Ozempic (semaglutide) and metformin are prescription drugs that are both used to help manage blood sugar levels in people with type 2 diabetes. Ozempic is a brand-name drug, while metformin is a generic drug.
This article explains the main ways that Ozempic and metformin are alike and different. For more information about these drugs, including details about their uses, see the in-depth articles on the Ozempic injection and metformin oral tablet.
Note: Metformin also comes in an oral solution. But only the oral tablet form is described in this article. If you’d like to learn about metformin’s other forms, talk with your doctor or pharmacist.
Ozempic is a brand-name drug, and metformin is a generic drug. (A generic contains an exact copy of the active ingredient* in a brand-name medication.) See the list below to learn about each drug’s available versions.
- Ozempic:
- Available as a generic: no
- Active ingredient: semaglutide
- Metformin:
- Available as a brand-name drug: yes (Glumetza, Fortamet)
- Active ingredient: metformin
If you’ve been prescribed metformin and are interested in taking a brand-name version instead, talk with your doctor or pharmacist.
Get answers to some frequently asked questions about Ozempic and metformin.
Is it safe to use Ozempic and metformin together?
Yes, it’s usually safe to use Ozempic and metformin together. Doctors commonly prescribe this combination of medications to help manage blood sugar levels in adults with type 2 diabetes. They work in different ways to lower your blood sugar levels.
If you have questions about taking these medications together, talk with your doctor or pharmacist.
Can Ozempic or metformin be used for weight loss?
Ozempic and metformin aren’t approved for weight loss. But in some cases, your doctor may prescribe Ozempic or metformin off-label for this purpose. (With off-label use, doctors prescribe a drug for a purpose other than what it’s approved for.)
To learn more about using Ozempic or metformin for weight loss, talk with your doctor. They can recommend the right treatment option for you.
Is Ozempic a better treatment option for diabetes than metformin or vice versa?
Ozempic and metformin are both used to help manage blood sugar levels in people with type 2 diabetes. Studies of Ozempic and metformin have shown that both drugs are effective for this use.
But Ozempic and metformin do have some differences. For example, if you have heart disease, Ozempic can also help lower your risk of heart attack and stroke. These drugs also belong to different drug groups and can cause different side effects. Because of this, one of them may be a better choice for you, depending on your specific health factors.
If you’re considering treatment with Ozempic or metformin, talk with your doctor about your health history. Ask whether one of these drugs may be a better option for you.
Ozempic and metformin may cause side effects ranging from mild to serious.
For more information about possible side effects, see the side effect articles on Ozempic and metformin.
Mild side effects
Ozempic and metformin may cause mild side effects. The table below lists examples of mild side effects that have been reported with these drugs.
| Ozempic | Metformin | |
|---|---|---|
| nausea and vomiting | ✓ | ✓ |
| abdominal pain | ✓ | ✓ |
| diarrhea | ✓ | ✓ |
| constipation | ✓ | |
| indigestion | ✓ | ✓ |
| flatulence (gas) | ✓ | ✓ |
| weakness | ✓ | |
| headache | ✓ | |
| weight loss | ✓ | ✓ |
This table may not include all mild side effects of these drugs. For more information on the mild side effects of the two drugs, see the Ozempic prescribing information and metformin prescribing information.
Serious side effects
In addition to the mild side effects described above, serious side effects may occur in people using Ozempic or metformin. See the table below for a list of side effects that have been reported with these drugs.
| Ozempic | Metformin | |
|---|---|---|
| pancreatitis | ✓ | |
| gallbladder problems | ✓ | |
| low blood sugar | ✓ | ✓ |
| risk of thyroid cancer* | ✓ | |
| lactic acidosis* | ✓ | |
| low level of vitamin B12 | ✓ | |
| allergic reaction | ✓ | ✓ |
To learn about your specific risk for serious side effects from Ozempic or metformin, talk with your doctor or pharmacist.
* The drug has a boxed warning for this side effect. A boxed warning is the most serious warning from the FDA. To learn more, see the “What are the warnings of Ozempic and metformin?” section below.
See the table below for details on the conditions each drug is used for.
| Use | Ozempic | Metformin |
|---|---|---|
| helping manage blood sugar levels in adults with type 2 diabetes | ✓ | ✓ |
| lowering the risk of heart attack and stroke in adults with type 2 diabetes and heart disease | ✓ |
To learn more about using Ozempic or metformin to treat your condition, talk with your doctor.
Ozempic or metformin and children
Metformin is used to help manage blood sugar levels in children ages 10 years and older with type 2 diabetes. Ozempic is not used in children.
For more information about the use of metformin in children, talk with your child’s doctor.
Here’s an overview of the dosage and how you’ll take Ozempic and metformin for the conditions they both treat.
Ozempic is also used to lower the risk of heart attack and stroke in adults with type 2 diabetes and heart disease, but this use isn’t addressed below. To learn more about the dosages for all conditions these drugs treat, see the dosage articles for Ozempic and metformin.
Dosage for helping manage blood sugar levels in adults with type 2 diabetes
| Ozempic for type 2 diabetes | Metformin for type 2 diabetes | |
|---|---|---|
| Forms | solution in prefilled injection pen | • immediate-release oral tablet* • extended-release oral tablet* |
| Strengths | • 2 milligrams per 1.5 milliliters (2 mg/1.5 mL) • 2 mg/3 mL • 4 mg/3 mL • 8 mg/3 mL | immediate-release oral tablet: • 500 mg • 625 mg • 750 mg • 850 mg • 1,000 mg extended-release oral tablet: • 500 mg • 750 mg • 1,000 mg |
| Dose | depends on the treatment plan your doctor prescribes for you | depends on the treatment plan your doctor prescribes for you |
| How often it’s used | once per week | • immediate-release tablets are usually taken twice per day • extended-release tablets are taken once per day |
* “Immediate release” means the drug is released into your body right away. “Extended release” means the drug is slowly released into your body over a long period of time.
You may wonder whether Ozempic or metformin is effective for your condition.
Ozempic and metformin are both prescribed along with diet and exercise to help manage blood sugar levels in adults with type 2 diabetes. Studies of Ozempic and metformin have shown that both drugs are effective for this use. In addition, the American Diabetes Association includes both drugs in its treatment recommendations for type 2 diabetes.
It’s important to note that your results from Ozempic or metformin may differ from those seen in studies. Talk with your doctor about whether one of these drugs is right for you.
If you’d like to read more about how each drug performed in studies, see the prescribing information for Ozempic and metformin.
Whether you have health insurance or not, cost may be a factor when you’re considering these drugs. Visit Optum Perks* to get price estimates for Ozempic and metformin when you use coupons from the site. It’s important to note that Optum Perks coupons cannot be used with any insurance copays or benefits.
Keep in mind that what you’ll pay for either drug will depend on your treatment plan, health insurance, and the pharmacy you use.
For other resources that might help you save on the price of these drugs, see the cost articles for Ozempic and metformin.
* Optum Perks is a sister site of Healthline.
Ozempic or metformin may not be right for you if you have certain medical conditions or other factors that affect your health. These may be referred to as warnings.
The two drugs share some of the same warnings, but they also have different ones. Some of these warnings are mentioned below. Before you start using Ozempic or metformin, be sure to talk with your doctor to see if these warnings apply to you.
Ozempic boxed warning: Risk of thyroid cancer
Ozempic has a boxed warning for the risk of thyroid cancer. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.
The active drug in Ozempic, semaglutide, can cause thyroid tumors in animals. It’s not known whether Ozempic can cause thyroid cancer in humans. But due to the possible risk, your doctor will likely not prescribe Ozempic if:
- you or a family member has ever had a type of thyroid cancer called medullary thyroid carcinoma
- you have a condition called multiple endocrine neoplasia syndrome type 2 (MEN2)
Metformin boxed warning: Lactic acidosis
Metformin has a boxed warning for the risk of lactic acidosis (a buildup of lactic acid in your body). This side effect can be serious and even life threatening.
You may have a higher risk of lactic acidosis if any of the following factors apply to you:
- being age 65 years or older
- having liver problems, kidney problems, or heart failure
- drinking large amounts of alcohol
- taking certain other medications with metformin
- having surgery or receiving contrast dye for CT scans or X-rays
If you have any of these risk factors, your doctor may monitor you more closely during your metformin treatment. Or they may recommend a medication other than metformin for you.
Other warnings
In addition to the boxed warnings described above, Ozempic and metformin have other warnings.
Before using Ozempic or metformin, talk with your doctor if any of the following conditions or health factors apply to you.
- Warnings for Ozempic:
- if you have a history of pancreatitis
- if you have a history of diabetic retinopathy
- Warnings for metformin:
- if you have liver problems
- if you have heart problems
- if you have metabolic acidosis, including diabetic ketoacidosis
- Warnings for both Ozempic and metformin:
- if you’ve had an allergic reaction to either drug or any of its ingredients
- if you’re pregnant or planning to become pregnant
- if you’re breastfeeding or planning to breastfeed
- if you have kidney problems
To learn more about these drugs, see the in-depth articles on Ozempic and metformin.
The short answer: It’s possible.
Details: If your doctor recommends switching from metformin to Ozempic or vice versa, the way this is done may depend on your blood sugar levels. It may also depend on other health factors you have or other medications you take. Always follow your doctor’s recommendations.
If you switch from metformin to Ozempic, your doctor will likely recommend starting Ozempic treatment the day after you take your last dose of metformin. Your doctor will likely increase your Ozempic dosage after 4 weeks. Your doctor may gradually increase your Ozempic dosage over the next few weeks until you reach the dose that’s right for you.
If you switch from Ozempic to metformin, your doctor will likely recommend starting metformin the week after you inject your last dose of Ozempic. If needed, your doctor may gradually increase your metformin dosage over the next few weeks until you reach the dose that’s right for you.
Reminder: You shouldn’t switch drugs or stop your current treatment unless your doctor recommends it.
If you have type 2 diabetes, your doctor may recommend Ozempic or metformin to help manage your blood sugar levels. If you also have heart disease, Ozempic can also help lower your risk of heart attack and stroke. Ozempic is taken by weekly injection, while metformin comes as an oral tablet that’s taken once or twice per day.
If you have any questions about these drugs, talk with your doctor. They can recommend the best treatment option for you. Examples of questions you may want to ask your doctor include:
- Do either of these drugs interact with other medications I take?
- Am I likely to lose more weight with metformin or Ozempic?
- Is either drug safer to take long term?
To learn more about Ozempic or metformin, see these articles:
- Ozempic: Overview, How It Works, and More
- All About Metformin Oral Tablet
- Side Effects of Ozempic: Examples and Treatment Options
- Metformin and Cost: What You Need to Know
- How Much Does Ozempic Cost? Plus, Discounts and Savings Tips
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.