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Over the past couple of months, Ozempic has become a worldwide sensation. This diabetes drug, manufactured by Danish pharma giant Novo Nordisk, is being discussed in the news, pharmaceutical science journals, and on social media.
While it’s a very effective medication used to treat type 2 diabetes, its popularity is mainly attributed to the fact that Ozempic has also been found to promote weight loss in overweight and obese patients. It hasn’t, however, been approved for use in weight management plans by the FDA.
It isn’t the only drug with such properties. Metformin, a slightly older medication approved for type 2 diabetes treatment by the FDA in 1994, shares many similarities with Ozempic. How do they differ, though, and is one more effective than the other?
Ozempic may be in the spotlight in 2023, but Metformin has been around for much longer than Novo Nordisk’s hotly-debated product. Below, you’ll find some of the basic information about both drugs.
Semaglutide, the main active ingredient in Ozempic, was first developed by Novo Nordisk’s scientists in 2012. It was approved by the American FDA in 2017. Ozempic has two alternatives, Wegovy and Rybelsus, both of which are manufactured by the Danish pharmaceutical giant and contain the same active ingredient.
To this day, Metformin is the most widely used oral diabetes medication. The drug’s origins in scientific literature date back to 1922. Its discovery is attributed to Emil Werner and James Bell. Known under many different brand names, such as Glucophage, Glumetza, or Fortamet, Metformin was first introduced as a diabetes medication in France in 1957. It took nearly four more decades for it to get approved in the US.
Both Ozempic and Metformin are medications designed to manage blood sugar levels in the bloodstream of individuals with type 2 diabetes. Thus, we can say that they achieve the same effect in that regard. But that’s where the similarities end.
Firstly, it’s important to highlight the fact that Metformin is a generic drug name sold and manufactured by many different companies. Ozempic, on the other hand, is a branded product solely manufactured and sold by Novo Nordisk. As of 2023, the Danish corporation is the only FDA-approved supplier of semaglutide medications.
The other main factors that differentiate Ozempic from Metformin are how it’s ingested, the way it is activated in the body, as well as the scope of conditions it can treat.
Ozempic is given to patients by way of a weekly injection. The injections are subcutaneous and can be delivered either in the thigh or upper arm, just like traditional insulin shots. It can also be injected into the stomach. Patients can take it after meals or on an empty stomach.
When it comes to Metformin, it comes in a few different ingestion options. It is sold as a simple oral tablet, liquid oral solution, or as an extended-release tablet. Given the risk of developing stomach side effects, Metformin should always be taken with meals.
Metformin is classified as a biguanide drug. Regardless of the brand name, its main active ingredient, metformin hydrochloride, makes the liver produce less glucose and promotes the sugar’s absorption by the cells.
Ozempic, on the other hand, is a GLP-1 (glucagon-like peptide-1) receptor antagonist. Semaglutide, Ozempic’s active ingredient, acts just like the GLP-1 hormone, stimulating the patient’s pancreas to increase its insulin output and reduce the production of glucagon.
Neither Ozempic nor Metformin has been approved for treating type 1 diabetes, although singular studies have pointed towards the latter’s effectiveness in reducing insulin requirement in patients suffering from the condition.
That aside, both drugs are mainly used as a first-line form of treatment for patients with type 2 diabetes. Metformin is prescribed solely for that purpose, whereas Ozempic has also been approved for risk reduction of cardiovascular events. This includes strokes and heart attacks in people with heart disease, on top of type 2 diabetes patients.
Finally, Ozempic and Metformin have both found their use as weight loss drugs. Ozempic has been recommended off-label to patients who are obese and struggling with weight-related health hazards like high cholesterol or high blood pressure. Some doctors prescribe Metformin to help patients who’ve gained weight due to using other medications.
| Ozempic | Metformin | |
| Intake method | Subcutaneous injection | Tablets, liquid solution, extended-release tablets |
| Drug class | GLP-1 receptor antagonist | Biguanide |
| Conditions treated | Type 2 diabetes, cardiovascular event risk reduction, weight loss (off-label) | Type 2 diabetes, weight loss (off-label) |
Determining whether Ozempic or Metformin is more effective is not a black-or-white assessment. In fact, both drugs are highly efficient at lowering patients’ blood sugar levels. Metformin is generally recommended as first-line type 2 diabetes treatment, used in combination with diet changes and exercise regimens to manage the condition.
Ozempic, on the other hand, isn’t prescribed as a first-line treatment by most doctors. It is usually recommended later in the treatment cycle once your primary care doctor determines that other drugs are not as effective as they should be. The general recommendation is that Ozempic, much like Metformin, should be taken in tandem with lifestyle changes.
When it comes to overall effectiveness, Ozempic can be considered superior to Metformin in that it can also tackle a number of cardiovascular issues that Metformin is not equipped to deal with.
A number of clinical studies have confirmed that Ozempic and Metformin are both effective weight loss aids. It is important to note, however, that neither has been approved by the FDA for that specific purpose. Using them to lose weight without prior consultation with a medical professional is therefore highly advised against. This is mainly because of the various contraindications for the use of these drugs, which we will go over later in this article.
How much weight, exactly, can you lose with these medications? According to recent studies, using semaglutide as part of a weight loss plan can result in a 15% body weight reduction over a period of one year. A Metformin study on patients trying to lose weight has determined that an average annual weight reduction rate for this drug lands at about 5% of body weight.
Bear in mind that these numbers don’t mean that Metformin or Ozempic are miracle weight loss drugs. Diet changes and regular exercise remain the most effective ways to lose weight, and while meds can help, they should be reserved for patients with severe obesity, especially those who also suffer from cardiovascular issues.
As is the case with most prescription drugs, Metformin and Ozempic carry the risks of undesired side effects, which can vary in severity. Below, you can find a side-by-side comparison table of Ozempic and Metformin’s side effects.
| Ozempic | Metformin | |
| Mild side effects |
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| Severe side effects |
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Due to the severity of some of the side effects listed above, the FDA has issued boxed warnings for both drugs. These are the most “serious” warnings that the FDA can issue on pharmaceutical packaging.
Should you be concerned about developing these side effects or consider not using these drugs altogether because of them? Probably not. The most dangerous reactions to Ozempic or Metformin are very rare and appear in a small percentage of patients.
With that said, however, you should never attempt to start treating your diabetes with Metformin or Ozempic without prior consultation with your primary care doctor. First of all, they’re both prescription drugs, so taking them without your doctor’s knowledge would be illegal. Secondly, only after being thoroughly examined by a professional who knows your medical history can you truly be certain that you’re not risking your health by using these medications.
Both Ozempic and Metformin have been found to interact with a number of different drugs. Neither should be taken alongside insulin, as that may increase the risk of hypoglycemia (low blood sugar).
Generally speaking, any medicine that affects how our bodies control blood sugar levels can interact with Ozempic or Metformin. This includes diuretics, contraceptives, and calcium channel blockers.
It’s important to note that taking Metformin or Ozempic alongside other drug types mentioned above does not guarantee negative interactions. However, there is a potential for them, so your usage should be closely monitored by your doctor.
Ozempic and Metformin are both relatively safe to use when treating type 2 diabetes, but individuals with certain medical conditions or genetic predispositions should steer clear of them.
The differences between Ozempic and Metformin are quite significant, especially when it comes to the potential side effects and use contraindications. Both medications also come with a boxed warning from the FDA, meaning that individuals with certain medical histories should not take them to avoid developing potentially deadly complications.
On the flip side, both drugs are highly effective in treating type 2 diabetes, with Ozempic additionally being a good option for mitigating cardiovascular risks associated with this condition. Ultimately, choosing between Metformin and Ozempic is a decision best left to your doctor, who can professionally assess all the risks and benefits of taking these medicines, given your medical history.
The ongoing discussion about Ozempic and its potential weight loss efficiency has resulted in a large number of people seeking out the drug to aid them on their weight loss journey. While most clinical trials have been promising in that regard, Ozempic still hasn’t been approved for that purpose by the FDA.
Interestingly enough, Wegovy, another injection-based semaglutide drug from Novo Nordisk, was granted approval for chronic weight management.
Yes. Your doctor may put you on both Metformin and Ozempic should they determine that a single drug is not enough to manage your blood sugar levels effectively.
Off-label prescriptions for Ozempic have been issued by doctors with the purpose of helping patients lose weight. However, these recommendations have mostly been given to patients struggling with severe obesity and increased risk of further health complications. If you simply want to shed just a bit of extra weight ahead of a vacation or build muscle, Ozempic will not help you and may even work against your efforts.
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