Is Ozempic better than metformin?

Ozempic (semaglutide) and metformin have not been directly compared in head-to-head clinical studies, so it is difficult to know if one works better than the other to treat type 2 diabetes. In separate studies, metformin and Ozempic lowered hemoglobin A1C by a similar percentage.

There are several factors that can help determine if Ozempic or metformin is the best treatment option for you, including route of administration, side effects, and cost.

Currently, Ozempic is available as a brand-name medication only and metformin is available in many generic versions.

How do metformin and Ozempic work?

Even though both metformin and Ozempic are used to treat type 2 diabetes, they work in different ways.

Metformin is a biguanide that is taken by mouth up to a few times daily. It works in different ways to manage blood glucose levels:

• Reduces glucose production in the liver
• Improves insulin sensitivity
• Slows down absorption of glucose from the intestines

Ozempic is glucagon-like peptide 1 (GLP-1) receptor agonist that is injected under the skin once a week. It causes your body to release insulin, which helps lower blood glucose levels. It also slows down the time it takes for food to move through your stomach, keeping you fuller longer.

How well do metformin and Ozempic work?

There are no head-to-head clinical trials comparing metformin and Ozempic for the treatment of type 2 diabetes, but each medication has been studied separately. Researchers looked at how well metformin and Ozempic lowered hemoglobin A1C during the studies. The A1C test measures your average blood sugar level over the past 2-3 months, and a lower A1C indicates better blood sugar control.

• In a 30-week clinical trial of 388 patients with type 2 diabetes, Ozempic lowered hemoglobin A1C by 1.4-1.6%.
• In a 29-week clinical trial of 286 patients with type 2 diabetes, metformin lowered hemoglobin A1C by 1.4%.

Each person's response to these medications can depend on factors such as the dose, lifestyle choices, and what other medications they are taking.

Metformin vs. Ozempic for weight loss

Neither the brand Ozempic nor metformin are approved for weight loss, but some studies have shown that both medications cause some patients to lose a modest amount of weight during treatment. Patients who took Ozempic lost more weight than patients taking metformin in separate clinical studies of similar length.

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Metformin

Experts classify metformin as a weight-neutral treatment option for patients with type 2 diabetes. It has the potential to cause a small amount of weight loss in some patients.

In a 29-week clinical trial submitted to the FDA for approval, patients with type 2 diabetes who took metformin lost 0.6 kg (1.4 lbs). However, this was compared to patients in the placebo group who lost 1.1 kg (2.4 lbs).

Another study showed the patients with type 2 diabetes who took metformin lost 2.9 kg (6.4 lbs) over a 5-year period.

Ozempic

Because Ozempic slows down how fast food moves through your digestive tract, it can decrease your appetite and result in lower calorie consumption. This can lead to weight loss in some patients.

In a 30-week clinical study of patients with type 2 diabetes, people taking Ozempic 0.5 mg by itself lost 3.8 kg (8.3 lbs) and those taking Ozempic 1 mg lost 4.7 kg (10.3 lbs). Patients in the placebo group lost 1.2 kg (2.6 lbs).

Can you take metformin and Ozempic together?

Yes. A study showed that Ozempic does not affect the way metformin works in the body, and concluded there is no interaction between the two medications. Additionally, Ozempic and metformin work differently to lower blood glucose levels.

During clinical studies submitted to the FDA for approval, some patients with type 2 diabetes took both Ozempic and metformin. If your blood sugar is not well controlled with one medication alone, your healthcare provider may recommend adding on another medication.

What are the side effects of metformin and Ozempic?

Ozempic and metformin can both cause stomach side effects. Additionally, metformin can raise the risk for lactic acidosis. Some patients have reported pancreatitis while taking Ozempic.

The most common side effects of metformin (>5%) include:

• Diarrhea
• Nausea/vomiting
• Excessive gas
• Feeling weak
• Indigestion
• Stomach discomfort
• Headache

The most common side effects of Ozempic (≥5%) include:

• Nausea
• Vomiting
• Diarrhea
• Stomach pain
• Constipation

This is not all the information you need to know about metformin and Ozempic for safe and effective use and does not take the place of talking to your doctor about your treatment. Review the full product information here, and discuss this information and any questions you have with your doctor or other health care provider.