are type 2 diabetes and type 2 diabetes with chronic kidney disease, and the PBS pays only when the authority criteria are met. A doctor can write a private Ozempic script for another reason. On its Ozempic shortage page, since taken down, the TGA said it "does not have the power to regulate the clinical decisions of health professionals" and cannot prevent doctors using their clinical judgement to prescribe it for other conditions; newsGP reported in July 2025 that the TGA said Ozempic was still being prescribed off-label. The registered semaglutide product for weight management in Australia is Wegovy. It is illegal to advertise Ozempic for weight loss, even to health professionals. Pharmacists have been barred from compounding GLP-1 medicines, including semaglutide, since 1 October 2024.
Which Is Better?
For weight loss the evidence favours semaglutide, but the registered comparison for Contrave is Wegovy, not Ozempic: Ozempic's 1 mg weight data come from people with type 2 diabetes (STEP 2, sponsor-reported), and no trial was found that measures its doses in people without diabetes. The 2026 BMJ meta-analysis could not distinguish Contrave from lifestyle change alone at one year. The Australian Journal of General Practice's April 2025 review puts incretin medicines first for people with type 2 diabetes, cardiovascular disease, sleep apnoea or fatty liver disease, and describes naltrexone/bupropion as a reasonable option for people without cardiovascular disease or hypertension when there are no other contraindications.
| Consideration | Why it matters |
|---|---|
| Whether you have type 2 diabetes | With diabetes and PBS eligibility, Ozempic costs $25.00 a script and is prescribed on-label; the AJGP review puts incretin medicines first line. Without diabetes, an Ozempic script is off-label and private, and the registered semaglutide option for weight management is Wegovy |
| Tablet or injection | Contrave is four tablets a day at full dose, taken with food and swallowed whole. Ozempic is one weekly injection from a prefilled pen |
| Contrave's exclusions | A history of seizures, uncontrolled blood pressure, bipolar disorder, an eating disorder, opioid use or dependence, MAOI antidepressants, severe liver or kidney disease, or pregnancy rule it out. Heavy alcohol use, tramadol and many antidepressants add seizure risk |
| Ozempic's warnings | A history of pancreatitis, gastroparesis, diabetic eye disease, kidney impairment or heart failure needs assessment; pregnancy is category D and it must be stopped two months before conceiving |
| How much weight loss the trials showed | Contrave 5.4% against 1.3% at 56 weeks (COR-I); semaglutide 1 mg 7.0% against 3.4% at 68 weeks in people with diabetes (STEP 2); semaglutide 2.4 mg (Wegovy) 14.9% against 2.4% in people without (STEP 1) |
| Side effects and dropouts | 23.8% stopped Contrave for an adverse event in its trials against 8.7% for Ozempic 1 mg in its diabetes trials. Nausea 31.8% against 19.9% |
| Monthly cost on a private script | Contrave $249.99 per 28 days; Ozempic 1 mg $144.99 a pen, $105 less, at Chemist Warehouse on 9 November 2026. The 2 mg pen is not listed by any of the three retailers |
| A built-in stop point | Contrave must be stopped at 16 weeks without 5% loss. Ozempic has no such rule because weight is not its indication |
| Heart disease | Contrave's cardiovascular safety beyond a year is undetermined and it is not recommended after a recent heart attack. Ozempic is registered to reduce cardiovascular death in type 2 diabetes with kidney disease |
| Mental health history | Both carry suicidality warnings. Contrave is contraindicated with a history of bipolar disorder and contains an antidepressant that interacts with SSRIs and SNRIs |
Switching Between Them
No Australian guideline covers moving from Contrave to Ozempic or back, and neither Product Information mentions the other medicine or its class. The Contrave document contraindicates only other bupropion or naltrexone products, MAOIs and opioids; the Ozempic document has no wording on weight-management medicines. Each starts at its own lowest dose and steps up over four weeks (Contrave) or in four-week stages (Ozempic), so a switch repeats an escalation and its early side effects.
Taking them together has not been studied in a trial and is not described in either Product Information. The only evidence found is a retrospective study from one Vancouver clinic of 415 patients on semaglutide or liraglutide, 22.9% of whom had naltrexone/bupropion added; the combination was associated with additional weight loss, but weights were self-reported and the study cannot show cause. An Australian Prescriber review in 2022, by an author with declared advisory roles at iNova and Novo Nordisk, said the two "could be combined" without citing a trial.
On stopping: no off-treatment follow-up data for Contrave were found in the COR trial papers or the Product Information, so no regain figure is given for it. The Ozempic Consumer Medicine Information says not to stop suddenly because blood sugar may rise. The STEP 1 extension (a 327-person subset on the 2.4 mg dose) found two thirds of lost weight regained within a year of stopping, and Australian Prescriber's December 2025 review describes regain after stopping GLP-1 medicines as the norm.
Questions to Ask Your Doctor
- Do I meet the BMI criteria for Contrave, and do any of my conditions or medicines exclude me, including opioid painkillers, tramadol or antidepressants?
- If Ozempic is being considered for weight loss, is that on-label for me, and why Ozempic rather than Wegovy?
- What will each option cost per month at my pharmacy, and how often will I need a new script?
- For Contrave, how will my blood pressure be checked, and what happens at the 16-week review if I have not lost 5%?
- What should I do about nausea or vomiting in the first weeks, and which symptoms mean stop and seek urgent care?
- What changes if I am planning a pregnancy or could become pregnant?
- If I need surgery or an opioid painkiller while on Contrave, what is the plan?
- What is the plan if I plateau, and if I stop?
Contrave vs Ozempic FAQ
How much does Contrave cost in Australia?
On 9 November 2026 Chemist Warehouse listed Contrave 8/90 mg, 112 tablets, at $249.99 and Chemist Outlet at $250.00; Your Discount Chemist showed $254.95 once its Private option was selected, with no store stock. The pack lasts 28 days at the full dose. It is not on the PBS.
Is Contrave on the PBS?
No. The PBS Schedule effective 1 November 2026 has no naltrexone with bupropion item, and no medicine registered for weight management is PBS-subsidised.
Is Contrave the same as Ozempic?
No. Contrave is a naltrexone/bupropion tablet registered for weight management. Ozempic is a weekly semaglutide injection registered for type 2 diabetes. They act on different systems, with different side effects and exclusions, and no trial has compared them.
Is Contrave better than Ozempic for weight loss?
No direct trial exists. Contrave's trials showed 5.4% loss against 1.3% on placebo at 56 weeks on the Australian Product Information's analysis. Semaglutide 1 mg showed 7.0% against 3.4% over 68 weeks in STEP 2, in people with type 2 diabetes. Ozempic is not registered for weight loss; Wegovy is.
Can you take Contrave with Ozempic?
Not studied. Neither Product Information mentions the other. The only evidence is a retrospective study at one Canadian clinic in which adding naltrexone/bupropion to a GLP-1 medicine was associated with extra weight loss, from self-reported weights.
What are the side effects of Contrave?
In the Australian Product Information's pooled trials: nausea 31.8% (6.7% on placebo), constipation 18.1% (7.2%), vomiting 9.9% (2.9%), and 23.8% stopped for an adverse event. Common effects include dizziness, dry mouth, tremor, palpitations, hot flushes and raised blood pressure. Seizures occurred in 0.06% of trial participants. Suicidal thoughts, serotonin syndrome with SSRI or SNRI antidepressants, hypertensive crisis during titration and severe skin reactions have been reported.
How long does Contrave take to work?
The dose is built up over four weeks to two tablets twice daily. The Product Information sets a checkpoint at 16 weeks: if less than 5% of starting weight has been lost, treatment should be stopped. In the trials, people who had reached 5% by week 16 averaged 11.3% loss at one year.
Is Contrave available in Australia?
Yes. It has been registered since 21 August 2018 (ARTG 288372, sponsor iNova) and on sale since February 2019. The TGA shortage database holds no entry for it and Chemist Warehouse, Your Discount Chemist and Chemist Outlet listed it on 9 November 2026.
Is Mysimba available in Australia?
No. The only naltrexone/bupropion product on the Australian Register of Therapeutic Goods is Contrave 8/90. Mysimba is the name the same 8 mg/90 mg naltrexone/bupropion tablet is sold under in the United Kingdom and the European Union.
Can I get Ozempic for weight loss in Australia?
Ozempic is registered and PBS-listed for type 2 diabetes only. A doctor can write a private script for another purpose, which the TGA has said it cannot prevent, but the PBS will not subsidise it, advertising it for weight loss is illegal, and the semaglutide product registered for weight management is Wegovy. On a private script a 1 mg pen cost $144.99 to $150.00 at the three retailers on 9 November 2026.
Sources and References
- Contrave 8/90 Australian Product Information, iNova Pharmaceuticals, revised 3 September 2026
- Contrave 8/90 Consumer Medicine Information, iNova, reviewed September 2026
- Ozempic Australian Product Information, Novo Nordisk, revised 25 September 2026
- Ozempic Consumer Medicine Information, Novo Nordisk, August 2026
- TGA, ARTG entry 288372, Contrave 8/90
- TGA, Contrave prescription medicine registration (iNova), registered 21 August 2018
- TGA, ARTG search results for Ozempic (four entries including the 2 mg pen)
- TGA, Ozempic prescription medicine registration, chronic kidney disease indication, 18 August 2025
- TGA, Advertising Ozempic and GLP-1 receptor agonists is prohibited, 30 November 2022
- TGA, Bupropion and serotonin syndrome, safety update, 21 June 2022
- TGA Medicine Shortage Reports Database, semaglutide entries
- TGA Medicine Shortage Reports Database, all shortage types, search for naltrexone bupropion (no entry)
- PBS medicine search, naltrexone (no results), 6 October 2026
- PBS medicine search, contrave (no results), 6 October 2026
- PBS medicine search, bupropion (no results), 6 October 2026
- PBS, restriction changes to type 2 diabetes mellitus medicines, effective 1 June 2024
- PBS, fees, patient contributions and safety net thresholds, from 1 January 2026
- PBS, Drug Utilisation Sub-Committee, semaglutide public release document, June 2024
- Healthdirect, Ozempic brand page (PBS verified 1 October 2026)
- Novo Nordisk Australia, product update notifications (Ozempic removed from the TGA shortage list 18 July 2025)
- Diabetes Australia, Ozempic supply returning to normal in Australia, 23 July 2025
- Greenway FL et al, COR-I; Apovian CA et al, COR-II; Wadden TA et al, COR-BMOD; Hollander P et al, COR-Diabetes (PubMed abstracts)
- Apovian CA et al, A randomized, phase 3 trial of naltrexone SR/bupropion SR on weight and obesity-related risk factors (COR-II), Obesity 2013
- Wadden TA et al, Weight loss with naltrexone SR/bupropion SR combination therapy as an adjunct to behavior modification (COR-BMOD), Obesity 2011
- Hollander P et al, Effects of naltrexone SR/bupropion SR on body weight and glycemic parameters in overweight and obese patients with type 2 diabetes (COR-Diabetes), Diabetes Care 2013
- Nissen SE et al, Effect of naltrexone-bupropion on major adverse cardiovascular events in overweight and obese patients with cardiovascular risk factors (LIGHT), JAMA 2016 (abstract)
- Davies M et al, Semaglutide 2.4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2), Lancet 2021 (abstract)
- Novo Nordisk, STEP 2 headline results announcement, 12 June 2020
- Comparative effects of drugs for adults with overweight or obesity: systematic review and network meta-analysis, BMJ, 8 July 2026
- Shi Q et al, Pharmacotherapy for adults with overweight and obesity: a systematic review and network meta-analysis, Lancet, republished April 2024
- Lancet, Retraction and republication notice for Shi et al, 6 April 2024
- Europe PMC search, randomised controlled trials of naltrexone and bupropion with liraglutide, semaglutide or tirzepatide (no head-to-head trial), 6 October 2026
- Endocrinology Advisor, Bupropion-naltrexone plus GLP-1 therapy elicits additional weight loss (Naude et al, International Journal of Obesity 2024), 9 May 2024
- Forner and Hocking, Pharmacotherapy for the management of overweight and obesity, Australian Journal of General Practice, April 2025
- Proietto J, Medicines for long-term obesity management, Australian Prescriber, 1 April 2022
- Australian Prescriber, Injectable drugs for weight management, 9 December 2025
- Chemist Warehouse, Contrave 8mg/90mg tablets 112, read 9 November 2026
- Chemist Outlet, Contrave Tab 8mg/90mg 112, read 9 November 2026
- Your Discount Chemist, Contrave 8/90mg tablets 112, read 9 November 2026
- Chemist Warehouse, Ozempic 1.34mg/mL 3mL pre-filled pen, read 9 November 2026
- Your Discount Chemist, Ozempic injection pen 1mg 3mL, read 9 November 2026
- Your Discount Chemist, Ozempic injection pen 0.25/0.5mg 3mL, read 9 November 2026
- Chemist Outlet, Ozempic pre-filled pen 1.34mg/mL 3mL, read 9 November 2026
- Chemist Outlet, Ozempic pre-filled pen 0.25/0.5mg 3mL, read 9 November 2026
- Weight Loss GP, Contrave in Australia: 2026 guide, 3 August 2026
- Weight Loss Meds, Contrave cost Australia, prices checked 3 April 2026
- Nine News, Weight loss pill Contrave launched in Australia, 14 February 2019
- PBAC, Obesity treatments, public summary document, November 2025 (March 2025 PBS compliance letters to Ozempic prescribers)
- TGA, About the Ozempic (semaglutide) shortage, archived copy of the page as at January 2025 (off-label prescribing wording; page since removed)
- RACGP newsGP, Push for weight-loss drugs' PBS listing ramps up, 4 July 2025
- TGA, Update on the GLP-1 RA pharmacy compounding changes, 18 June 2024
- European Medicines Agency, Mysimba (naltrexone/bupropion) EPAR overview
- emc (UK), Mysimba 8 mg/90 mg prolonged-release tablets, Summary of Product Characteristics, Orexigen Therapeutics Ireland
- Wilding JPH et al, Weight regain and cardiometabolic effects after withdrawal of semaglutide: the STEP 1 trial extension, Diabetes Obes Metab 2022 (abstract)
- Your Discount Chemist, NovoFine pen needle 32G x 4 mm 100 pack, read 9 November 2026
- HCF, Claiming prescriptions and PBS medications, read 6 October 2026
- Teachers Health, Medications used for weight loss, read 6 October 2026
- Bupa, Pharmacy cover frequently asked questions, read 6 October 2026
- Chemist Outlet, Novofine Plus Insulin Needles 32G 4 mm 100 pack, read 9 November 2026
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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. Last reviewed 9 November 2026.