Metformin and Ozempic are both commonly prescribed medications for managing type 2 diabetes, but they differ significantly in how they work, their side effects, costs, and other factors. Here’s a breakdown of how these two drugs compare.
What are Metformin and Ozempic?
Metformin has been a staple in treating type 2 diabetes since it was approved in 1994. It works by lowering the amount of glucose produced by the liver and improving insulin sensitivity. It’s commonly prescribed to people who are newly diagnosed with diabetes or those with mild to moderate cases. However, it is not FDA-approved for obesity treatment.
Ozempic, on the other hand, is a newer drug, approved in 2017, and is part of the GLP-1 agonist class. It works by mimicking a hormone called GLP-1, which stimulates insulin release, slows digestion, and increases feelings of fullness, leading to weight loss. Ozempic has also been shown to lower the risk of heart attacks, strokes, and protect kidney function, making it beneficial for people with both diabetes and cardiovascular disease.
Dosing Differences
Metformin is usually taken once or twice daily in pill or liquid form. The typical starting dose is 500 milligrams, which can be increased if needed. There’s also an extended-release version that’s taken once a day, usually with the evening meal.
Ozempic is injected once a week. You start with a low dose of 0.25 mg for four weeks, followed by a 0.5 mg dose for at least another four weeks. The dose can go up to 2 mg per week. The injectable format can be more convenient for those who forget daily pills, but some may find injections off-putting.
Side Effects Comparison
Both medications have similar side effects, such as stomach issues like diarrhea, nausea, and bloating. However, metformin’s side effects are usually milder and tend to improve over time. Ozempic, on the other hand, can cause more intense side effects, including vomiting and constipation, which can be trickier to manage.
Metformin has been on the market for decades, so its side effects are well understood. Ozempic, being newer, has less long-term data, but it has been shown to be less tolerable for some people.
Weight Loss
While both drugs can lead to weight loss, Ozempic is much more effective in this regard. Research shows that people with type 2 diabetes and obesity lost an average of 5% to 6% of their body weight after using Ozempic for a year, compared to just a 2% loss for those on metformin over two years. Higher doses of GLP-1 agonists, such as Wegovy (semaglutide) and Zepbound (tirzepatide), are also available for weight loss.
Costs
Metformin is significantly more affordable than Ozempic. Since it’s available as a generic, its price is relatively low. With insurance, metformin may cost around $4 per month, and without insurance, it ranges from $4 to $15. On the other hand, Ozempic can cost between $25 to $200 with insurance, and without insurance, it may range from $1,000 to $1,400 per month.
Which Medication is Right for You?
Metformin is usually the first choice for managing blood sugar due to its affordability and ease of use. It’s a great option if you are newly diagnosed or have mild diabetes. Ozempic is more effective for people with more severe diabetes, those needing significant weight loss, or those with heart or kidney complications. However, its higher cost and more intense side effects might make it a less desirable option for some.
Other Considerations
For people with conditions like polycystic ovary syndrome (PCOS), both metformin and Ozempic can help, but metformin is generally preferred if weight loss isn’t the primary concern. Additionally, while Ozempic is not approved for treating prediabetes, it can still lower blood sugar and assist with weight loss.
