| Obesity
Contrave vs Xenical
Side-by-side clinical, coverage, and cost comparison for obesity.Deep comparison between: Contrave vs Xenical 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 signalsXenical has a higher rate of injection site reactions vs Contrave based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Xenical but not Contrave, including UnitedHealthcare
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Category
Contrave
Xenical
At A Glance
Oral
Twice daily
Opioid antagonist / NDRI combination
Oral
Three times daily
Gastrointestinal lipase inhibitor
Indications
- Obesity
- Obesity
Dosing
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.
Obesity One 120-mg capsule three times a day with each main meal containing fat (during or up to 1 hour after the meal); distribute daily fat, carbohydrate, and protein over three main meals.
Contraindications
- 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
- Pregnancy
- Chronic malabsorption syndrome
- Cholestasis
- Known hypersensitivity to XENICAL or to any component of this product
Adverse Reactions
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
Most common (>=5%) Oily spotting, flatus with discharge, fecal urgency, fatty/oily stool, oily evacuation, increased defecation, fecal incontinence
Postmarketing Hepatitis, hepatic failure, hypersensitivity reactions (pruritus, rash, urticaria, angioedema, bronchospasm, anaphylaxis), bullous eruption, leukocytoclastic vasculitis, acute oxalate nephropathy, pancreatitis, lower gastrointestinal bleeding
Pharmacology
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.
Orlistat is a reversible inhibitor of gastrointestinal lipases that forms a covalent bond with the active serine residue site of gastric and pancreatic lipases, preventing hydrolysis of dietary triglycerides into absorbable free fatty acids and monoglycerides, resulting in a caloric deficit that may have a positive effect on weight control.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Contrave
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (9/12)
Xenical
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (4/12) · Qty limit (9/12)
UnitedHealthcare
Contrave
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (0/8) · Qty limit (0/8)
Xenical
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Contrave
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Xenical
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Contrave.
No savings programs available for Xenical.
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ContraveView full Contrave profile
XenicalView full Xenical profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.