Ozempic (semaglutide) is a brand-name drug, while metformin is a generic drug. They’re both prescribed to help manage blood sugar levels in people with type 2 diabetes.
This article explains the main similarities and differences between Ozempic and metformin. If you’re considering taking one of these drugs, discussing this information with your doctor can help you decide whether one of these treatments may be right for you.
Note: For more comprehensive information about these two drugs, you can refer to our Ozempic and metformin articles.
Key differences between Ozempic and metformin
These are a few of the main differences between Ozempic and metformin:
- Conditions treated: Ozempic and metformin are both used to help manage type 2 diabetes. Ozempic is also prescribed to reduce the risk of serious cardiovascular problems in certain people. (See the “Uses of Ozempic vs. metformin section below.)
- Dosage: Metformin is taken more often than Ozempic. (See the “Dosage, forms, and administration” section below.)
- Forms: Ozempic comes as a solution for subcutaneous injection. Metformin comes in forms that you swallow. (See the “Dosage, forms, and administration” section below.)
Here’s information about the generic status of Ozempic and metformin, as well as details on their active ingredients.
| Ozempic | metformin | |
|---|---|---|
| Generic available | no | yes |
| Active ingredients | semaglutide | metformin |
| Drug class | glucagon-like peptide-1 receptor agonist | biguanide |
Ozempic and metformin have been approved by the Food and Drug Administration (FDA) to treat the following:
- Both Ozempic and metformin are FDA approved to help manage blood sugar levels in adults with type 2 diabetes. They’re used in combination with diet and exercise.
- Ozempic is also FDA approved to reduce the risk of serious cardiovascular problems in adults with cardiovascular disease and type 2 diabetes. Examples of these problems include heart attack and stroke.
Ozempic or metformin and children
Ozempic is not FDA approved for children.
Certain forms of metformin are FDA approved to help manage blood sugar levels in children with type 2 diabetes. For this use, metformin is prescribed with diet and exercise.
Metformin oral solution and immediate-release (IR) oral tablets are approved for children ages 10 years and older. (“Immediate release” means the drug is released into your body right away.) Metformin extended-release (ER) oral tablets are not approved for children. (“Extended release” means the drug is released slowly into your body over a long period of time.)
Note: For more information about the drugs’ uses, see our articles about Ozempic and metformin.
Here’s a quick look at the dosage and administration of Ozempic and metformin for the conditions both drugs treat.
Below are the dosages of Ozempic and metformin for managing blood sugar levels in adults with type 2 diabetes. Strengths are given in milligrams per milliliter (mg/mL) and mg.
| Ozempic for type 2 diabetes | Metformin for type 2 diabetes | |
|---|---|---|
| Forms | solution in a prefilled injection pen, given as a subcutaneous injection | • oral solution • IR oral tablet • ER oral tablet |
| Strengths | • 2 mg/3 mL • 4 mg/3 mL • 8 mg/3 mL | oral solution: • 500 mg/5 mL IR oral tablet: • 500 mg • 625 mg • 750 mg • 850 mg • 1,000 mg ER oral tablet: • 500 mg • 750 mg • 1,000 mg |
| Dose | 0.25 mg for 4 doses, then 0.5 to 2 mg | oral solution and IR oral tablet: 500 to 2,550 mg ER oral tablet: 500 to 2,000 mg |
| Frequency | once per week | oral solution and IR oral tablet: 1 to 3 times per day ER oral tablet: once per day |
| Given by | self (see below) | self |
Your doctor will show you or a caregiver how to inject Ozempic at home. You’ll inject the drug under the skin of your upper arm, abdomen, or thigh.
Your doctor will recommend the dosage of Ozempic or metformin that’s right for you.
Note: For more information about dosage, see our dosage articles about Ozempic and metformin.
Ozempic and metformin treat type 2 diabetes. These drugs can cause some of the same side effects, as well as some different ones. Some of the side effects reported in clinical trials of these drugs are mentioned below.
For more details about side effects of the two drugs, see our side effect articles about Ozempic and metformin. You can also refer to the prescribing information for Ozempic and metformin oral solution, IR oral tablet, and ER oral tablet.
Mild side effects
The following table lists some of the more commonly reported mild side effects of Ozempic and metformin. The table may also include mild side effects that are less common but that you might have concerns about in some cases.
| Mild side effects | Ozempic | metformin |
|---|---|---|
| injection site reactions, such as discoloration or discomfort around the injection area | ✓ | |
| abdominal pain or discomfort | ✓ | ✓ |
| diarrhea | ✓ | ✓ |
| constipation | ✓ | |
| flatulence (gas) | ✓ | ✓ |
| indigestion | ✓ | ✓ |
| headache | ✓ | |
| nausea and vomiting | ✓ | ✓ |
| weakness | ✓ | |
| mild allergic reaction* | ✓ | ✓ |
These side effects may be temporary, lasting a few days to weeks. If they last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
* An allergic reaction is possible after using either drug. However, this side effect wasn’t reported in clinical trials of Ozempic or metformin oral solution, IR oral tablet, or ER oral tablet.
Serious side effects
The following table lists the reported serious side effects of Ozempic and metformin.
| Serious side effects | Ozempic | metformin |
|---|---|---|
| severe digestive problems, which may lead to dehydration and acute (sudden) kidney injury | ✓ | |
| pancreatitis (inflammation of the pancreas) | ✓ | |
| hypoglycemia (low blood sugar) | ✓ | ✓ |
| acute gallbladder disease, such as gallstones | ✓ | |
| diabetic retinopathy | ✓ | |
| low level of vitamin B12 | ✓ | |
| risk of thyroid cancer* | ✓ | |
| risk of lactic acidosis† | ✓ | |
| severe allergic reaction‡ | ✓ | ✓ |
If you have serious side effects while using Ozempic or metformin, call your doctor immediately. If the side effects feel life threatening or you believe you’re having a medical emergency, call 911 or your local emergency number right away.
* Ozempic has a boxed warning for this side effect. A boxed warning is a serious warning from the Food and Drug Administration (FDA). To learn more, see the “Precautions for Ozempic and metformin” section below.
† Metformin oral solution, IR oral tablet, and ER oral tablet have a boxed warning for this side effect. To learn more, see the “Precautions for Ozempic and metformin” section below.
‡ An allergic reaction is possible after using either drug. However, this side effect wasn’t reported in clinical trials of Ozempic or metformin oral solution, IR oral tablet, or ER oral tablet.
ALLERGIC REACTIONFor some people, Ozempic and metformin can cause an allergic reaction.
But this side effect wasn’t reported in studies of Ozempic or metformin oral solution, IR oral tablet, or ER oral tablet.
In general, symptoms of allergic reaction can be mild or serious.
Ways to manage
For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know whether you should keep taking the medication.
For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to Ozempic or metformin, your doctor may recommend taking a different medication instead.
Below are answers to some common questions about Ozempic and metformin.
Can I take metformin and Ozempic together?
Yes, if your doctor recommends it.
Ozempic and metformin are prescribed to treat type 2 diabetes. They work in different ways to help manage blood sugar levels. Each drug can be taken individually or in combination with other diabetes medications.
Metformin is often the first drug prescribed for type 2 diabetes. If blood sugar levels are not managed well with metformin alone, doctors may add Ozempic or switch to Ozempic altogether.
If you have other questions about taking Ozempic with metformin, talk with your doctor or pharmacist.
Is Ozempic or metformin used for weight loss, prediabetes, or PCOS?
Ozempic and metformin are not approved for weight loss, prediabetes, or polycystic ovary syndrome (PCOS). However, doctors may prescribe either drug off-label for these uses. (Off-label use is when 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, prediabetes, or PCOS, talk with your doctor. They can recommend the right treatment option for your specific condition.
Details about the effectiveness of Ozempic and metformin are provided below.
Prescribing information: For information about how effective these drugs were in clinical trials, see the prescribing information for Ozempic and metformin oral solution, IR oral tablet, and ER oral tablet. Keep in mind that trial results may not apply to your individual health situation.
Treatment guidelines: Another way to see whether a drug is considered effective is to look at treatment guidelines. When an organization includes certain drugs in treatment guidelines, this means that research has shown the drug to be safe and effective.
The American Diabetes Association recommends Ozempic and metformin as treatment options for people with type 2 diabetes.
The cost of Ozempic or metformin depends on the treatment plan your doctor prescribes, your insurance plan, and your pharmacy. You can visit Optum Perks for price estimates of Ozempic and metformin. (Optum Perks is a sister site of Medical News Today.)
Ozempic is a brand-name drug that doesn’t come in a generic form. Metformin is a generic drug. Brand-name medications are often more expensive than generics. Talk with your doctor or pharmacist to learn about the forms of either drug.
Ozempic and metformin may not be right for you if you have certain medical conditions or other factors that affect your health. The two drugs share some of the same precautions, but they also have different ones. Some of these precautions are mentioned below.
Boxed warning: Risk of thyroid cancer
Ozempic has a boxed warning for the risk of thyroid cancer. A boxed warning is a serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.
In animal studies, semaglutide (the active ingredient in Ozempic) caused thyroid tumors. However, animal studies do not always predict what happens with humans. The risk of thyroid cancer in humans using Ozempic is not known for certain.
To be safe, doctors typically won’t prescribe Ozempic for people with factors that increase their risk of thyroid cancer. These include:
- having a personal or family history of medullary thyroid cancer
- having a genetic (inherited) condition called multiple endocrine neoplasia type 2 (MEN2)
Symptoms of thyroid cancer include a hoarse voice, trouble swallowing, and a lump in your neck.
If you have symptoms of thyroid cancer during Ozempic treatment, tell your doctor right away. They may do tests to check for thyroid cancer.
Boxed warning: Risk of lactic acidosis
Metformin has a boxed warning for the risk of lactic acidosis. A boxed warning is a serious warning from the FDA. A boxed warning alerts doctors and patients about drug effects that may be dangerous.
Lactic acidosis wasn’t reported in clinical trials of metformin oral solution, IR oral tablet, or ER oral tablet. However, this side effect has been reported since metformin became available.
With lactic acidosis, you have a high level of lactic acid in your body. Symptoms can include fatigue, abdominal pain, difficulty breathing, and low blood pressure.
Certain factors may increase your risk of lactic acidosis with metformin. Examples include having kidney, liver, or heart problems. Your doctor can review your health history and talk with you about your risk of this side effect.
If you have symptoms of lactic acidosis during metformin treatment, tell your doctor right away. This condition can be a medical emergency and may need treatment in a hospital.
Precautions
In addition to boxed warnings, Ozempic and metformin have other warnings.
If any of the following medical conditions or other health factors are relevant for you, talk with your doctor before using Ozempic or metformin.
| Precaution | Ozempic | metformin |
|---|---|---|
| if you’ve had an allergic reaction to either drug or any of its ingredients | ✓ | ✓ |
| if you’re pregnant or thinking about becoming pregnant | ✓ | ✓ |
| if you’re breastfeeding or thinking about breastfeeding | ✓ | ✓ |
| if you have diabetic retinopathy | ✓ | |
| if you’ve had pancreatitis (inflammation of the pancreas) | ✓ | |
| if you have kidney disease | ✓ | ✓ |
| if you have liver disease | ✓ | |
| if you have heart problems, such as heart failure | ✓ | |
| if you have a planned surgery or imaging tests | ✓ |
Note: For more comprehensive information about these two drugs, you can refer to our Ozempic and metformin articles.
Switching between Ozempic and metformin might be possible.
If you’d like to know more about switching between Ozempic and metformin, talk with your doctor. They can give you additional details and help determine the best course of action for your situation. Even if two drugs treat the same condition or are in the same drug class, your body can still respond differently.
It’s important that you do not stop, start, or switch any of your drug treatments without your doctor’s recommendation.
Disclaimer: Medical News Today 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.