Metformin and Ozempic are popular prescription drugs that help manage diabetes.
Because these drugs work differently and are relatively new to use together, you may have questions about how they interact, what side effects they have, and how well they work together.
What is the difference between Metformin and Ozempic?
To understand why one drug, the other, or both drugs may be prescribed at a time, it’s important to know a little about each drug and the differences between them.
Ozempic and metformin differ in several ways. First, metformin is an oral medication that is taken daily (or twice a day) and usually comes in pill form, whereas Ozempic is a once-weekly injection.
These two drugs have different active ingredients and have different effects on the body.
metformin
Metformin is one of the most prescribed drugs in the world. It is most commonly used as a first-line treatment for type 2 diabetes.
Metformin reduces the amount of glucose released by the liver, reduces the amount of glucose absorbed by the intestines, and increases insulin sensitivity. This allows individual cells in the body to consume more sugar and use that sugar more efficiently.
It has been shown to have a wide range of other health benefits as well. Metformin is increasingly prescribed to people with the following symptoms:
Metformin has also been shown to help you lose weight in some situations.
Ozempic
Ozempic is the brand name of the most common drug that uses the active ingredient semaglutide and is primarily used to manage diabetes.
Other pharmaceutical companies also produce medicines containing the same active ingredient as Ozempic (brand names include Rybelsus and Wegovy).
Ozempic is a glucagon-like peptide-1 (GLP-1) agonist. It mimics hormones in the body that help regulate blood sugar levels.
It increases the body’s natural insulin production, reduces glucose production by the liver, and slows the emptying of food from the stomach into the small intestine, which tends to reduce appetite and lead to weight loss.
Ozempic is a relatively new drug, approved by the FDA in 2017, while metformin has been sold in the United States since 1994. Use of both drugs has increased significantly since their introduction.
Why am I being prescribed Metformin and Ozempic?
The main reason these drugs are prescribed is to help manage blood sugar levels.
These help most people lower their average blood sugar levels, as measured by the HbA1c (A1C) blood test, a measure of blood sugar control over the past two to three months. The effect is huge.
In clinical trials, metformin has been shown to be able to lower A1C levels by 1.5 percent at the highest dose, while the average dose of Ozempic lowers A1C by 1.4 percent.
If you are currently taking metformin and are no longer getting the full benefit from it, your health care provider may consider prescribing Ozempic. This could include assessing how effective metformin alone is instead of metformin, or as an additional treatment in conjunction with existing metformin therapy.
There are other reasons why metformin or Ozempic may be prescribed. However, these uses tend to be off-label (not approved by the U.S. Food and Drug Administration (FDA)).
Both metformin and Ozempic have been shown to help with weight loss, in addition to their primary function of lowering average blood sugar levels. Although neither drug is FDA-approved for weight loss, they may have beneficial effects, especially for people with type 2 diabetes who have difficulty maintaining a healthy weight.
Both drugs have been established to reduce the risk of major cardiovascular events such as heart attack.
Although many of these off-label effects can be helpful, metformin and Ozempic are not typically prescribed for these reasons alone.
Can I safely take my medications together?
In most cases, the answer is yes. Clinical trials have shown that the combination of metformin and Ozempic is generally safe.
It is actually becoming more common to prescribe these drugs together as combination therapy, not only because they are generally safe, but because they complement each other in managing blood sugar levels.
These drugs also help with cardiovascular health and weight loss in a mutually reinforcing manner.
Metformin and Ozempic together can be an effective way to manage blood sugar levels, especially for people with type 2 diabetes.
What are the side effects of taking both Metformin and Ozempic?
Although both of these drugs are effective in controlling blood sugar levels, they can also have side effects, and taking them together may increase the risk of certain side effects or undesirable effects.
Both metformin and Ozempic can cause gastrointestinal symptoms such as nausea, vomiting, and diarrhea.
For more information, see: Can metformin cause diarrhea?
Taking these two drugs together can increase the likelihood and severity of side effects.
It is especially important to watch for signs of hypoglycemia (hypoglycemia) if you are taking metformin and Ozempic together or if it is prescribed in addition to insulin.
Low blood sugar levels may cause symptoms such as:
- hunger
- dizziness
- anxiety and irritation
- sweating (sweating)
- trembling
- tingling sensation on lips
- fast heart rate
- fatigue or weakness
- Changes in vision, such as blurred vision
- confusion
If you experience any of these symptoms, it’s important to check your blood sugar levels. If your blood sugar levels are low, it’s important to eat or drink something that contains carbohydrates to quickly bring your blood sugar levels back into the normal range.
Metformin and Ozempic each have their own potential side effects that are very rare but important to be aware of.
In the case of metformin, these include vitamin B12 deficiency and lactic acidosis, a potentially fatal condition in which lactic acid builds up in the body.
For more information, see: Can metformin cause lactic acidosis?
In Ozempic’s case, this includes a thyroid tumor.
Clinical trials have shown that taking both drugs at the same time does not increase the overall risk of developing serious side effects.
It is important to read the documentation that comes with your prescription and discuss each prescribed drug and its potential side effects with your doctor.
Click here to learn more about the side effects of each drug.
Is Ozempic more effective than metformin?
Metformin and Ozempic work in different ways, so neither is guaranteed to be effective. better than others.
Depending on the dose, metformin or Ozempic may lower blood sugar levels more than other drugs.
In general, Ozempic has been shown to help you lose weight better than metformin, but everyone’s experience is different and results will vary from person to person. Also, neither drug guarantees weight loss, and neither drug is approved by the FDA for that purpose.
Can I take Metformin and Ozempic together?
Combination medications for people with type 2 diabetes often combine metformin with another drug that works differently. This approach increases the overall effectiveness of treatment, as each drug targets a different aspect of diabetes management, thereby improving overall glycemic control.
Because each of the three (or more) active ingredients may have its own side effects, interactions, and contraindications (situations in which it should not be used because it may cause harm), be sure to discuss this with your doctor before adding Ozempic to your metformin combination medication.
Is Metformin safer than Ozempic?
Metformin is considered one of the safest and best-studied drugs to help people manage their blood sugar.
Metformin has been commonly used longer than Ozempic, and each drug has undergone extensive and rigorous testing.
However, everyone’s experience with risk factors and side effects is different. Therefore, it is important to work with your doctor to understand how each drug’s safety profile, risks, and side effects stack up against its benefits in light of your personal health history and goals.
See below for more information. Is metformin safe?
What foods should I avoid when taking Metformin and Ozempic together?
When taking Metformin and Ozempic together, it is best to avoid foods that can cause stomach upset. These include greasy, fatty foods and foods high in saturated fat (such as butter, fatty meats, and cheese).
It is generally best to also avoid refined and highly processed foods (such as white bread and processed foods), and you may also be advised to avoid alcohol when taking Metformin and Ozempic.
Follow all guidelines and instructions regarding any prescription medications you are taking. When starting a new regimen, it’s always a good idea to talk to your doctor about what foods, drinks, and activities you should eat and avoid.
Learn more about which foods to avoid.
How much weight can I lose using Metformin and Ozempic together?
It is important to remember that using Metformin and Ozempic together for weight loss purposes is an off-label purpose that is not FDA approved, so it is especially important to work with your doctor to understand the benefits and risks.
If you have type 2 diabetes and are prescribed Metformin and Ozempic but want to lose weight, there are FDA-approved weight loss medications that are safe for people with diabetes and may be prescribed by your doctor.
Clinical trials have shown that metformin alone causes weight loss of about 5 percent of average body weight in about one-third of people who take the drug, and about 12 to 15 pounds in people without diabetes.
For people who are overweight or obese, Ozempic has been shown to cause an average weight loss of 14.9% of body weight.
See below for more information.
