Can you take metformin and Ozempic together?

Metformin and Ozempic are popular prescription drugs that help people manage diabetes.

Many people can prescribe metformin or Ozempic alone, but sometimes a doctor may prescribe both at the same time as a type of combination therapy.

Because these drugs work in different ways, and their use together is relatively new, you may have questions about how these drugs interact, what the side effects can be, and how well they work together.

This article will tell you what you need to know about taking Ozempic and metformin together.

What is the difference between Ozempic and metformin?

To understand why you might be prescribed one drug, the other, or both, it’s important to know a little about each drug and how they differ.

Ozempic and metformin differ in several ways. To start with, Ozempic is an injectable once-a-week medication, while metformin is an oral medication that is taken daily (or twice a day) and usually comes in tablet form.

But these two drugs have different active ingredients and act on the body in different ways.


ozempic 
Ozempic is the trade name of the most popular drug that uses the active ingredient semaglutide, which is mainly used to treat diabetes.  Ozempic is manufactured by the pharmaceutical company Novo Nordisk.
Other pharmaceutical companies also produce drugs with the same active ingredient as Ozempic (these include the brands Wegovy and Rybelsus).
Ozempic is a glucagon-like peptide 1 (known as ‘GLP-1’) agonist.  The drug mimics the hormones in the body that help regulate blood sugar levels.
Ozempic increases the body’s natural production of insulin, reduces the production of glucose in the liver, slows down the emptying of food from the stomach into the small intestine, and reduces appetite, which usually leads to weight loss. 
Metformin
Metformin is one of the most commonly prescribed drugs in the world.  The most common use of metformin is in the first-line treatment of type 2 diabetes. 
Metformin increases insulin sensitivity and has been shown to have a wide range of other health benefits.  Increasingly, metformin is being prescribed to people with prediabetes, gestational diabetes, type 1 diabetes and polycystic ovary syndrome (PCOS).
Metformin lowers the amount of sugar produced by the liver, reduces the absorption of sugar in the intestines, and enables individual cells in the body to consume more sugar and use it more efficiently.
Like Ozempic, metformin has been shown to help people lose weight under certain circumstances. 
While Ozempic is a relatively new drug that was approved by the FDA in 2017, metformin has been on the market in the United States since 1994. Both drugs have seen a significant increase in their use since their introduction.

Why should I prescribe Ozempic and metformin?
The main reason these medications are prescribed is to help control blood sugar levels.
Ozempic and metformin help most people lower their average blood sugar levels (as measured by the A1c blood test), and these effects are quite significant. 
Clinical studies have shown that (at the maximum dose) metformin can help lower A1c by 1.5%, while the average dose of Ozempic can reduce A1c by 1.4%.
If metformin has already been prescribed and is no longer providing the maximum intended benefit, your doctor or healthcare team may write a prescription for Ozempic to evaluate its effectiveness as a standalone replacement for metformin or as an add-on therapy to an existing metformin prescription.
There are other reasons why you may be prescribed metformin or Ozempic.  However, these uses are usually off-label (not FDA approved).
Both drugs have been shown to help with weight loss in addition to their primary function of lowering average blood sugar levels.  While no drug is approved by the FDA for this use, it can be a helpful effect, especially for people with type 2 diabetes and struggling to maintain a healthy weight.
Both drugs are also established to reduce the risk of serious cardiovascular events such as a heart attack.
While many of these off-label effects can be helpful, metformin and Ozempic are generally not prescribed for these reasons alone.

Can you safely take metformin and Ozempic together?
In most cases, the answer is yes.  Clinical studies have shown that it is generally safe to take metformin and Ozempic together. 
Not only is it generally safe, but it’s becoming more common to prescribe these drugs together as combination therapy as the two drugs complement each other to help control blood sugar levels.
Medications can also help with cardiovascular health and weight loss in ways that can be mutually reinforcing.
Taking metformin and Ozempic together may be an effective way to control blood sugar levels, especially in people with type 2 diabetes.

What are the side effects of taking Ozempic and metformin?
While both of these drugs can be effective in controlling blood glucose levels, they can also cause side effects, and taking them together can increase the risk of certain side effects and side effects.
Both metformin and Ozempic can cause gastrointestinal symptoms such as nausea, vomiting, and diarrhea.
Taking these two drugs together can increase the likelihood and severity of the side effects you may experience.
If you are taking metformin and Ozempic together – or if they have been prescribed together with insulin – it is especially important to be aware of the signs of low blood sugar (hypoglycaemia).
Low blood sugar can cause sweating and tremors, dizziness, or confusion.  If your blood sugar is low, you may also experience a racing heart or rapid changes in your perceptions or emotions.
If you experience any of these symptoms, it’s important to check your blood sugar – and if it’s low, quickly bring your blood sugar back into the normal range by eating or drinking something containing carbohydrates.
Metformin and Ozempic have their own potential side effects that are very rare but important to know about.  These include the risk of lactic acidosis with metformin and thyroid tumors with Ozempic.
Clinical trials have shown that taking both drugs together does not increase the overall risk of serious side effects.
It’s important to read any documents that come with your prescription and talk to your doctor about each prescription drug and its potential side effects.
You can read more about the side effects of each drug here:

Does Ozempic work better than metformin?
Because Ozempic and metformin work in different ways, neither of them need work better than others. 
Depending on the dose, metformin or Ozempic may lower blood sugar more than the other drug.
Overall, Ozempic has been shown to help people lose more weight than metformin, but everyone’s experience is different, and weight loss is not guaranteed by any drug – nor is any drug approved by the FDA for this purpose.
Can you take metformin combination medicines with Ozempic?
Combination drugs for people with type 2 diabetes often combine metformin with another drug with a different mechanism of action, as this allows you to maximize the effectiveness of both drugs.
Adding an Ozempic prescription to a metformin combination drug should only be done after consulting your doctor, as each of the three (or more) active ingredients may have its own set of side effects and contraindications.

Is Metformin Safer Than Ozempic?
Metformin is often considered to be one of the safest and most researched drugs to help people control their blood sugar levels. 
Although metformin has been in widespread use longer than Ozempic, each drug has undergone extensive, rigorous testing.
However, each person’s risk factors and their own experience of side effects will vary.  That’s why it’s important to work with your doctor to understand how each drug’s safety profile, risk, and side effects stack up against its benefits, all within the context of your health history and goals.
What foods should I avoid while taking Ozempic and metformin?
Foods that may cause an upset stomach are best avoided while taking Ozempic and metformin at the same time.  These include heavy, greasy or oily foods. 
In general, it’s also best to avoid overly processed foods, and you may also be advised to avoid drinking alcohol while taking metformin and Ozempic. 
Follow all guidelines and instructions for any prescription drugs and follow them.  And remember, it’s always a good idea to talk to your doctor about the diet you should be eating and any foods, drinks, or behaviors you should avoid when starting a new prescription. 
You can read more about what foods to avoid here:

How Much Weight Can You Lose On Ozempic And Metformin Together?
It’s important to note that taking Ozempic and metformin together for weight loss is an off-label goal that’s not FDA-approved, so it’s especially important to work with your doctor to understand the benefits and risks. 
If you’ve been prescribed Ozempic and metformin for type 2 diabetes but want to lose weight, there are FDA approved weight loss medications that are safe for people with diabetes that your doctor can also prescribe.
Clinical trials have shown that metformin alone leads to a 5% average weight loss in about a third of people taking the drug, including a loss of about 12-15 pounds in people who did not have diabetes.
In people who are overweight or obese, Ozempic has been shown to cause weight loss of 14.9% of body weight.