What is your current activity level?
🧍‍♂️Sedentary
🚶 Moderately active
🏃 Very active
This will help us personalize your experience
Blog
>

Metformin vs. Ozempic: How Do They Compare?

Published on
Updated on
Metformin vs. Ozempic: How Do They Compare?

Table of Contents

Key Takeaways

  • While metformin and Ozempic are both medications that treat type 2 diabetes, they are very different in how they work, their administration method, and their cost.
  • Both medications are similar in that they are non-insulin-based medications that effectively manage blood sugar and lower A1c levels.
  • Your care provider can help you determine which medication is best based on your medical history and current health goals.

When it comes to managing type 2 diabetes, metformin and Ozempic are both great medication options, each with their own unique way of maintaining blood sugar levels.

While both medications provide additional benefits beyond glycemic control, they also come with unique adverse side effects. 

Metformin is a long-standing medication used for diabetes management.

It’s known for lowering blood sugar and improving insulin sensitivity. 

Ozempic, is a newer medication that offers blood sugar regulation, weight loss benefits, and reduces the risk of cardiovascular events. 

Read on for a comprehensive comparison of metformin and Ozempic. 

{{splash}}

What is Metformin? 

Since its approval in 1994 by the Food and Drug Administration (FDA), providers have been prescribing metformin for treating type 2 diabetes.

It is an oral medication that is available in immediate-release and slow-release forms, and providers often recommend using it with other diabetes medications, such as insulin.

Metformin is FDA-approved to treat adults and children over the age of 10.

Several off-label uses include treating gestational diabetes, minimizing weight gain from antipsychotic drugs, and treating or preventing polycystic ovarian syndrome

Mechanism of Action 

Metformin is from the biguanide drug class and is the only drug of its kind.

It performs three mechanisms of action:

  • Decreasing glucose production in the liver.
  • Decreasing sugar absorption in the intestines.
  • Enhancing insulin sensitivity.

Effectiveness 

Metformin has a long and proven safe and effective track record.

It’s also very affordable. 

In studies, it has been shown to reduce hemoglobin A1c by up to 2%.

This test gives a three-month snapshot of your blood sugar’s average range. 

Additional benefits of metformin are that it very rarely causes hypoglycemia—low blood sugar, and it may help protect the cardiovascular system from damage caused by diabetes.

Common Side Effects 

Most people tolerate metformin very well when taken with food.

Less than half of metformin users experience side effects that may include:

  • Diarrhea.
  • Nausea.
  • Vomiting.

{{local}}

What is Ozempic? 

Ozempic is a newer medication the FDA approved in 2017.

Providers prescribe this medication for people with type 2 diabetes to help them manage their blood sugar.

You can take it with other FDA-approved diabetes medications such as insulin and metformin, but use caution as it can cause your blood sugar to drop too low.

This medication is approved for adult use only.

It comes in a liquid slow-release form and is administered as a once-weekly injection.

People who have a history of pancreatitis, medullary thyroid cancer, or MEN syndrome should avoid this medication and talk with their provider  about other options for managing their blood sugar.

While Ozempic may help you lose some weight, it is not approved as a weight-loss medication.

However, some providers may prescribe this medication off-label to help people lose weight. 

Mechanism of Action

Ozempic is a glucagon-like peptide 1 (GLP-1) receptor agonist that works alongside eating healthy and exercising regularly.

It mimics the actions of a naturally occurring hormone and has three ways of working to keep your blood sugar stable. 

  • Stimulates your pancreas to produce more insulin when your blood sugar rises. 
  • Decreases the amount of glucose (sugar) your liver produces.
  • Slows down how quickly food leaves your stomach during digestion.

Effectiveness

Ozempic doesn’t have a long track record like metformin, but results from the clinical trials are very positive.

After 30 weeks of using Ozempic, up to 73% of clinical trial participants got their HgA1c results in the healthy range below 7%.

Ozempic is also effective at reducing the risk of heart attack and stroke for people with type 2 diabetes who also have cardiovascular disease. 

Common Side Effects 

Some people experience side effects when they start using Ozempic.

However, these symptoms typically fade as their body adjusts to the medication. Common side effects include:

Key Differences Between Metformin and Ozempic

While metformin and Ozempic are both medications prescribed for type 2 diabetes management, they have several distinct differences.

Mechanism Of Action

Each medication works differently in your body to help you manage your blood sugar.

Metformin primarily works to increase insulin sensitivity, reduce how much glucose your liver makes, and decrease the amount of sugar your intestines absorb during digestion. 

Ozempic, on the other hand, mimics the natural hormone GLP-1 and stimulates insulin secretion from your pancreas, decreases glucose production in your liver, and slows down gastric emptying. 

{{splash}}

Hypoglycemia

Because these medications work differently, they can sometimes be taken together to help you keep your blood sugar in a healthy range.

Metformin shouldn’t cause your blood sugar to drop, while Ozempic has been known to cause hypoglycemia.

While taking Ozempic, it is a good idea to regularly check your blood sugar while your body adjusts to the medication.

Cost

Metformin and Ozempic are also very different regarding their cost.

Depending on your insurance plan, you may be able to get help covering the cost of your diabetes medications.

However, without insurance, you will notice a dramatic difference in cost. 

Metformin can cost around $4 for 30 tablets, depending on your needed dose.

Ozempic is around $994 for 3 mL. Ozempic does have a savings card available for those who qualify, but overall, Ozempic is much more expensive than metformin. 

Key Similarities of Metformin vs Ozempic

Despite their differences, metformin and Ozempic have several similarities. 

Both of these medications aid in blood sugar management for people with type 2 diabetes.

Neither medication is approved for use in treating type 1 diabetes. 

Metformin and Ozempic have proven themselves to be effective in managing blood sugar levels and lowering HgA1c. 

When it comes to cardiovascular benefits, metformin may reduce the risk of cardiovascular events, and Ozempic has been shown to directly help protect against heart attack and stroke for people with type 2 diabetes and cardiovascular disease. 

Both medications are non-insulin-based and can be taken for long-term diabetes management.

Neither one is designed as a short-term treatment.

By controlling blood sugar levels, you may reduce the risk of long-term complications associated with diabetes. 

How Much Weight Can You Expect to Lose?

Weight loss results are significantly different between metformin and Ozempic. 

Metformin

The weight loss potential for metformin is generally modest.

During clinical trials, some individuals experienced a slight weight reduction, typically ranging from about one to three pounds.

Experts believe this may be due to metformin causing some people to feel nauseous, which may reduce their nutritional intake. 

Ozempic

Ozempic, however, helps people lose significantly more weight.

During clinical studies, people taking Ozempic lost an average of 8 –14 pounds.

It's important to note that participants in the clinical trial used Ozempic as a tool along with following a reduced-calorie diet, and participating in regular exercise.  

Which One is Right for You?

Deciding whether metformin or Ozempic is right for you is a decision you need to make with your care provider as it hinges on several individual factors. 

This choice greatly depends on your specific health needs, including your past medical history, current health conditions, and individual treatment goals. 

Your care team can help you consider potential side effects, the mode of administration, and any existing health concerns like kidney function or heart disease.

Sometimes, metformin and Ozempic are prescribed together. 

{{splash}}

Takeaway

Metformin and Ozempic have unique strengths and considerations for treating type 2 diabetes.

Metformin is a well-established medication.

It’s known for safely and effectively managing blood sugar and has few side effects that are generally quite tolerable.

Metformin is also very affordable compared to other medications.

Ozempic is a newer medication that offers the benefits of blood sugar control, protection against cardiovascular events, and helping people lose excess weight.

Side effects of Ozempic are typically tolerable and tend to disappear.

However, Ozempic carries a high price tag that people without insurance coverage may find prohibitive. 

The choice between the two medications is very personal and should be made in collaboration with your care provider based on your medical history and current health goals. 

How a Dietitian Can Help

A dietitian can help give you personalized advice if you have questions about type 2 diabetes management and are wondering about metformin and Ozempic.

They can give individual guidance on dietary counseling for type 2 diabetes and how each medication may help you. 

Frequently Asked Questions

How quickly will you lose weight on metformin?

Metformin is not considered a weight loss medication.

During clinical trials, people taking metformin lost a minimal amount of weight.

How much weight can you lose on metformin?

The amount of weight a person loses while taking metformin can vary.

Some people lose between one to three pounds, while others do not experience any weight loss.

Weight loss results depend on a person's diet and level of physical activity.

Does metformin make you gain weight?

Metformin should be a weight neutral medication.

If you're experiencing weight gain while taking metformin, you should discuss these changes with your care provider.

References

View all references
Nourish has strict sourcing policies and prioritizes primary sources, including medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about our medical review process and editorial guidelines.

See a Registered Dietitian with Nourish

  • Covered by insurance
  • Virtual sessions
  • Personalized care
Schedule an appointment

Frequently asked questions

No items found.

Find a virtual dietitian in {State}

Find a dietitian near you

Covered by insurance.
Question 1

Are you more thirsty than usual?

Question 1

Are you urinating more than usual?

Question 1

Is your blood sugar level consistently high?

Question 1

Do you experience extreme hunger or fatigue?

Question 1

Do you have blurry vision or numbness and tingling in your hands and feet?

Question 1

Do you experience frequent infections or slow-healing wounds?

Question 1

Do you have a family history of diabetes?

Your Result

Your results are in!

While you don’t seem to be at risk for prediabetes or type 2 diabetes based on this quiz, please contact your healthcare provider with any concerns. If you want to learn more about diet and lifestyle changes with diabetes, find a registered dietitian covered by insurance with Nourish.

Your Result

Your results are in!

You should seek guidance from your healthcare provider about the possibility of prediabetes or type 2 diabetes.

If you want to learn more about diet and lifestyle changes with diabetes, find a registered dietitian covered by insurance with Nourish.

Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
Charleston
SC
South Carolina
32.7884363, -79.9399309
Paterson
NJ
New Jersey
40.916611, -74.172188
Palmdale
CA
California
34.576469, -118.116096
Lancaster
CA
California
34.697472, -118.144524
Murfreesboro
TN
Tennessee
35.845619, -86.390266
Santa Rosa
CA
California
38.547134, -122.816383
Eugene
OR
Oregon
44.052151, -123.091187
Shreveport
LA
Louisiana
32.523659, -93.763504
Clarksville
TN
Tennessee
36.527279, -87.360336
Cary
NC
North Carolina
35.7882893, -78.7812081
Salem
OR
Oregon
44.944099, -123.040283
Newport News
VA
Virginia
37.087082, -76.473015
Chattanooga
TN
Tennessee
35.0457219, -85.3094883
Akron
OH
Ohio
41.0842496, -81.6777863
Providence
RI
Rhode Island
41.823990, -71.412834
Tallahassee
FL
Florida
30.438255, -84.280731
Peoria
AZ
Arizona
33.7528919, -112.4902079
Sioux Falls
SD
South Dakota
43.536388, -96.731667
Yonkers
NY
New York
40.930790, -73.898293
Fayetteville
NC
North Carolina
35.052666, -78.878357
Rochester
NY
New York
43.156578, -77.608849
McKinney
TX
Texas
33.214561, -96.614456
Moreno Valley
CA
California
33.920891, -117.261162
Fremont
CA
California
37.548271, -121.988571
Frisco
TX
Texas
33.150673, -96.823608
Spokane
WA
Washington
47.658779, -117.426048
Boise
ID
Idaho
43.6008183, -116.2421086
Port St. Lucie
FL
Florida
27.273270, -80.342148
Irving
TX
Texas
32.814018, -96.948891
Winston-Salem
NC
North Carolina
36.096260, -80.243736
St. Petersburg
FL
Florida
27.773056, -82.639999
Laredo
TX
Texas
27.507130, -99.507500
Jersey City
NJ
New Jersey
,
Buffalo
NY
New York
42.8867166, -78.8783922
St. Louis
MO
Missouri
38.627003, -90.199402
Chandler
AZ
Arizona
33.3062031, -111.841185
Durham
NC
North Carolina
35.994034, -78.898621
Lincoln
NE
Nebraska
40.806862, -96.681679
Pittsburgh
PA
Pennsylvania
40.440624, -79.995888
Greensboro
NC
North Carolina
36.072701, -79.793900
St. Paul
MN
Minnesota
44.954445, -93.091301
Newark
NJ
New Jersey
40.735657, -74.172363
Lexington
KY
Kentucky
38.040585, -84.503716
Stockton
CA
California
37.957703, -121.290779
Honolulu
HI
Hawaii
21.306944, -157.858337
Cleveland
OH
Ohio
41.499321, -81.694359
Arlington
TX
Texas
32.7355816, -97.1071186
Oakland
CA
California
37.804363, -122.271111
Long Beach
CA
California
33.770050, -118.193741
Raleigh
NC
North Carolina
35.779591, -78.638176
Omaha
NE
Nebraska
41.256538, -95.934502
Colorado Springs
CO
Colorado
38.833881, -104.821365
Fresno
CA
California
36.737797, -119.787125
Albuquerque
NM
New Mexico
35.084385, -106.650421
Memphis
TN
Tennessee
35.117500, -89.971107
Washington DC
WA DC
Washington, DC
38.889805, -77.009056
Las Vegas
NV
Nevada
36.169941, -115.139832
Seattle
WA
Washington
47.606209, -122.332069
Charlotte
NC
North Carolina
35.2272086, -80.8430827
Sacramento
CA
California
38.590576, -121.489906
Richmond
VA
Virginia
37.540726, -77.436050
Surprise
AZ
Arizona
33.629002, -112.330170
Mesa
AZ
Arizona
33.415184, -111.831474
Louisville
KY
Kentucky
38.252666, -85.758453
Des Moines
IA
Iowa
41.586834, -93.624962
Lakewood
CO
Colorado
39.704708, -105.081375
Kansas City
KS
Kansas
39.112701, -94.626801
Reno
NV
Nevada
39.529633, -119.813805
Tacoma
WA
Washington
47.258728, -122.465973
Aurora
CO
Colorado
39.7405111, -104.830994
Oxnard
CA
California
34.197659, -119.175949
Amarillo
TX
Texas
35.221996, -101.831299
Henderson
NV
Nevada
36.039524, -114.981720
Vancouver
WA
Washington
45.633331, -122.599998
Gilbert
AZ
Arizona
33.352825, -111.789024
San Bernardino
CA
California
34.115784, -117.302399
Columbus
GA
Georgia
27.800583, -97.396378
Hayward
CA
California
37.668819, -122.080795
Milwaukee
WI
Wisconsin
43.038902, -87.906471
Lubbock
TX
Texas
33.576698, -101.855072
Norfolk
VA
Virginia
36.850769, -76.285873
Tulsa
OK
Oklahoma
36.153980, -95.992775
Garland
TX
Texas
32.914341, -96.636559
Fort Lauderdale
FL
Florida
26.124161, -80.143593
Tucson
AZ
Arizona
32.248814, -110.987419
Salt Lake City
UT
Utah
40.760780, -111.891045
Corona
CA
California
33.875670, -117.568840
Madison
WI
Wisconsin
43.073051, -89.401230
Huntsville
AL
Alabama
34.7014286, -86.6597495
Kansas City
MO
Missouri
39.099728, -94.578568
Irvine
CA
California
33.684566, -117.826508
Chula Vista
CA
California
32.640072, -117.084038
Denton
TX
Texas
33.215530, -97.132446
Aurora
IL
Illinois
41.7571701, -88.3147539
Baton Rouge
LA
Louisiana
30.4494155, -91.1869659
Columbus
OH
Ohio
39.961178, -82.998795
Baltimore
MD
Maryland
39.2908816, -76.610759
Detroit
MI
Michigan
42.331429, -83.045753
Chesapeake
VA
Virginia
36.7183708, -76.2466798
Atlanta
GA
Georgia
33.7489924, -84.3902644
Birmingham
AL
Alabama
33.5206824, -86.8024326
Scottsdale
AZ
Arizona
33.501324, -111.925278
Cincinnati
OH
Ohio
39.103700, -84.513610
North Las Vegas
NV
Nevada
36.201946, -115.120216
Riverside
CA
California
33.980602, -117.375496
Plano
TX
Texas
33.019844, -96.698883
Minneapolis
MN
Minnesota
44.977753, -93.265015
Salinas
CA
California
,
Anaheim
CA
California
33.836594, -117.914299
Springfield
MO
Missouri
37.208958, -93.292297
Fort Wayne
IN
Indiana
41.077469, -85.137489
Phoenix
AZ
Arizona
33.448376, -112.074036
Bakersfield
CA
California
35.3738712, -119.0194639
Garden Grove
CA
California
33.774269, -117.937996
Anchorage
AK
Alaska
61.2163129, -149.894852
Indianapolis
IN
Indiana
39.768402, -86.158066
Nashville
TN
Tennessee
36.162663, -86.781601
Tempe
AZ
Arizona
33.425522, -111.941254
Mobile
AL
Alabama
30.695366, -88.039894
New Orleans
LA
Louisiana
29.951065, -90.071533
Knoxville
TN
Tennessee
35.960636, -83.920738
Grand Rapids
MI
Michigan
42.963360, -85.668083
Fontana
CA
California
34.102890, -117.435760
Elk Grove
CA
California
38.418129, -121.393257
Cape Coral
FL
Florida
26.5625742, -81.9438802
Grand Prairie
TX
Texas
32.745499, -97.003532
Fort Collins
CO
Colorado
40.588970, -105.082458
Killeen
TX
Texas
31.117119, -97.727798
Modesto
CA
California
37.639095, -120.996880
Oklahoma City
OK
Oklahoma
35.468491, -97.521263
Santa Ana
CA
California
33.745571, -117.867836
Ontario
CA
California
34.063343, -117.650887
Brownsville
TX
Texas
25.9015688, -97.4984005
Montgomery
AL
Alabama
32.379223, -86.307739
Hialeah
FL
Florida
25.857595, -80.278107
Springfield
MA
Massachusetts
42.102051, -72.585762
Toledo
OH
Ohio
41.652805, -83.537865
Pembroke Pines
FL
Florida
26.007765, -80.296257
Overland Park
KS
Kansas
38.974819, -94.683601
Little Rock
AR
Arkansas
34.746483, -92.289597
Glendale
CA
California
34.142509, -118.255074
Roseville
CA
California
38.752125, -121.288010
Wichita
KS
Kansas
37.687176, -97.330055
Huntington Beach
CA
California
33.659485, -117.998802
Augusta
GA
Georgia
33.4709714, -81.9748429
Worcester
MA
Massachusetts
42.271389, -71.798889
Virginia Beach
VA
Virginia
36.852924, -75.977982
Oceanside
CA
California
33.1958696, -117.3794834
Santa Clarita
CA
California
34.456043, -118.571335
Philadelphia
PA
Pennsylvania
39.952583, -75.165222
Corpus Christi
TX
Texas
27.800583, -97.396378
Portland
OR
Oregon
45.512230, -122.658722
Denver
CO
Colorado
39.739235, -104.990250
Boston
MA
Massachusetts
42.3554334, -71.060511
Atlanta
GA
Georgia
33.7489924, -84.3902644
Chicago
IL
Illinois
41.8755616, -87.6244212
Orlando
FL
Florida
28.538336, -81.379234
Jacksonville
FL
Florida
30.332184, -81.655647
Tampa
FL
Florida
27.950575, -82.457176
Long Island
NY
New York
40.757801, -73.940033
Queens
NY
New York
40.728226, -73.794853
Bronx
NY
New York
40.8466508, -73.8785937
Staten Island
NY
New York
40.643501, -74.076202
Brooklyn
NY
New York
40.6526006, -73.9497211
New York
NY
New York
40.712776, -74.005974
San Jose
CA
California
37.342205, -121.851990
San Francisco
CA
California
37.774929, -122.419418
San Diego
CA
California
32.834686, -117.130775
Los Angeles
CA
California
34.052235, -118.243683
El Paso
TX
Texas
31.761877, -106.485023
San Antonio
TX
Texas
29.387428, -98.496574
Dallas
TX
Texas
32.776665, -96.796989
Fort Worth
TX
Texas
32.755489, -97.330765
Houston
TX
Texas
29.760427, -95.369804
Austin
TX
Texas
30.2711286, -97.7436995

Book an appointment with a {category} dietitian

Covered by insurance.

Book an appointment with an online dietitian

Covered by insurance.

Find a

dietitian covered by insurance

No items found.
Weight loss medication
Mental Health
Intuitive Eating