Ozempic vs Metformin: Which is Better for Treating Diabetes?

Ozempic and metformin are two popular type 2 diabetes medications that people can use to help manage blood sugar levels and provide other health benefits. But, is one of them better than the other? Do they have different side effects? How do they help manage type 2 diabetes symptoms?

If you have diabetes and want to know the differences between metformin and Ozempic, here is everything you need to know about these two drugs so you can make an informed decision about your health.

What is Metformin?

Metformin is a drug that was originally introduced in the 1950s and is a key treatment for type 2 diabetes. It helps lower hemoglobin A1C (also known as HbA1C or just A1C), which is your average blood glucose level over the past three months. Metformin also reduces glucose absorption from the intestines, helps reduce liver glucose production, and helps improve insulin sensitivity.

It’s also available as a low-cost generic drug, making it a popular choice for people who are looking for affordability. Metformin can be helpful for people with type 2 diabetes, prediabetes, gestational diabetes, and even polycystic ovary syndrome (PCOS).

What is Ozempic?

Ozempic uses semaglutide, a glucagon-like peptide 1 (GLP-1) receptor agonist, which is a compound that mimics the natural GLP-1 hormones your body produces when you eat. Ozempic helps stimulate the pancreas to produce and release insulin, which helps stabilize blood sugar levels, helps prevent the liver from producing too much sugar, and slows digestion to help you feel fuller longer after eating.

Ozempic is a fairly new drug, having only been on the market since 2017 when it was approved for use in adults with type 2 diabetes. Studies have also shown that it can help reduce the risk of major cardiovascular events because it can also help lower blood pressure.

Comparing Side Effects

Both Ozempic and metformin have possible side effects that you may encounter while taking them, and it can be helpful to know what to expect before you begin.

Ozempic Side Effects

Common side effects of Ozempic include:

• Nausea
• Vomiting
• Diarrhea
• Abdominal or stomach pain
• Constipation

Less common side effects include:

• Injection site reactions
• Low blood sugar (hypoglycemia)

Rare but very serious side effects can include:

• Thyroid cancer

Metformin Side Effects

Common side effects of metformin include:

• Abdominal or stomach pain
• Coughing
• Decreased appetite
• Diarrhea
• Fever or chills
• Back or side pain
• Muscle pain or cramping
• Sleepiness

Less common side effects include:

• Blurred vision
• Chest discomfort
• Cold sweats
• Difficulty breathing
• Dizziness
• Headache
• Increased hunger
• Nausea
• Shakiness
• Weakness
• Vitamin B12 deficiency (typically only occurs after extended use)

6 Similarities Between Ozempic and Metformin

1. Both metformin and Ozempic are FDA-approved as type 2 diabetes medications.
2. Both drugs help lower and control blood sugar levels.
3. Both drugs can potentially lead to weight loss
4. Both drugs have some similar side effects, such as nausea, vomiting, diarrhea, stomach pain, or indigestion.
5. Both medications are prescription drugs that will need to be prescribed by a doctor.
6. Both medications are available both as brand-name drugs and as generic drugs.

4 Differences Between Metformin and Ozempic

Just like how there are a lot of similarities between metformin and Ozempic, there are also some key differences that you should know.

1. How the Medications are Taken

One of the biggest differences between the two medications is how they are taken. Ozempic is a weekly injectable medication, while metformin is an oral tablet that can be taken either once or twice a day. There are also different types of metformin prescriptions, such as extended-release tablets and immediate-release tablets.

2. How the Medications Work

Ozempic is in the GLP-1 receptor agonist drug class, while metformin is in the biguanide drug class. Because they are from different drug classes, they work in completely different ways. Ozempic works by mimicking GLP-1 hormones that stimulate the pancreas to release insulin and block the liver from creating extra glucose. Meanwhile, metformin works by helping increase your body’s insulin sensitivity while also helping your body decrease the amount of glucose it makes and absorbs.

3. Drug Prices

Metformin is generally very affordable with insurance, while Ozempic is typically quite a bit more expensive with insurance coverage. Prices will vary depending on the exact prescription and type of insurance, however.

The retail price of Ozempic without insurance is around $1,177 per pen. Meanwhile, the retail price for metformin 500mg is just under $10 for 60 tablets without insurance.

4. Ozempic Can Lead to More Weight Loss

One of Ozempic’s side effects is weight loss, and the active ingredient semaglutide has even been used to develop weight loss medications like Wegovy. Metformin, on the other hand, is considered a weight-neutral medication. While it has the potential to cause some weight loss, its results don’t compare to Ozempic. On average, metformin users typically lose about six pounds.

Who Should Not Take Ozempic or Metformin?

Like with any other medications, there are some groups of people that are not advised to take Ozempic or metformin due to the risks the medications can pose to people with certain health conditions. Here is what you should know about the different groups that Ozempic and metformin can negatively affect.

People Who Should Not Take Ozempic

• People with a personal or family history of medullary thyroid carcinoma (MTC)
• People with Multiple Endocrine Neoplasia syndrome type 2 (MEN2)
• People with a history of pancreatitis
• People with kidney problems, such as kidney disease
• People with severe gastrointestinal disease
• People with diabetic retinopathy (vision loss due to diabetes)
• People with gallbladder disease or other gallbladder problems
• People who are pregnant, plan to become pregnant, or are currently nursing

People Who Should Not Take Metformin

• People with liver or kidney problems
• People with a severe infection
• People being treated for heart failure or who have recently had a heart attack
• People with severe breathing or circulation problems
• People who drink alcohol excessively

How to Get the Best Results From Your Medications

If you’re taking Ozempic or metformin, there are a few simple ways to help improve their effectiveness and support better blood sugar control. One of the most important things you can do is maintain a healthy diet. Focus on eating balanced meals that include lean protein, fiber, whole grains, vegetables, and healthy fats. Try to limit added sugars and processed foods, which can cause blood sugar spikes.

Adding regular physical activity to your routine can also make a big difference. Even light exercise, like walking for 20 to 30 minutes a day, can help improve insulin sensitivity and lower your A1C levels over time.

Be consistent with your medication. Take it exactly as prescribed, and don’t skip doses. Staying hydrated, avoiding excessive alcohol, and not smoking can also help reduce side effects and support overall health.

It’s also a good idea to track your blood sugar levels with glucose sticks or a CGM if you have one, especially if you’re trying a new medication or adjusting your lifestyle habits. Knowing how these medications affect your blood sugar levels is important, especially when you’re just starting out with them.

Which is Better: Ozempic or Metformin?

Both Ozempic and metformin are good medications that can provide a lot of health benefits to people with type 2 diabetes. Both medications have their pros and cons and may be appealing to different people for different reasons.

For instance, people who are sensitive to needles may find it difficult to use Ozempic due to it being an injectable medication. Metformin, on the other hand, is a daily tablet that people who are sensitive to needles can easily take. But on the other hand, people who have trouble swallowing pills or who may forget to take a daily pill may find Ozempic more appealing because it’s injectable and only needs to be taken once a week.

Ozempic may also be a better option for someone interested in losing weight to help manage their type 2 diabetes, as it typically leads to more weight loss than metformin hydrochloride tablets do.

Ozempic vs Metformin: Choose the Best Medication For You

Choosing between Ozempic and metformin isn’t about finding which medication is “better,” but rather which one is better for you. Both medications are effective at blood sugar control and reducing risks associated with type 2 diabetes, but they work in different ways and come with different benefits and side effects. Ultimately, the best choice depends on your health history, lifestyle, and treatment goals. But you don’t have to make this decision alone.

Talk to a registered dietitian today at no cost to you to get personalized guidance on managing your type 2 diabetes and choosing the right treatment plan. Sign up now to take the next step in your diabetes care with confidence and support.

Ozempic & Metformin FAQ

Can Children Take Ozempic or Metformin?

Ozempic is not approved for children of any age, but specific types of metformin may be acceptable for children who are at least ten years old, such as the immediate-release tablets. If you have any questions about type 2 diabetes medications for children, consult your child’s pediatrician.

Can You Take Ozempic and Metformin at the Same Time?

It’s generally safe for people to take both Ozempic and metformin at the same time. Novo Nordisk, the manufacturer behind Ozempic, sponsored a study that found some participants in the study experienced mild to moderate gastrointestinal side effects, but the side effects they felt weren’t any different than those who only took Ozempic.

What Other Diabetes Medications Are Available?

In addition to metformin and Ozempic, there are a lot of other type 2 diabetes medications that your doctor may prescribe. These include options such as:

• Alpha-glucosidase inhibitors like acarbose and miglitol – slow down carbohydrate digestion in your intestines to prevent blood sugar spikes after meals
• Dopamine-2 agonists like bromocriptine – affect brain chemistry to improve blood sugar control (less commonly used)
• Dipeptidyl peptidase-4 (DPP-4) inhibitors like alogliptin, linagliptin, saxagliptin, and sitagliptin – help your body produce more insulin when blood sugar rises and reduce glucose production by the liver
• Other GLP-1 RAs like liraglutide or tirzepatide – injectable medications that slow digestion, reduce appetite, and help insulin release (work similarly to Ozempic)
• Meglitinides like nateglinide and repaglinide – boost insulin production specifically at mealtimes
• Sodium-glucose transport protein 2 (SGLT2) inhibitors like dapagliflozin and empagliflozin – help your kidneys remove excess glucose through urine and provide heart/kidney benefits
• Sulfonylureas like glimepiride, gliclazide, and glyburide – stimulate your pancreas to release more insulin throughout the day (one of the oldest diabetes drug classes)
• Thiazolidinediones like pioglitazone and rosiglitazone – make your body’s cells more sensitive to insulin so they use glucose more effectively

Your doctors will prescribe you whatever medication they feel suits your needs best, whether it’s Ozempic, metformin, or another medication like the ones listed above.

Can Pregnant People Take Metformin or Ozempic?

People who are pregnant, planning to become pregnant, or nursing can take metformin. However, it is not recommended for those same groups to take Ozempic due to the risk of birth defects for the child.