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?
Are you considering Ozempic or Wegovy for weight loss but uncertain which is right for you? Get all the details on these GLP-1 weight loss medications here.
While medication-assisted weight loss is decades old, it has recently moved to the forefront of the cultural zeitgeist via the popularity of two medications—Wegovy®and Ozempic.® The media coverage for these GLP-1 (glucagon-like peptide-1 receptor agonist) medications has been exhaustive in the last year. As Ozempic’s rumored weight loss effects spread across social media, consumer demand for the medication rose rapidly. The news-fueled frenzy around Ozempic has since turned into supply issues, a rise in questionable prescribing practices, and a decrease in the drug’s coverage by many insurance policies. Wegovy’s also been in short supply since early 2022. And after a study published in November 2023 publicized the cardiovascular benefits of semaglutide—the active ingredient in both Wegovy and Ozempic—there is renewed interest in it.
But what are Ozempic and Wegovy, and how do they work for weight loss? At Found, we use a doctor-designed weight loss program and our proprietary metabolic health analysis, MetabolicPrint,™ to match members with the right medication to address the root causes of their weight challenges. We’ve gathered all available resources to help you understand the difference between Ozempic and Wegovy for weight loss.
Wegovy and Ozempic have two immediate similarities: they are both brand-name medications with the active ingredient semaglutide and are manufactured by Novo Nordisk, a Danish pharmaceutical company.
Semaglutide medication belongs to a drug class called glucagon-like peptide-1 (GLP-1s) receptor agonists. Semaglutide drugs work for weight loss by mimicking the GLP-1 gut hormone. This hormone sends signals to the brain, slowing digestion to help people feel full and prompts the body to release more insulin, which decreases blood sugar. These processes help control blood sugar spikes and reduce appetite and cravings, which can lead to weight loss.
More on Wegovy
Even though Wegovy and Ozempic share the same active ingredient, there are important differences.
The main difference is that Wegovy is approved by the U.S. Food and Drug Administration (FDA) for chronic weight management in patients with excess weight and obesity. Combined with lifestyle changes like diet and physical activity, Wegovy treats patients with a body mass index (BMI) of 30 or greater or a BMI of 27 or greater with at least one weight-related medical condition like high cholesterol or high blood pressure. Wegovy also has significant benefits for heart health. The “Semaglutide and Cardiovascular Outcomes in patients with Overweight or Obesity Who Do Not Have Diabetes” trial, also known as the SELECT Trial, found that people treated with weekly injections of semaglutide reduced their relative risk of a cardiovascular event by 20%. Another study published in August 2023 also showed Wegovy may help lower the risk of heart attacks and strokes.
Wegovy is a once-weekly injectable medication with a maximum maintenance dose of 2.4 mg.
You inject the medication in the pre-filled pen subcutaneously into your upper arm, upper thigh, or stomach. The suggested weekly injection dosing schedule is as follows:
Dosages for Wegovy
According to reports from the FDA, lower doses of Wegovy continue to be in short supply.
More on Ozempic
Ozempic is FDA-approved to support glycemic control in people with type 2 diabetes. Ozempic is also FDA-approved to help lower the risk of major cardiovascular events like heart attack and stroke in these patients. Physicians can also prescribe Ozempic off-label to treat clinically defined excess weight and obesity. Ozempic is a once-weekly injectable medication, and its maximum maintenance dose is 2 mg.
Like Wegovy, you inject the medication in the pre-filled pen under your skin into your upper arm, upper thigh, or stomach. The suggested weekly injection dosing schedule is as follows:
Dosages for Ozempic
In a clinical trial of 1961 adults published in The New England Journal of Medicine, Wegovy supported meaningful weight loss results in adults with obesity or overweight who were given a 2.4 mg semaglutide dosage each week. Of those participants, the average weight loss was about 15% of body weight over 68 weeks compared to 2.4% in the placebo group.
A 2022 study published in JAMA Network Open compared weight loss in patients given different doses of semaglutide. Out of 175 patients, 44% received the highest doses of semaglutide. This is similar to Wegovy’s weekly maximum maintenance doses of 1.7 mg and 2.4 mg. The other patients received lower weekly doses of 0.25 mg, 0.5 mg, and 1 mg. After three months, the patients receiving the higher doses lost about 7% of their body weight, while those on the lowest doses lost about 5%. Both groups continued to lose weight over time with the sustained use of semaglutide in combination with a healthy diet and exercise.
Cost can be a barrier when deciding to use Wegovy, Ozempic, or an alternative treatment. Even though obesity is a disease—and weight loss medication is often needed to treat it—Wegovy isn’t always covered by insurance and can be much more expensive than Ozempic or alternative treatments.
Wegovy’s list price is $1,349.02 per package, which is the out-of-pocket cost to the patient if your insurance doesn’t cover the medication. The manufacturer does have a savings offer, the Wegovy Savings Card, for this medication, much like other agonist medications. However, patients looking to claim a discounted price on the first few boxes of the medication must have commercial drug insurance and activate the offer by December 31, 2023.
On the other hand, Ozempic is approved to treat type 2 diabetes, so it’s often covered by insurance plans if prescribed for its indicated use. However, when prescribed off-label to treat overweight and obesity, coverage varies greatly. In fact, Found’s members have seen a decline in coverage for drugs like Ozempic in the last few months as insurers struggle to cover the demand.
For those paying cash, Ozempic’s list price is $935.77 for a month’s supply. A savings program is also in place for this medication, so consult the manufacturer’s website to see if you qualify. Much like Wegovy, this medication requires commercial drug insurance to be eligible for the offer.
If you and your Found-affiliated provider decide that a GLP-1 medication may be right for you, talk to your clinician about step therapy. Ultimately, a provider trained in obesity should prescribe a medication that matches your needs. However, if you find that non-GLP-1 drugs aren’t helping you lose weight, you may find it easier to unlock coverage for a GLP-1 if you have a record of trying other medications first.
Other medications work similarly to Ozempic and Wegovy, including Saxenda® and Victoza,® both brand names for liraglutide, and Mounjaro,® a brand name for tirzepatide. Liraglutide and semaglutide are GLP-1 receptor agonists, while Mounjaro is a GLP-1/GIP (glucose-dependent insulinotropic polypeptide) dual agonist.
There is also a pill version of semaglutide available, Rybelsus,® that’s used to treat type 2 diabetes. It may also be prescribed off-label for excess weight and obesity. If needles and the idea of weekly semaglutide injections put you off, Rybelsus may be a better option.
Found’s medication toolkit also has a variety of non-GLP-1 medications, which can be much more cost-effective and easily accessible. Ultimately, discovering which medication is right for you is a conversation to have with your provider because every person’s biology and root cause of excess weight is different—and so is the medication that unlocks success for you.
As with other prescription medications, Ozempic, Wegovy, and other GLP-1s have side effects. Some of the most common side effects of semaglutide and liraglutide are nausea, constipation, vomiting, stomach pain, and diarrhea. More serious but less common side effects of these drugs include:
GLP-1s like Ozempic and Wegovy, as well as similar medications (Saxenda, Victoza, Rybelsus, and the GLP-1/GIP Mounjaro), come with a black box warning issued by the FDA. You shouldn’t take the medication if you have a family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). You can find detailed side effects and risk information for specific GLP-1 medications here.
Additionally, you should avoid alcohol while taking semaglutide and other GLP-1s. If you are taking diabetes medication, have a discussion with your prescribing physician before taking any of these medications for weight loss, as diabetes medication may need to be adjusted as you lose weight. Do not take this medication if you plan to become pregnant, are pregnant, or are nursing.
Obesity is a chronic condition that needs to be treated like other chronic diseases. Many people will likely need medication to maintain weight loss. Obesity is a complex, relapsing disease you can manage through medication and lifestyle changes for long-term results.
If you stop taking semaglutide, you may regain the weight you’ve lost or risk losing glycemic control if you have diabetes. It’s important to continue taking semaglutide unless otherwise directed by your health care provider.
Deciding between Ozempic and Wegovy is up to you and your health care provider. Both drugs share the same active ingredient, and are effective for weight management. However, as the labeling for Ozempic and Wegovy explains, pairing any weight loss drug with behavioral changes, like a healthy diet and exercise is important for sustainable results. Taking care of your mental health is important, too. Obesity is a disease that needs to be cared for and treated with a comprehensive approach, no matter which medication you are prescribed.
Both weight loss medications have a similar safety profile, and coverage for both drugs varies based on your individual health insurance coverage. Ozempic and Wegovy are meant to be taken long-term alongside lifestyle changes to maintain glycemic control and weight loss.
The best medication is the one that matches your unique biology. Taking the MetabolicPrint quiz will help your Found-affiliated clinician determine which personalized prescription weight loss plan is right for you. You may experience side effects with one weight loss drug that you don’t experience with the other. Or you might find that neither of these drugs helps you lose weight.
If you find that a GLP-1 medication doesn’t help you, there are a variety of options in Found’s broad medical toolkit for your provider to choose from based on your MetabolicPrint profile. Your Found provider will be able to guide you through your options and craft a lifestyle change plan that will maximize your results.
Found is among the largest medically-supported weight care clinics in the country, having served more than 200,000 members to date. To start your journey with Found, take our quiz.
GLP-1*
GLP-1 prescriptions, filled through your local pharmacy, are now available as part of Found's weight-loss toolkit. While GLP-1s are 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, eating behavior, lab work, and insurance coverage. 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
Found is among the largest medically-supported weight care clinics in the country, serving more than 200,000 members to date. To start your journey with Found, take our quiz.
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