Metformin vs Ozempic: How Do They Compare?

by Laura Schaefer   ·  1 month ago  
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Diabetes and other insulin- or weight-based issues affect millions of Americans, but fortunately there are great treatments available. For example, it’s hard to miss all the talk about the new medication Ozempic these days. It feels as if everywhere you look, there’s a story in the news about this Type 2 diabetes treatment and how it usually leads to weight loss. However, it’s not the only option in town. Another drug, Metformin, has been around much longer and may be a better fit for your needs.

If you want to know more about Metformin and Ozempic, you are right to arm yourself with knowledge. Read on for a deep dive comparison of Metformin vs Ozempic, what they both do for you, and which is better.

An Overview of Ozempic vs Metformin

Metformin was first developed in the 1950s to manage Type 2 diabetes. Ozempic (a semaglutide) was introduced and received FDA approval much more recently, in 2017. Both Ozempic and Metformin work well to lower blood glucose – but work differently in the body. Ozempic belongs to the GLP-1 receptor agonist drug class, while Metformin belongs to the biguanides drug class. They can be prescribed alone or be taken together.

Here’s a quick look at the similarities and differences between Ozempic and Metformin: 

  • Ozempic is taken via injection, while Metformin is taken orally
  • Metformin has a longer drug history and has fewer severe side effects than Ozempic
  • Metformin is more efficient at managing insulin and blood glucose levels
  • Ozempic is typically more expensive due to its younger age and time on market

Both of these diabetes medications offer good results and may be a viable option to help you with managing blood sugar levels.

What Are Metformin and Ozempic Used For?

Metformin and Ozempic primarily target blood sugar, insulin, and appetite, so they’re predominantly used to treat type 2 diabetes, but they can also be used to treat other conditions that have similar symptoms.

In addition, Metformin and Ozempic may be used to treat PCOS (Polycystic Ovarian Syndrome), and they may—in some cases—be prescribed as part of a weight management plan.

Metformin vs Ozempic for PCOS

Both Metformin and Ozempic may be treated as part of a care plan for PCOS, a condition that frequently causes insulin resistance and can lead to the eventual development of type 2 diabetes. Insulin resistance in PCOS is associated with a defect in insulin receptor signaling, but it can be treated and managed with Metformin and even Ozempic before it develops into diabetes.

Metformin vs Ozempic for diabetes

Both drugs work to lower your blood glucose levels and both accomplish this reduction in two to three months. Both are prescribed to those suffering from Type 2 diabetes.

However, between the two, Metformin is more effective at treating type 2 diabetes. Whereas Ozempic works by stimulation insulin production in your pancreas and slowing and suppressing your appetite and digestion, Metformin works by managing glucose production in your liver and improving your glucose absorption, more directly targeting the symptoms of diabetes.

Metformin vs Ozempic for Weight Loss

Because Ozempic functions as an appetite suppressant, it has become an incredibly popular drug for individuals pursuing weight loss. The active ingredient, semaglutide, mimics the hormones that tell you you’re full, helping to slow food intake and digestion.

Metformin may also cause weight loss, however, it works by managing how much glucose is released from your liver and improving how well your body absorbs glucose from your bloodstream. Weight loss may happen on Metformin, but it’s more of a side effect.

However, while both of these medications can result in weight loss, neither of them are FDA-approved for such treatment. They are primarily approved for insulin resistance, pre-diabetes, and type 2 diabetes, though another semaglutide-based medication like Ozempic, WeGovy, has been approved for weight loss.

Pros & Cons of Using Metformin

Metformin for Diabetes

Metformin, a widely prescribed medication, offers both advantages and drawbacks, making it essential to weigh its pros and cons. Understanding its uses, mechanism of action, and proper administration is crucial for informed decision-making. Additionally, considering potential side effects, dosages, and insurance coverage are important factors to consider when contemplating Metformin therapy.

What is Metformin Used For?

Metformin is a medication used to treat type 2 diabetes and gestational diabetes. If you’re insulin resistant or at a high risk of developing diabetes, Metformin can also be used as part of your preventative care strategy. Therefore, you may be prescribed Metformin if you have PCOS, insulin resistance, or prediabetes.

How Does Metformin Work?

Metformin works by lowering your blood glucose levels in two separate ways.

  1. Reducing the amount of glucose released from your liver, where it is stored
  2. Improving how well the cells of your body can absorb glucose

It excels at reducing blood sugar levels and reducing low-density lipoprotein (LDL) cholesterol without the risk of causing excessively low blood sugar levels (hypoglycemia).

How Do You Take Metformin?

Metformin is typically taken in tablet form, but because Metformin has been on the market for so long, there are several options for generic and brand-name Metformin. In the United States, you can find Metformin under these brand names:

  • Fortamet
  • Glucophage
  • Glucophage XR
  • Glumetza
  • Riomet
  • Riomet ER

Metformin offered in an instant-release and an extended-release format and can be taken in one of the following dosage forms:

  • Extended release tablets
  • Extended release suspensions
  • Tablets
  • Solutions
  • 24-Hour Extended Release Tablets

Side Effects of Metformin

Like other medications, Metformin does cause side effects that range from mild to moderate, and both Metformin and Ozempic can cause nausea and vomiting, diarrhea, stomach pain or discomfort, and indigestion or dyspepsia. Metformin also causes the following side effects:

  • Long-term use of Metformin can increase the risk of vitamin B12 deficiency.
  • Metformin can cause fatigue, dizziness, and an irregular heartrate. It can lead to a buildup of lactic acid in the bloodstream.

Metformin Dosages

The dosage for Metformin varies depending on how your Metformin is administered—suspension, tablet, or solution—and whether the dose is being prescribed to a child or an adult.

For adults, here’s a look at the normal dosing for Metformin:

  • Tablet format: Between 500 mg and 2500 mg daily
  • Suspension format: Between 5 ml and 20 ml daily
  • Solution format: Between 5ml and 25.5 ml daily.

If you miss a Metformin dose, you should take it as quickly as possible. However, if you’re close to the time where you would take your next dose, you should skip the missed dose and continue with your normal dosing schedule instead.

Will Insurance Cover Metformin?

Metformin has been around for a long time, and because of that, its efficiency and outcomes are well-documented. If you are insulin resistant or have diabetes, it’s highly likely that your health insurance company will cover your Metformin prescription when it’s issued by your doctor.

Pros & Cons of Using Ozempic

Metformin for Diabetes

Exploring the benefits and drawbacks of Ozempic usage provides insight into its suitability for individual treatment plans. If you’re considering using Ozempic, you need to know what it’s used for and how it works before starting it. Also, understanding how to take it, what side effects to watch out for, how much to take, and if your insurance covers it are important things to consider.

What is Ozempic Used For?

Like Metformin, Ozempic can be used to treat type 2 diabetes, but its medical benefits don’t stop there. In individuals taking Ozempic for type 2 diabetes, the risk of death from kidney disease and major cardiac events was reduced by 24%.

This is in addition to the benefits it offers in treating diabetes. Ozempic can reduce your A1C, lower your blood sugar, and stimulate your pancreas to create more insulin.

How Does Ozempic Work?

Similarly to how Metformin stimulates the liver, Ozempic stimulates the pancreas. However, where Metformin reduces the amount of glucose released, Ozempic increases the amount of insulin released. This can make Ozempic pair well with Metformin, since they tackle the same problem from different angles.

In addition to stimulating your pancreas, Ozempic also releases a semaglutide that reduces your appetite by sending hormones that simulate fullness and slow down the digestive process. This also simulates the strategy behind bariatric surgery without the severe risk of complications and the limited ability to fully reverse such an operation.

How Do You Take Ozempic?

Unlike Metformin, which is taken orally, Ozempic is exclusively taken via injection. Ozempic is taken by injecting it into your lower stomach once a week, with one Ozempic pen containing multiple doses that you take week over week.

Side Effects of Ozempic

Both Metformin and Ozempic have a number of potential side effects, particularly affecting the stomach. However, between the two, Ozempic has much more severe potential side effects, and those side effects are less extensively studied due to how new the drug is compared to Metformin.

Common side effects of Ozempic include:

  • Nausea
  • Dizziness
  • Bloating
  • Diarrhea
  • Blurred vision
  • Constipation
  • Fatigue

However, there are a number of more severe side effects you can experience from Ozempic:

  • Gastroparesis, or stomach paralysis
  • Cyclic Vomiting Syndrome
  • Acute Kidney Injury
  • Hypoglycemia
  • Acute Gallbladder Disease
  • Pancreatitis
  • Thyroid Cancer

Ozempic Dosages

When you first start taking Ozempic, there’s a period of taking lower doses so your body can acclimate to the drug before you start the full-sized dose. Typically, you will start with a 0.25 mg dose, increasing to 0.5 mg, the standard dose. However, doses can increase to 1–2 mg depending on the needs of the user.

Will Insurance Cover Ozempic?

While insurance won’t cover Ozempic in all cases (such as weight loss), it will cover Ozempic for its FDA-approved purpose—type 2 diabetes.

However, because Ozempic is a highly expensive drug, many plans may have additional criteria that need to be met before they will authorize an Ozempic prescription. These criteria may include having a certain body weight, having tried other medication, or having a certain severity of disease.

What to Consider Before Taking Metformin or Ozempic

There are many factors to consider, including your age, goals, budget (Metformin is far more affordable), and other diagnoses beyond Type 2 diabetes. For example, Ozempic and other similar medications can be used to treat heart disease and kidney problems, in addition to diabetes. 

For more information, consider this list of key differences between the two medications:

1. Metformin Has a Longer Medicinal History than Ozempic. 

As a result of its short history, Ozempic is generally more expensive without insurance. It is a newer drug (under ten years on the market) and doesn’t yet have any available generic alternatives on the market like Metformin does. 

Metformin has been used to treat diabetes since 1957, which means it has an over-sixty-year history and generics available.

2. Ozempic and Metformin Manage Blood Glucose Levels Differently. 

Ozempic works by mimicking the effects of GLP-1, a hormone that stimulates insulin secretion by the pancreas and lowers glucagon secretion from the liver. This reduces the amount of sugar released into the bloodstream and reduces appetite. 

Metformin works by helping to decrease the liver’s sugar production and the intestines’ absorption of sugar while improving the body’s sensitivity to insulin, meaning it uses insulin more efficiently.

3. Metformin and Ozempic Have Different Side-Effects. 

Both medications can cause nausea or vomiting, diarrhea, stomach pain or discomfort, and indigestion or dyspepsia. 

  • Extended usage of Metformin may increase the likelihood of vitamin B12 deficiency. Metformin usage can result in fatigue, dizziness, and irregular heart rate, as well as accumulation of lactic acid in the blood.
  • Ozempic can cause inflammation of the pancreas, too-low blood sugar levels, diabetic eye disease, fever, depression, and acute kidney injury. There’s an increased risk of thyroid tumors with its use as well. 

4. Metformin and Ozempic are Taken Differently.

Ozempic is a once-weekly injection approved for use by adults only. Its users receive a “pen” with six doses you store in the refrigerator. You must use a new needle for each weekly injection and carefully follow all instructions. You must also rotate where you inject the medication. Options include your thigh, stomach, or upper arm.

Metformin is an oral pill approved for adults and children ages 10 and older. It is generally taken twice daily.

5. Metformin Can Be Taken by Children, but Ozempic is for Adults Only.

Metformin is approved for children ages 10 and older. Ozempic can only be prescribed to those ages 18 and older, though its manufacturer (and the makers of similar medications) is exploring its safety in younger populations. One issue to consider is this medication needs to be used continually to maintain effectiveness. 

6. Ozempic May Cause More Weight Loss Effects Than Metformin. 

Metformin has been associated with mild to moderate weight loss, but it is not approved for this purpose. 

The active ingredient in Ozempic has been approved for weight loss. Clinical studies have also shown it can reduce major cardiovascular events.

7. Metformin Has Cheaper Generics Available, While Ozempic Does Not. 

Because Metformin has been available for much longer, it is more affordable. For example, the average cost of generic Metformin can be as low as $4.00. Ozempic, conversely, has no generic version and its cost is approximately $900.00 per month.

Can I Take Ozempic and Metformin Together?

Yes, you can take Ozempic and Metformin together. Ozempic is a type of medication called a GLP-1 receptor agonist, which helps lower blood sugar levels, while Metformin is a medication commonly used to treat type 2 diabetes by improving insulin sensitivity and lowering blood sugar levels. Taking these two medications together can often be beneficial in managing diabetes because they work in different ways to help control blood sugar levels.

Taking both Ozempic and Metformin together can help improve blood sugar control and may reduce the risk of complications associated with diabetes. These medications can complement each other’s effects, leading to better management of your diabetes symptoms. Always talk to your healthcare provider if you have any questions or concerns about taking multiple medications together, and they can provide guidance tailored to your individual needs.

Are Metformin and Ozempic the Same Chemical?

No. Metformin is in the non-sulfonylureas drug class. Ozempic is in the incretin mimetics class.

Your healthcare provider will likely prescribe Metformin as the first choice to lower your blood sugar after a diabetes diagnosis. Over time, if the levels are not where your doctor would like to see them, you may need additional support. This could then include Ozempic injections.

Will Drinking Alcohol Affect My Metformin Dose vs. Ozempic?

Yes. Excessive alcohol intake should be avoided during Metformin treatment. Taking this medication with alcohol may increase the risk of lactic acidosis, which is a buildup of lactic acid in the blood.

The guidance on Ozempic and alcohol is that you should talk to your doctor before using alcohol with a semaglutide. Alcohol may affect blood glucose levels in patients with diabetes. 

What If My Doctor Misdiagnosed My Metformin or Ozempic Dose?

It’s possible. There are over 200 medications that interact with these two drugs, so communication with your healthcare provider is the key. They must know what else you are taking and keep close track of it. 

Your doctor adjusts your dose according to your body’s response to the medications, so it is a good idea to keep a journal of the effects. They can increase or decrease your dose. They can also delay your dose escalation if your body is not tolerating a medication well.

Find a Medical Malpractice Attorney to Support Your Case

If you are dealing with difficult complications from diabetes or other prescription drugs, having an attorney can provide clarity on your options. If you’d like to pursue legal action against a healthcare provider, a lawyer can also ensure your rights are protected as you pursue compensation.

Choosing a lawyer with experience in medical negligence or prescription medication complications is the right first step. Click here to access our network.

Laura Schaefer
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Laura Schaefer is the author of The Teashop Girls, The Secret Ingredient, and Littler Women: A Modern Retelling. She is also an active co-author or ghostwriter of several nonfiction books on personal and business development. Laura currently lives in Windermere, Florida with her husband and daughter and works with clients all over the world. Visit her online at lauraschaeferwriter.com and linkedin.com.