Can you take metformin and Ozempic together?

Taking a single prescription medication is one thing. But when you add another drug to your routine, questions may come up: Can you take metformin and Ozempic® together? Will it boost your weight loss or help you break through a plateau? What if they cause unwanted side effects? Is this combination beneficial or risky?

If you’re weighing your options between taking metformin, semaglutide (the active ingredient in Ozempic, Rybelsus®, and Wegovy®), or both of these FDA-approved drugs, there’s good news. In most cases, it’s safe to take these medications together. 

Here’s what you need to know about taking Ozempic and metformin together to meet your health needs and weight loss goals.

Benefits of taking metformin and Ozempic together 

Metformin, a daily oral medication, is typically the first-line therapy recommended by the American Diabetes Association for treating type 2 diabetes (but not for type 1 diabetes). A first-line therapy is the option that health care providers use to treat the disease to see how well it works for the patient and if they tolerate it before adding or changing medications. If needed, the next steps may include additional medications that enhance the effects of first-choice drugs (known as combination therapy). Or it can mean moving on to another medication altogether as part of a step therapy approach. For diabetes, GLP-1 drugs like semaglutide are considered second-line treatments.

While metformin and Ozempic (a brand name for semaglutide) have received approval from the U.S. Food and Drug Administration (FDA) for treating type 2 diabetes and managing blood sugar levels, they’ve also demonstrated weight loss effects. 

“When just one medication isn’t sufficient to treat diabetes, patients can take metformin and semaglutide together,” explains Rekha Kumar, MD, MS, chief medical officer at Found Health. “The combination is also used off-label for weight loss to take advantage of the medicines’ different mechanisms for increasing satiety.”

So, how exactly do these diabetes medications work together to help with weight loss? 

Metformin promotes weight loss by regulating the body’s response to insulin, reducing blood sugar levels, decreasing appetite cravings, and lowering the tendency to store fat, especially belly fat. 

Ozempic, taken as a weekly injection, also stabilizes blood sugar levels. It mimics glucagon-like peptide-1 (GLP-1), a gut hormone that plays a role in digestion and appetite regulation, helping you to feel fuller faster and longer, which, in turn, can promote weight loss. 

Like Ozempic, Wegovy® is a GLP-1 receptor agonist with the active ingredient, semaglutide, which uses the same mechanisms. Both prescription drugs are taken weekly as an injection just under the skin. However, unlike Ozempic, Wegovy is FDA-approved for weight management in patients who have a body mass index (BMI) of 30 or greater or a BMI of 27 or higher and at least one weight-related health issue condition related to body weight (such as  high cholesterol or high blood pressure). 

Risks of taking metformin and Ozempic together

Starting metformin and Ozempic at different times makes it easier to observe how your body reacts to each medication. 

“The risk of side effects always increases when taking several medications at once,” says Dr. Kumar. “It can be challenging to distinguish which medicine is causing side effects when two meds are started at once.” Her recommendation for understanding each drug’s impact? “I would stagger when you start each medication.” 

Note any side effects you experience and discuss them with your health care provider before adding another medication to your regimen.

Metformin: Potential side effects and warnings

Though many people don’t experience side effects while taking metformin, some do. The most common side effects are gastrointestinal:

• Upset stomach (gas, bloating, and stomach cramps)
• Diarrhea
• Nausea 
• Vomiting

These symptoms typically subside after your body adjusts to the medication. A pro tip? Taking metformin with your evening meal can help reduce these side effects.

The FDA also has a “black box warning” on metformin as it carries a serious safety risk of lactic acidosis. This rare but potentially fatal condition is when too much lactic acid builds up in the bloodstream. It can lead to low blood pressure, breathing issues, heart failure, and even death.

Additionally, metformin may stimulate ovulation in those with polycystic ovary syndrome (PCOS) or who are premenopausal. This may increase the risk of unintended pregnancy. If you’re in a sexual relationship that can result in pregnancy, use at least one form of birth control unless you’re planning on getting pregnant. Find detailed side effect and risk information on our dedicated metformin page. 

Ozempic: Potential side effects and warnings

According to the drug’s manufacturer, Novo Nordisk, the most common side effects of Ozempic are:

• Nausea
• Constipation
• Diarrhea
• Vomiting
• Stomach pain

Although rare, in animal studies, semaglutide caused thyroid C-cell tumors. Ozempic’s “black box” warns of the risk of these thyroid tumors. If you have trouble swallowing, develop hoarseness, or feel swelling or a lump in your neck, contact your health care provider immediately. The FDA also warns not to take Ozempic if you have a personal or family history of multiple endocrine neoplasia syndrome type 2, medullary thyroid cancer, insulin-dependent diabetes, or diabetic ketoacidosis. So, if that’s you, Ozempic isn’t the right fit. Find detailed side effect and risk information on our dedicated Ozempic page. 

Potential drug interactions for metformin and Ozempic

Anytime you take more than one drug, consider how all your medications may interact. While some prescription drugs have an enhancing effect, others can cause harm or increased risk for certain health issues. Whether your physician prescribes metformin or Ozempic singly or together, avoid drinking alcohol when taking these drugs because they can lower blood glucose levels, resulting in fainting or dizziness.

While taking metformin and Ozempic together is clinically considered safe, look at your whole regimen. Are you taking any additional prescription medications or supplements in addition to these drugs? If so, you’ll want to work with your health care provider to find out about any potentially harmful drug interactions before proceeding.

For reference, here are some medications known to cause interactions when taken with metformin or Ozempic.

Metformin

Some drugs can make metformin less effective or increase risk of lactic acidosis or low blood sugar (also known as hypoglycemia). Here are a few medications that may interact with metformin:

• Carbonic anhydrase inhibitors
• Cephalexin
• Cimetidine
• Dolutegravir
• Glycopyrrolate
• Insulin
• Iodine contrast agents
• Lamotrigine
• Ranolazine
• Topiramate

Ozempic

These drugs may interact with Ozempic:

• Insulin
• Certain oral medications including birth control pills
• Sulfonylureas 

How to make a personalized medication plan

Working with a health care provider trained in obesity medicine—an expert in tailoring prescriptions for weight loss medications and treatment options to match individual circumstances—can make all the difference. Dr. Kumar recommends working with your provider to assess how well you tolerate each drug, as well as the severity of your diagnosis, whether that’s diabetes, obesity, or something else. Found’s clinical team designs a treatment plan personalized to your unique biology and needs—to help you lose weight safely and sustainably.

Found is among the largest medically-supported telehealth weight care clinics in the country, having served more than 250,000 members to date. To start your journey with Found, take our quiz.


While GLP-1s and metformin can be effective for weight loss, they are not clinically appropriate for everyone. Eligibility for a GLP-1 and metformin is based on a thorough evaluation of your medical history and lab work. If a GLP-1 or metformin is not appropriate for you, our providers will work with you to determine an effective medication for your health profile.