Victoza Vs. Contrave: Drug Comparison

Victoza^® (liraglutide) is an injectable medication used to improve blood sugar control in adults and children aged 10 years and older with type 2 diabetes. It works as a glucagon-like peptide-1 (GLP-1) receptor agonist, enhancing insulin secretion, inhibiting glucagon release, and slowing gastric emptying to lower blood sugar levels. Victoza is also indicated to reduce the risk of major adverse cardiovascular events, such as heart attack, stroke, and cardiovascular death,] in adults with type 2 diabetes and established cardiovascular disease. Common side effects include nausea, diarrhea, and headache. It should be used with caution in patients with a history of pancreatitis​.

Contrave^® (naltrexone hydrochloride and bupropion hydrochloride) is a prescription medication used for weight management in adults, combining two active ingredients: naltrexone, which affects the brain's reward system, and bupropion, which influences appetite and cravings. It works by targeting the hypothalamus to reduce hunger and the mesolimbic reward system (a pathway in the brain that plays a key role in regulating feelings of pleasure, motivation, and reinforcement) to curb food cravings. Contrave is FDA-approved for chronic weight management. Common side effects include nausea, constipation, headache, and insomnia, while drug interactions can occur with MAO inhibitors, opioid pain medications, and drugs that lower the seizure threshold. Contrave carries a boxed warning for an increased risk of suicidal thoughts and behaviors, particularly in young adults, due to its bupropion component.

Glucagon-like peptide-1 (GLP-1) receptor agonist

Naltrexone: opioid antagonist

Bupropion: aminoketone antidepressant

Victoza (liraglutide) is indicated:

• As an adjunct to diet and exercise to improve glycemic control in adults and pediatric patients aged 10 years and older with type 2 diabetes mellitus

• To reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes mellitus and established cardiovascular disease

Contrave (naltrexone hydrochloride and bupropion hydrochloride) is indicated:

• As an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index (BMI) of:

  • 30 kg/m² or greater (obese)

  • 27 kg/m² or greater (overweight) in the presence of at least one weight-related comorbidity (e.g., hypertension, type 2 diabetes mellitus, or dyslipidemia)

• Typically taken as an injection once daily

• Comes in single-patient-use pens that deliver 0.6 mg, 1.2 mg, or 1.8 mg per injection

• Typically taken orally twice daily

• Comes as 8 mg/90 mg extended-release tablets

Most common adverse reactions (incidence ≥5%) in clinical trials are:

• Nausea

• Diarrhea

• Vomiting

• Decreased appetite

• Indigestion

• Constipation

Immunogenicity-related events, including hives, were more common among Victoza-treated patients (0.8%) than among comparator-treated patients (0.4%) in clinical trials

Most common adverse reactions (greater than or equal to 5%):

• Nausea

• Constipation

• Headache

• Vomiting

• Dizziness

• Insomnia

• Dry mouth

• Diarrhea

• Patients with a personal or family history of medullary thyroid carcinoma or in patients with multiple endocrine neoplasia syndrome type 2

• Patients with a serious hypersensitivity reaction to liraglutide or any of the excipients in Victoza

• Drug interactions: Victoza delays gastric emptying and may impact absorption of concomitantly administered oral medications

• Uncontrolled hypertension

• Seizure disorders, anorexia nervosa or bulimia, or undergoing abrupt discontinuation of alcohol, benzodiazepines, barbiturates, and antiepileptic drugs

• Use of other bupropion-containing products

• Chronic opioid use

• During or within 14 days of taking monoamine oxidase inhibitors (MAOI)

• Known allergy to any of the ingredients in Contrave

• Drug interactions: MAOIs, antidepressants (e.g., selective serotonin reuptake inhibitors and many tricyclics), antipsychotics (e.g., haloperidol, risperidone, and thioridazine), beta-blockers (e.g., metoprolol), type 1C antiarrhythmics (e.g., propafenone and flecainide), digoxin, CYP2B6 inhibitors (e.g., ticlopidine or clopidogrel), CYP2B6 inducers (e.g., ritonavir, lopinavir, efavirenz, carbamazepine, phenobarbital, and phenytoin), drugs that lower seizure threshold, dopaminergic drugs (levodopa and amantadine)

• Pancreatitis

• Never share a Victoza pen between patients, even if the needle is changed

• Low blood sugar: Adult patients taking an insulin secretagogue or insulin may have an increased risk of low blood sugar, including severe low blood sugar

• Acute kidney injury

• Hypersensitivity reactions

• Acute gallbladder disease

• Pregnancy: Victoza should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus

• Suicidal behavior and ideation

• Neuropsychiatric adverse events during smoking cessation

• Risk of seizure may be minimized by adhering to the recommended dosing schedule and avoiding coadministration with high-fat meal

• Increase in blood pressure and heart rate

• Liver toxicity

• Angle-closure glaucoma

• Use of antidiabetic medications: Weight loss may cause hypoglycemia

• Pregnancy: Weight loss during pregnancy may cause fetal harm. Discontinue when a pregnancy is recognized

WARNING: RISK OF THYROID C-CELL TUMORS

Liraglutide causes thyroid C-cell tumors at clinically relevant exposures in both genders of rats and mice. It is unknown whether Victoza causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans, as the human relevance of liraglutide-induced rodent thyroid C-cell tumors has not been determined.

Victoza is contraindicated in patients with a personal or family history of MTC or in patients with multiple endocrine neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk of MTC and the symptoms of thyroid tumors.

WARNING: SUICIDAL THOUGHTS AND BEHAVIORS

Increased risk of suicidal thinking and behavior in children, adolescents, and young adults taking antidepressants for major depressive disorder and other psychiatric disorders. Monitor for worsening and emergence of suicidal thoughts and behaviors.

Contrave has not been studied in pediatric patients.

*This information is from the label for brand name Victoza^®. See the Full Prescribing Information for more complete information. Liraglutide, the active ingredient in Victoza, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient liraglutide.

*This information is from the label for brand name Contrave^®. See the Full Prescribing Information for more complete information. Naltrexone and bupropion, the active ingredients in Contrave, may also be the active ingredients in other medications, and this information may not be accurate for all medications that include the active ingredients naltrexone and bupropion.