Ozempic and metformin are used to treat Type 2 diabetes, but they are not the same. They work differently and have different formulations. Ozempic is a brand-name drug that contains semaglutide, while metformin is a generic drug. Ozempic is a GLP-1 receptor agonist, while metformin is a biguanide.
Ozempic (semaglutide) and metformin are medications used to treat Type 2 diabetes. Ozempic is a once-weekly injection approved for adults. Metformin is an oral pill approved for adults and children ages 10 and older. Ozempic and metformin work in different ways to lower blood glucose (sugar).
Why do doctors no longer recommend metformin? Doctors still often prescribe metformin to help treat T2DM. However, metformin may not be suitable for everyone with T2DM. For example, a doctor may prescribe alternative treatments, such as SGLT2 inhibitors, in people with kidney problems.
Many people with diabetes who are prescribed metformin lose around 2% to 3% of their body weight within the first year of starting the drug.
Metformin is often the first drug prescribed for type 2 diabetes. If blood sugar levels are not managed well with metformin alone, doctors may add Ozempic or switch to Ozempic altogether. If you have other questions about taking Ozempic with metformin, talk with your doctor or pharmacist.
Both Ozempic and metformin (Fortamet, Glumetza) may be used to help manage PCOS symptoms. The best option for you depends on your specific symptoms, health history, and other factors. Ozempic improves blood sugar, slows digestion, and supports weight loss. These effects may be beneficial for people with PCOS.
Metformin may also have health benefits for people who don't have diabetes. Doctors have long prescribed it off-label — that is, to treat conditions outside its approved use, including: Prediabetes. People with prediabetes have elevated blood sugar that isn't yet high enough to qualify as diabetes.
Diarrhea and gas
Diarrhea is the most common metformin side effect.
An analysis of 143 studies revealed that phentermine-topiramate and GLP-1 receptor agonists (like liraglutide and semaglutide) are among the most effective medications for reducing weight in people with obesity. The typical body weight reduction with these medications is 6% to 11%.
Metformin has been referred to as a “miracle drug” because of some early findings in animal studies and small human studies showing that it may have some other benefits, including: Preventing cancer. Slowing down the aging process. Protecting the heart.
If you're having trouble accessing Ozempic, your healthcare team may recommend an alternative that works in a similar way. For Type 2 diabetes, this may include Rybelsus, Trulicity, or Mounjaro. If you're taking Ozempic off-label for weight loss, Wegovy, Zepbound, and Saxenda are three FDA-approved options.
Non-insulin Ozempic® works with your body's own ability to lower blood sugar and A1C. Ozempic® helps your body release its own insulin. And it's designed to respond when your blood sugar rises.
Dapagliflozin is mainly used to treat type 2 diabetes. It can also be used to treat heart failure and chronic kidney disease (CKD). Dapagliflozin is usually prescribed if: you have type 2 diabetes and cannot take metformin.
Even though metformin may lead to some weight loss, the amount you lose may be far less than expected. On average, weight loss after one year on the drug is only six pounds, according to past research.
Metformin is often a first-choice treatment for Type 2 diabetes. It's not known to be harmful to your kidneys or other organs. But if you have kidney problems, there's a greater risk of a serious condition called lactic acidosis.
Metformin treatment brought about a significant reduction of visceral fat mass compared to controls accompanied by an up-regulation of fat oxidation-related enzyme in the liver, UCP-1 in the brown adipose tissue and UCP-3 in the skeletal muscle.
Long-term side effects
Taking metformin can cause vitamin B12 deficiency if you take it for a long time. This can make you feel very tired, breathless and faint, so your doctor may check the vitamin B12 level in your blood. If your vitamin B12 levels become too low, vitamin B12 supplements will help.
Key Takeaways
Metformin is usually the first-line treatment due to its long-standing safety profile and affordability, while Ozempic may be considered when additional blood sugar or weight management is needed.
“When participants took metformin during bed rest, they had less muscle atrophy. During the recovery period, their muscles also had less fibrosis or excessive collagen. That buildup can make it harder for the muscle to properly function.”
Under certain conditions, too much metformin can cause lactic acidosis. The symptoms of lactic acidosis are severe and quick to appear, and usually occur when other health problems not related to the medicine are present and are very severe, such as a heart attack or kidney failure.
Commonly, however, in trials with longer follow-up periods, weight loss generally starts after 4 weeks of treatment with metformin and occurs mainly during the first 6 to 12 months of continuing metformin therapy.