Semaglutide vs Metformin
SemaglutideMetformin
GLP-1 receptor agonist
Classification
BiguanideOzempic, Rybelsus, Wegovy
Brand Names
Glucophage, Glumetza, others2017 (Ozempic), 2019 (Rybelsus), 2021 (Wegovy)
FDA Approval Year
1994Mimics the incretin hormones that the body usually produces after eating to increase insulin secretion.
Mechanism of Action
Decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity.Type 2 diabetes management, weight loss (Wegovy)
Primary Use
Type 2 diabetes management, sometimes used for polycystic ovary syndrome (PCOS)Subcutaneous injection (Ozempic, Wegovy), oral tablet (Rybelsus)
Administration Route
OralInjection: 0.25 mg, 0.5 mg, 1 mg, 2 mg; Oral tablet: 3 mg, 7 mg, 14 mg
Dosage Forms
Oral tablet: 500 mg, 850 mg, 1000 mg; Extended-release oral tablet: 500 mg, 750 mg, 1000 mgNausea, vomiting, diarrhea, abdominal pain, constipation, injection site reactions
Common Side Effects
Diarrhea, nausea, abdominal pain, potential vitamin B12 deficiency, rarely lactic acidosisPancreatitis, kidney problems, vision changes, severe gastrointestinal issues, increased heart rate
Serious Side Effects
Lactic acidosis (rare but serious condition), kidney issues, severe hypoglycemia when combined with insulinPersonal or family history of medullary thyroid carcinoma, Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
Contraindications
Severe kidney impairment, metabolic acidosis, diabetic ketoacidosisMay affect absorption of oral medications due to gastrointestinal motility; careful timing of doses is recommended
Interactions
Alcohol can increase the risk of lactic acidosis; effects may be decreased by corticosteroids and diureticsHigher cost, especially for weight loss formulations
Cost (approximate)
Generally low cost, widely available as a genericBlood glucose levels, renal function, signs of gastrointestinal disease, thyroid tumors
Monitoring
Blood glucose levels, renal function, vitamin B12 levels, especially in long-term useHighly effective for reducing HbA1c and weight loss
Effectiveness
Effective for reducing HbA1c, less potent for weight loss compared to GLP-1 agonistsWeight loss
Weight Impact
Neutral or slight weight lossCoupon code
CMP30
Coupon code
Coupon code
CMP30
