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Managing type 2 diabetes through healthy lifestyle changes is ideal; however, it is not always possible. Sometimes people with type 2 diabetes need medications to control their blood sugar. There are several medications available, Ozempic and metformin being two of them.
Ozempic is a once-a-week injection, whereas metformin is an oral pill, usually taken twice a day. Both medications help control blood sugar; however, they work differently in the body.
This article explores the differences and similarities between Ozempic and metformin.
Ozempic vs. Metformin
While both medications keep blood sugar in check, there are several differences.
What is Ozempic?
Ozempic’s design is similar to a naturally occurring hormone called GLP-1.
- Slow down digestion
- Stimulate insulin release
- Lower the amount the glucose the liver releases
It comes in a pre-filled injection pen that is easy to use and disposable.
The recommendation is to use Ozempic along with diet and exercise to improve glucose levels in people with type 2 diabetes. However, this medicine does not treat type 1 diabetes.
Ozempic is usually only given after a person with diabetes tries other medications.
This medicine also reduces the risk of major heart problems such as heart attack, stroke, or death in people with type 2 diabetes mellitus with a history of heart disease.
What is metformin?
People with type 2 diabetes have used metformin for years to manage their disease.
- Decrease sugar absorption from the intestines
- Lower the amount of glucose made in the liver
- Improve insulin sensitivity
It is available in immediate and extended-release tablets, along with oral suspensions.
This medicine is meant for use along with healthy lifestyle changes such as regular exercise, following a balanced diet, and maintaining a healthy weight. Along with metformin, people can use other diabetes medicines such as insulin and other non-insulin injectables to manage their sugar levels.
Metformin does not treat type 1 diabetes.
Uses of Ozempic and Metformin
Ozempic and metformin share some similar uses, as discussed below.
Uses of Ozempic
Ozempic is prescribed for treating type 2 diabetes in adults.
Consider it for people who:
- Cannot tolerate metformin
- Have a hemoglobin A1c greater than 1.5% over their target
- Do not reach their target A1c in three months
- Have atherosclerosis, heart failure, or chronic kidney disease
In 2014, the Federal Drug Association (FDA) approved Ozempic for chronic weight management.
Those who qualify are adults with obesity or overweight who also have a weight-related condition such as type 2 diabetes, high blood pressure, or high cholesterol.
Uses of metformin
The FDA approved metformin as an antidiabetic medication in 1994.
According to the American Diabetes Association (ADA), metformin is usually the first medication prescribed when diagnosed with type 2 diabetes.
Other non-FDA-approved indications include
- Treating gestational diabetes
- Managing antipsychotic-induced weight gain
- Preventing type 2 diabetes
- Treating polycystic ovary syndrome (PCOS)
Currently, researchers are studying metformin for possible antiaging, anticancer, and neuroprotective uses.
Ozempic and Metformin Dosages
Ozempic dosages
The initial dose of Ozempic is small; then, after four weeks, it is increased.
Ozempic is a once-a-week subcutaneous injection.
- Initial dose: 0.25 mg once a week for four weeks
- Maintenance dose 0.5mg – 1mg once a week
Metformin dosages
For treating type 2 diabetes with the immediate release pills, the initial dose is usually:
- 500mg once or twice a day
- 850 mg once a day
The typical maintenance dose is 850 mg or 1000mg twice a day.
For treating type 2 diabetes with extended-release pills, the daily dose usually starts at 500 mg or 1000mg once a day and is titrated up weekly in increments of 500mg for six weeks.
The maximum dose for extended-release pills is 2000mg once a day.
Side Effects of Ozempic vs. Metformin
When starting any new medication, get emergency help for signs of an allergic reaction such as:
- Hives
- Trouble breathing
- Swelling of your lips, tongue, or throat
| Ozempic Side Effects | Metformin Side Effects |
| Low blood sugar Nausea Heartburn Bloating, gas, or burping Loss of appetite Diarrhea or constipation Headache Dizziness Fatigue Call your doctor at once if you experience: Vision changes Unusual mood changes Thought about hurting yourself Pounding heartbeats or fluttering in your chest Lightheadedness Lump in your neck or trouble swallowing Hoarse voice Pain in your upper stomach spreading to your back Fever Clay-colored stools Yellow skin and eyes Low blood sugar symptoms Lower back pain Urinating less often Stomach flu symptoms | Low blood sugar Nausea Diarrhea Get emergency help if you experience signs of lactic acidosis: Unusual muscle pain Feeling cold Trouble breathing Feeling dizzy, light-headed, tired, or very weak Stomach pain Vomiting Slow or irregular heart rate |
This is not a complete list of side effects and others may occur. Call your medical provider for medical advice about side effects.
Warnings
Ozempic warnings
Avoid taking Ozempic if you have:
- Multiple endocrine neoplasia type 2
- Personal or family history of medullary thyroid cancer
- Insulin-dependent diabetes
- Diabetic ketoacidosis
Call your medical provider if you have signs of a thyroid tumor such as
- Swelling or a lump in your neck
- Difficulty swallowing
- A hoarse voice
- Shortness of breath
Metformin warnings
Avoid taking metformin if you have a medical history of severe kidney disease, metabolic acidosis, or diabetic ketoacidosis.
If you need any diagnostic imaging that requires injection of a dye or contrast, such as an x-ray or CT scan, you must let the medical provider know you are taking metformin.
You may need to stop taking it temporarily.
Although rare, lactic acidosis is a serious potential side effect of taking metformin. Lactic acidosis is a dangerous build-up of lactic acid in your blood.
Get emergency help if you:
- Have unusual muscle pain
- Difficulty breathing
- Stomach pain
- Dizziness
- Feeling cold
- Fatigue
- Weakness
Ozempic and Metformin Interactions
| Ozempic Interactions | Metformin Interactions |
| Ozempic can slow digestion which may cause your body to absorb oral medication slower. Talk to your medical provider about all medications you take, especially: Insulin dulaglutide Exenatide Liraglutide Byetta Trulicity Victoza Other diabetes medicines There are a total of 245 known drug interactions. Drinking alcohol is not recommended while taking this medication. | Many drugs may interact with metformin making it less effective or increasing your risk for lactic acidosis. Some medications increase your risk for hypoglycemia. This includes over-the-counter medications, vitamins, and herbal supplements. Talk to your medical provider about all medications you take, especially: Bupropion Carbonic anhydrase inhibitors Cephalexin Cimetidine Dolutegravir Glycopyrrolate Iodine contrast agents LamotrigineRanolazineTopiramate There are a total of 355 known drug interactions. Drinking alcohol is not recommended while taking this medication. |
Cost of Ozempic and Metformin
The cost of medications depends on several factors:
- If you have health insurance or are cash paying
- What your health insurance plan covers
- Which pharmacy you purchase medications from
- If you purchase the generic or brand
According to drugs.com, the price of metformin is significantly lower than Ozempic, but again, check with your insurance provider for details.
Can You Take Ozempic and Metformin Together?
Ozempic and metformin are safe to take together.
If metformin is not keeping your blood sugar in the target range, your medical provider may also prescribe Ozempic.
Both medications have a low risk of causing low blood sugar, making them safe to take together.
Because they have different mechanisms of action, taking both may better control your blood sugar.
Which Is Best?
Determining which medication is best for you depends on how your body works with the medication. Most people with a new diagnosis of type 2 diabetes start taking metformin first. If you control your sugar well, you may not need to change a thing.
However, if you still struggle to keep your sugar within the target range, you can also try Ozempic. Some people prefer to swallow a pill rather than take an injection. While others prefer the ease of a once-a-week injection over remembering to take a pill once or twice a day.
Get Metformin or Ozempic Online with K Health
Now you can get Ozempic or Metformin online using K Health for just $29 per month.
It’s just three easy steps:
- Answer a few simple questions.
- Meet your primary care provider.
- Get the care you need.
Frequently Asked Questions
K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
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FDA approves new drug treatment for chronic weight management, first since 2014. (2021).
https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014 -
Glucagon-like Peptide-1 Receptor Agonists. (2022).
https://www.ncbi.nlm.nih.gov/books/NBK551568/ -
Metformin (2022).
https://www.ncbi.nlm.nih.gov/books/NBK518983/ -
Metformin. (2022).
https://www.drugs.com/metformin.html -
Ozempic (2022).
https://www.drugs.com/ozempic.html
