Can you take metformin and Ozempic together?
Doctors often prescribe metformin and Ozempic to type 2 diabetes. But they can also help with weight loss. Can you take them together?
Mounjaro can cost big bucks out of pocket. The Mounjaro coupon expired in December, but there are other ways to save.
In recent years, drugs like Ozempic® and Wegovy® became media darlings. The medications, rumored to be behind the dramatic weight loss of some of Hollywood’s brightest stars, are part of the GLP-1 receptor agonist drug class being used to treat obesity and overweight. The idea of medication-assisted weight loss is nothing new, and the off-label use of FDA-approved drugs for weight management is well documented.
In May 2022, following a year of social media frenzy around Ozempic and Wegovy, Eli Lilly announced the U.S. Food and Drug Administration (FDA) approved Mounjaro® (tirzepatide) to treat type 2 diabetes. Since its approval, Mounjaro’s popularity has sky-rocketed. The big reason: Lilly announced that in clinical trials tirzepatide assisted obese or overweight patients with type 2 diabetes to lose an average of 15.7% of body weight. Subsequent trials have had even more impressive results: In one, participants lost up to 20% of their body weight when combining the weekly drug with lifestyle changes. One reason Mounjaro is so effective at aiding weight loss is that it helps suppress appetite and delay gastric emptying, making you feel fuller, longer because it changes the rate at which your stomach empties.
However, Ozempic and Mounjaro are also known for their eye-watering price tags. This is driven in part by the fact that health insurance plans don't always cover these drugs, even when they’re prescribed to treat type 2 diabetes. And when the drugs are prescribed off-label for weight loss, insurance coverage is even trickier. So the question for those who are prescribed Mounjaro—what are the best ways to save money on this medication?
Found, a doctor-designed weight loss program that targets your unique biology with medication, has gathered a list of resources to help you save money and lower your out-of-pocket costs.
Mounjaro (tirzepatide) is a dual agonist that activates the receptors for two of the body’s incretin hormones, GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1). The once-weekly injectable is FDA-approved to treat type 2 diabetes. One monthly fill of the medication includes four pre-filled pens, which is a 28-day supply.
Health care providers already prescribe Mounjaro off-label to treat excess weight and obesity. But before you reach out to your provider to see if you can get a prescription, consider that Mounjaro and GLP-1s receptor agonists don’t work for everyone, and may not be a good fit for your unique biology. With biology in mind, Found-affiliated clinicians can prescribe a wide range of medications, including GLP-1s and non-GLP-1s, to personalize the best treatment for you. One of Found’s pillars for clinical excellence is the MetabolicPrint™ weight health assessment tool which evaluates your unique biology, medical history, and lifestyle to determine a MetabolicPrint profile. Found providers use this profile to find the most effective medication to address the root causes of your weight gain and personalize your weight loss plan. (That may mean a GLP-1 or your Found provider may suggest a different medication that is more widely available and cost-effective.)
Not surprisingly, whether you get Mounjaro prescribed to you off-label or for type 2 diabetes, for many, Mounjaro’s cost can be a significant hurdle.
Eli Lilly is notably transparent about Mounjaro's list price. Without health insurance coverage or the Mounjaro coupon card, Mounjaro's retail price is $1,069.08 per fill, which is about one month’s supply. Because Mounjaro is such a new drug, the specific health insurance plan pricing data isn’t available yet. However, once the data is available, the company “is committed to sharing the average patient out-of-pocket cost once they become available.”
There are other Mounjaro weight loss savings options and patient assistance programs including:
Variability in price: The medication may be cheaper depending on your location and pharmacy. It may help to comparison shop in your area to find the best pricing. Ask your health care professional about supply and demand in your area and where they recommend filling your prescription.
The Food and Drug Administration recently approved tirzepatide for weight loss under the brand name ZepboundTM, which is also manufactured by Eli Lilly. If you’re considering tirzepatide for weight loss, this new version may be a more cost-effective alternative to Mounjaro. Like Mounjaro, Zepbound is costly. Eli Lilly’s list price for the new drug is $1,059.87 each month. If you have private health insurance with coverage for Zepbound, you may pay as low as $25 for a 1-month or 3-month prescription. If your health insurance does not cover Zepbound, you may pay as low as $550 for a 1-month prescription of Zepbound, approximately 50% lower than the list price. Zepbound's savings card, which expires December 31, 2024.
Luckily, there are other options that don’t fall under the GLP-1 medication class but can be helpful for your weight-loss journey. One such alternative is metformin, an FDA-approved medication for the treatment of type 2 diabetes that health care professionals often prescribe off-label for weight loss.
Like other non-GLP-1 medications, metformin works to help with weight loss. A Diabetes Prevention Program Research Group study published in 2012 in Diabetes Care determined that metformin works for weight loss. The study also found that long-term treatment helped sustain weight loss for at least ten years. According to the study, metformin also “lowers glucose and reduces risk for diabetes in part through weight loss.”
Rekha Kumar, MS, MD, Found’s chief medical officer, explains that metformin is “a plant-derived off-label option for weight loss, appetite control, and sugar and carbohydrate craving control.” Dr. Kumar says metformin may help people be more adherent to a low carbohydrate diet for those on that type of plan. Metformin is also reasonably priced and easily accessible. And, metformin is taken orally, not injected.
Among GLP-1 receptor agonists as alternative treatments are Ozempic and Wegovy. Both have semaglutide as the active ingredient. However,while Wegovy is FDA-approved for chronic weight management, Ozempic is prescribed at a slightly lower dose. Ozempic is indicated for treating type 2 diabetes and prescribed off-label for weight loss. All prescription medications carry risks, and weight-loss drugs are no exception. Common side effects of GLP-1s and metformin include nausea, vomiting, diarrhea, and acid reflux. More serious but less common side effects of tirzepatide (Mounjaro) and GLP-1s such as Ozempic and Wegovy include pancreatitis, gallbladder disease, and worsening of diabetic eye disease. Those with a personal or family history of medullary thyroid cancer or multiple endocrine neoplasias should not use these drugs.
Metformin may cause lactic acidosis, which can result in death, hypothermia, hypotension, and resistant bradyarrhythmias. Studies show taking metformin long-term may, in rare cases, lead to complications such as pancreatitis, hepatitis, abnormal blood clotting, abnormal vitamin B12 levels, and reactive hypoglycemia. Find detailed side effect and risk information for specific medications here.
GLP-1*
GLP-1 prescriptions, filled through your local pharmacy, are now available as part of Found's weight-loss toolkit. While GLP-1s can be effective for weight loss, they are not clinically appropriate for everyone. Eligibility for a GLP-1 is based on a thorough evaluation of your medical history and lab work. If a GLP-1 is not appropriate for you, our providers will work with you to determine an effective medication for your health profile.
About Found
To discover your MetabolicPrint and start your journey with Found, take our quiz. Found is among the largest medically supported weight care clinics in the country, having served more than 200,000 members to date.
Get the best of Found right in your inbox
Get started with Found
Ready to lose weight and live your healthiest life?