Metformin vs Ozempic: What’s the Difference?

Key Takeaways

Both Ozempic and metformin are prescription medications prescribed to people with Type 2 diabetes mellitus. Ozempic mimics a naturally occurring hormone in the body called glucagon-like peptide-1 (GLP1). Metformin improves blood glucose levels and promotes insulin sensitivity.
Metformin and Ozempic both commonly have digestive side effects, including abdominal pain, heartburn, nausea, vomiting, diarrhea, and constipation. Diabetic patients taking Ozempic, metformin, and other diabetes medications are also at risk of low blood sugar.
Ozempic can cost as much as $995 for a one-month supply. Metformin is an inexpensive generic drug, and average costs are around $20 for a one-month supply.

Ozempic and metformin are both medications prescribed to people with Type 2 diabetes mellitus. Similar to other diabetes drugs, metformin and Ozempic are used for managing blood sugar levels even though they work through different mechanisms of action.

In general, oral diabetes medicines such as metformin are tried first for blood sugar control before injectables such as Ozempic are considered. The choice of diabetes medication also depends on your medical history, such as heart disease or kidney disease.

Drug interactions with your other medicines are also taken into consideration by your doctor when choosing your diabetes treatment. Please continue reading to learn some of the key differences between Ozempic vs metformin.

What are the main differences between Ozempic and metformin?

Type of drug

Both Ozempic and metformin are prescription medications. Ozempic is a brand name product for the generic drug semaglutide; It mimics a naturally occurring hormone in the body called glucagon-like peptide-1 (GLP-1). Ozempic belongs to a group called GLP1 receptor agonists.

Metformin belongs to a drug class called biguanides. It is a generic medication that is also sold under brand names such as Glucophage and Fortamet, though most of these brand names are no longer available in the U.S.

Uses

Ozempic (semaglutide) is a once-weekly injection used to manage blood sugar levels in people with Type 2 diabetes. People with type 1 diabetes may be able to reduce their reliance on mealtime insulin by taking Ozempic for diabetes treatment. The generic medication semaglutide is also available under the brand name Wegovy for chronic weight management.

Metformin is used to treat Type 2 diabetes mellitus. It is also prescribed off-label for gestational diabetes and polycystic ovary syndrome (PCOS). Metformin is not used to treat Type 1 diabetes or if you have diabetic ketoacidosis.

Mechanism of action

Ozempic and metformin both affect blood sugar levels. Ozempic lowers blood sugar by increasing insulin production in the pancreas. It also slows gastric emptying and reduces glucose production by the liver.

In addition to lessening the amount of sugar absorbed in the stomach and intestines, metformin improves blood glucose levels by reducing glucose production in the liver. It also improves insulin sensitivity but does not affect insulin secretion from the pancreas.

Age range

The safety and efficacy of Ozempic have not been established in pediatric patients younger than 18 years of age. Adults and children 10 years of age and older can take regular metformin or metformin immediate-release. The extended-release metformin is not approved for anyone younger than 18 years old.

Dosage forms

Ozempic comes as an injection solution in a prefilled pen for subcutaneous injection (under the skin) to be given once a week.

Metformin comes as tablets, extended-release tablets, and a liquid oral suspension to take by mouth. The extended-release form of metformin is not approved for pediatric patients. Metformin immediate-release is taken by mouth twice daily, while the extended-release formulation allows once-daily dosing.

Storage

Ensure the proper storage for both medications to maintain their effectiveness. Unused Ozempic pens should be stored in the refrigerator. They should not be frozen. An Ozempic pen that is currently in use can be stored in the refrigerator or at room temperature, but not in hot places like the glove compartment of a car. The pen should be discarded 56 days after starting use, even if there is some medication remaining.

Metformin should be stored at room temperature. Avoid storing it in the bathroom, where it can be exposed to heat and humidity. Keep all medications safely out of reach of children and pets.

Side effects

Common side effects of Ozempic include abdominal pain, heartburn, nausea, vomiting, diarrhea, and constipation.

Taking metformin can cause side effects such as stomach pain, heartburn, gas, bloating, upset stomach, diarrhea, constipation, metallic taste, and headache.

These side effects are not exhaustive. Consult your healthcare provider for a comprehensive list.

Diabetic patients taking Ozempic, metformin, and other diabetes medications are also at risk of hypoglycemia (low blood sugar). The risk of hypoglycemia is generally higher with Ozempic compared to metformin. Drinking alcohol is associated with an increased risk of hypoglycemia.

Risks

Serious health complications associated with Ozempic use include thyroid tumors. You should not take this medicine if you have a personal or family history of thyroid cancer or a rare condition called multiple endocrine neoplasia type 2.

Metformin use can lead to lactic acidosis (too much lactic acid) and vitamin B12 deficiency.

The mentioned risks are rare but serious. Report any unusual symptoms to your healthcare provider promptly.

Price

Prices may vary based on location, insurance coverage, and other factors. Ozempic can cost as much as $995 for a one-month supply. Generic forms of semaglutide may be available at a lower cost than brand-name Ozempic. Metformin is an inexpensive generic drug, and average costs are around $20 for a one-month supply.

How quickly do diabetes medications work to control blood glucose levels?

Both Ozempic and metformin lower blood sugar levels over a period of time. You might see some improvement in high blood sugar levels after one week of treatment, but it can take 2 to 3 months to get the full benefits of these medicines. Individual responses may vary. Follow your healthcare provider's guidance.

Which is better for weight loss: Ozempic vs metformin?

Weight loss results can vary among individuals, and the effectiveness of these medications may depend on various factors.

Taking diabetes medications, such as metformin and Ozempic, not only lowers blood sugar but can also help in losing weight. Studies have shown that regular semaglutide use can help in losing 5-10% of body weight over 3-6 months. Metformin has also been found to result in modest but clinically significant weight loss.

If you are unable to control weight gain or lose weight with lifestyle measures like diet and exercise, your healthcare provider may recommend Wegovy (semaglutide) or other medications that are FDA-approved to promote weight loss along with regular exercises and healthy diets.

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