For people who have been diagnosed with type 2 diabetes mellitus, finding the right medication to control varying blood sugars and ensure a healthy metabolism can be a challenge. 

There are a number of diabetes medications for people with type 2 diabetes, as you might know from television advertisements or research. Two of the most common antidiabetic medications available today are Metformin and Ozempic. Both medications are only available via prescription. 

To obtain one of these medications, a person with type 2 diabetes mellitus should make an appointment with their physician to discuss options and form a care plan in order to begin a pill regimen or weekly injection treatment plan. 

Before speaking to a doctor, people with type 2 diabetes should understand the difference between these two medications. Read on for an explanation of the differences and similarities between Metformin and Ozempic.

Metformin Ozempic
Drug class Biguanides  Glucagon-like peptide 1 (GLP-1) receptor agonist, semaglutide 
Mechanism of action Decreases blood glucose absorption from food & lowers glucose production in the liver Stimulates insulin secretion & lowers glucose production in the liver
Side effects
  • nausea
  • vomiting
  • diarrhea
  • flatulence,
  • constipation,
  • heartburn
  • indigestion
  • bloating
  • abdominal pain
  • muscle cramps
  • skin flushing
  • nausea
  • vomiting
  • diarrhea
  • flatulence
  • constipation
  • heartburn
  • indigestion
  • bloating
  • abdominal pain
  • reduced appetite
  • burping, fatigue
Rare Complications
  • Allergic reactions
  • Hypoglycemia
  • Lactic acidosis
  • Liver damage
  • Allergic reactions
  • Hypoglycemia
  • Pancreatitis or liver damage
  • Thyroid disease or thyroid cancer
Price Up to $77 but may be partially or fully covered by insurance Up to $2,544 but might be partially or fully covered by insurance
Route Per Oral pill form. Taken once or twice daily. Subcutaneous injection into adipose tissue. Once per week.
Discovered 1957, but established in the U.S. in 1995 Approved by FDA in 2017

Metformin (Glucophage, Riomet, Glumetza) 

What is Metformin?

Metformin is an antidiabetic medication that has been prescribed to people with type 2 diabetes since 1957 in France and popularized more recently in 1995. This medication has a common reputation among medical professionals and has been around for several decades. 

It is only available by prescription and cannot be used to treat type 1 diabetes mellitus.

Common Metformin brands include:

Multi-ingredient medications containing metformin:

  • ActoPlus (Pioglitazone, Metformin)
  • Avandamet (Rosiglitazone, Metformin)
  • Invokamet (Canagliflozin, Metformin Hydrochloride)
  • Janumet / Janumet XR (Metformin Hydrochloride, Sitagliptin Phosphate)
  • Jentadueto (Metformin Hydrochloride, Linagliptin)
  • Synjardy (Metformin Hydrochloride, Empagliflozin)
  • Xigduo (Dapagliflozin Propanediol Monohydrate, Metformin)

What does Metformin do?

Metformin is in a drug class called biguanides. The mechanism of action of biguanides is to decrease the amount of blood glucose (or blood sugar) that your body absorbs from your food, plus also lower glucose production in the liver.  

So, rather than the intestines absorbing the full amount of glucose in food, they only absorb some glucose, lowering overall blood glucose. This can help control hyperglycemia or high blood sugar. Lowered blood sugar can lead to improved vascular and heart health, weight loss, lowered risk of diabetic ketoacidosis, and improved overall health. 

Metformin is taken once or twice per day in pill form (by mouth, per oral/PO) with or without food. This medication is best used in conjunction with exercise and healthy eating habits such as limiting portions and improving nutritional choices.

Common Side Effects Associated with Metformin:

There are a few known side effects of Metformin, although not every person is affected by these conditions. 

Some reported side effects include nausea, vomiting, diarrhea, flatulence (or gas), heartburn and indigestion, bloating, stomach cramps, muscle cramps, skin flushing, and constipation. There are also occasional reports that the medication can taste unpleasant, leaving a metallic taste in the mouth. 

These side effects do not occur in every person, and can sometimes be managed with the help of a primary care doctor and lifestyle changes. Most often, these side effects are outweighed in the long-term by the longevity type 2 diabetes control can offer.  

Rare Complications Associated with Metformin:

There have also been reports of serious reactions to the Metformin medication. These rare complications usually warrant stopping or switching medications with the help of one’s primary care doctor. 

Signs of an allergic reaction, such as a growing rash, shortness of breath, and throat and lip swelling, all require immediate emergency medical treatment. Chest pain is another reason to immediately seek emergency medical attention.

Metformin can lead to low blood sugar, or hypoglycemia reactions, when overused or used with too little food/water consumption. This will present as shakiness, sweats, nervousness, dizziness, lightheadedness, and skin pallor. Some people with diabetes know how to check and treat low blood sugars at home. If a person is not confident in this matter, they should seek immediate medical treatment for signs of hypoglycemia. Upon examination, a physician might also diagnose someone with lactic acidosis or high blood acidity in this condition