You’ve probably heard of metformin—the most widely prescribed type 2 diabetes drug in the United States. But Ozempic (also known as semaglutide) may not be on your radar yet. These medications have similarities; both are approved by the U.S. Food and Drug Administration (FDA) to treat type 2 diabetes.
In addition to Ozempic, semaglutide is also listed under the brand name, Rybelsus—the pill version of the medication. Both are glucagon-like peptide-1 receptor agonists (GLP-1s)— we’ll get into the details about what that means in a little bit—while metformin belongs to a different drug class called biguanides.
Ozempic is often given when metformin—which is first in line to be prescribed— doesn’t work for someone with type 2 diabetes mellitus.
Healthcare professionals also prescribe metformin and Ozempic off-label to treat overweight and obesity as part of a holistic approach to weight care. During your weight loss journey with Found, your health care provider may suggest metformin or Ozempic (or in combination). This gives you the most sustainable options to meet your goals in combination with lifestyle changes.
It’s easy to get confused with different drug names on the market, which is best, and how they work—all totally understandable questions! That’s why we’re here to clarify.
If you have questions about Ozempic vs. metformin and which might be best to take, you’re in the right place.
Both diabetes drugs help lower blood glucose levels in those people who have high blood sugar and may be insulin resistant. But they do vary in quite a few ways.
To explore Ozempic vs. metformin, we must first pause to review what GLP-1s are.
GLP-1, or glucagon-like peptide 1, is a hormone your body secretes in your intestines. It helps produce insulin when you eat and naturally lowers blood sugar. Ozempic copycats the effects of this hormone.
Ozempic for weight loss is possible because it works to stimulate insulin and slow digestion. Because it plays a role in digestion and regulates appetite, it can make you feel full and eat fewer calories.
In 2021 the FDA approved semaglutide — under the brand name Wegovy — for treating type 2 diabetes and those with obesity or overweight (defined as a body mass index (BMI) of 30 or greater, or people with a BMI of 27 who also have at least one weight-related condition like high cholesterol, high blood pressure, and type 2 diabetes). It’s the first of its kind to be approved for weight loss since 2014. And insurance companies will cover it as a form of obesity treatment.
This is fantastic news in the fight against the obesity epidemic for the ongoing treatment of the disease.
Metformin has been an FDA-approved medication to treat type 2 diabetes since 1994. Unlike Ozempic, metformin doesn’t mimic the GLP-1 hormone. It’s a biguanide that lowers the amount of sugar your intestines absorb, helping decrease how much glucose is made in the liver and improving insulin sensitivity.
Additionally, it’s used off-label for treating obesity, and metformin is proven to be an effective medication for weight loss. One study of metformin and weight loss in 2001 on 31 non-diabetic obese participants found that after 28 weeks, participants lost an average of 16 pounds. Metformin can also be used side-by-side with other diabetes medications, like Glipizide and insulin, to see what works best and to increase efficacy.
Good question. Ozempic comes in a prefilled pen that is injected under the skin—usually weekly. Metformin is a pill taken in either immediate or extended-release form, once or twice daily. Your Found health care provider will decide which medication and dosages may be right for you.
Like any prescription medication, there can be side effects. Here are some of the most common ones that participants in controlled trials have reported, according to the FDA:
Low blood sugar (hypoglycemia)
We want you to be fully aware of what you’re taking. So here’s the run-down on warnings to consider in your metformin vs. Ozempic debate:
In Ozempic drug trials, although extremely rare, thyroid tumors have developed when taking it. If you have trouble swallowing, develop hoarseness, or feel swelling or a lump in your neck—contact your Found health care provider immediately.
The FDA also warns not to take Ozempic if you have or have a 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 a right fit.
The FDA also has a “blackbox warning” on metformin as it carries a serious safety risk of lactic acidosis. This rare but potentially fatal condition causes too much lactic acid in the blood. It can lead to low blood pressure, breathing issues, heart failure, and even death.
Additionally, metformin may stimulate ovulation in those who are premenopausal and may increase the risk of unintended pregnancy. If you’re in a sexual relationship that can result in pregnancy, make sure you use at least one form of birth control unless you’re planning on getting pregnant.
The short answer is yes. A 2017 study looked at the effects of metformin paired with a semaglutide such as Ozempic. Researchers found there were no drug interactions between the two. And additional research suggests combining Ozempic and metformin may make them more effective.
Ozempic reduces appetite, and when taken with metformin, it can help lower blood glucose levels further. If your Found health care provider finds that metformin isn’t working for you, they may also prescribe Ozempic.
When considering metformin vs. Ozempic, it’s important to tell your physician about any medications you may be taking, as serious drug interactions can occur. Here’s what we know.
Some drugs can make metformin less effective or increase your risk of lactic acidosis or low blood sugar.
These are some of the things that can interact with metformin:
Carbonic anhydrase inhibitors
Iodine contrast agents
These are some of the drugs that can interact with Ozempic:
Sulfonylureas (these can cause blood sugar levels to drop dangerously low when combined with Ozempic).
Some birth control pills
Trulicity (also known as Dulaglutide—another type 2 diabetes medication).
Whether Found’s health care professionals prescribe metformin or Ozempic, you should not drink alcohol because it lowers your blood sugar. Combined with the medications, it may fall too fast, leading to fainting and dizziness.
It truly depends. Several factors determine whether metformin vs.Ozempic is suitable for you, and Found takes a personalized approach to treatment. We’re here to find the best and most sustainable form of treatment.
Also, some folks prefer taking a pill over a weekly injection, and others may like the ease of only having to remember a medication once a week.
It’s all about finding the medication that’s just right for you. As you talk to your Found health care provider, they’ll go through a complete medical history check and help in your metformin vs. Ozempic debate.
Access to GLP-1s prescriptions is now available as part of Found's weight-loss program. 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 medical history, eating behavior, lab work, and insurance coverage. If a GLP-1 is not appropriate or affordable for you, Found providers can help determine if another effective medication is.
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.