Metformin is a medication prescribed to help people with type 2 diabetes manage their blood sugar levels. It may also help with weight management.
Metformin
Metformin
Metformin is an oral medication commonly prescribed to manage blood sugar levels in people with type 2 diabetes. It works by decreasing glucose production in the liver, improving the body's sensitivity to insulin, and reducing the amount of sugar absorbed by the intestines.
Metformin is sometimes used off-label to treat conditions like PCOS, obesity, and overweight. Common side effects include gastrointestinal issues like nausea, diarrhea, and abdominal discomfort.
Metformin hydrochloride tablets are indicated:
As an adjunct to diet and exercise to improve glycemic control in adults and pediatric patients 10 years of age and older with type 2 diabetes mellitus
Biguinide
For metformin hydrochloride, the most common adverse reactions (>5%) are:
Diarrhea
Nausea/vomiting
Flatulence
Weakness
Indigestion
Abdominal discomfort
Headache
The cost of metformin varies depending on your insurance plan, which pharmacy you use, the dose, and quantity. Without insurance, metformin may cost between $10 and $30 for 60 tablets (typically a month’s supply). Insurance plans may cover all or some of the cost of these medications.
You may be eligible for coupons or discount cards that can help bring down the cost. Ask your provider or pharmacist if you qualify.
Personalized Weight Loss Medication Kits (which may feature metformin along with a combination of other medications) are available through the Hers platform starting at $69 per month. This price includes the many benefits of the Hers app, such as unlimited messaging with your care team, recipes and healthy eating tips, and behavior change exercises.
Metformin is available with a prescription from a licensed healthcare provider. Your provider will determine if the medication is right for you based on factors like your symptoms and medical history.
If you’re interested in metformin, you can connect with a licensed healthcare provider on the Hims platform. They will create a personalized weight loss treatment plan that fits your needs. For those who qualify, Hims offers access to metformin starting at $69 a month.
When you access weight loss medication through the Hims platform, your medication is shipped directly to your door. You get all the supplies you need, along with instructional videos, ongoing provider support through the app, and a wealth of holistic health resources like meal plans, recipes, and fitness content.
Interested in Weight Loss by Hims? Get started with our free online weight loss assessment.
Severe renal impairment (eGFR below 30 mL/min/1.73 m2)
Hypersensitivity to metformin
Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma
Drug interactions: Carbonic anhydrase inhibitors, drugs that reduce metformin clearance (such as ranolazine, vandetanib, dolutegravir, and cimetidine), alcohol
Lactic acidosis: See Boxed Warning
Vitamin B12 deficiency: Metformin may lower vitamin B12 levels
Low blood sugar with concomitant use with insulin and insulin secretagogues
Females and males of reproductive potential: Potential for an unintended pregnancy
WARNING: LACTIC ACIDOSIS
Postmarketing cases of metformin-associated lactic acidosis have resulted in death, hypothermia, hypotension, and resistant bradyarrhythmias. Symptoms included malaise, myalgias, respiratory distress, somnolence, and abdominal pain. Laboratory abnormalities included elevated blood lactate levels, anion gap acidosis, increased lactate/pyruvate ratio; and metformin plasma levels generally >5 mcg/mL.
Risk factors include renal impairment, concomitant use of certain drugs, age >65 years old, radiological studies with contrast, surgery and other procedures, hypoxic states, excessive alcohol intake, and hepatic impairment. Steps to reduce the risk of and manage metformin-associated lactic acidosis in these high risk groups are provided in the Full Prescribing Information.
If lactic acidosis is suspected, discontinue metformin hydrochloride tablets and institute general supportive measures in a hospital setting. Prompt hemodialysis is recommended.
Other drugs are available that can help manage type 2 diabetes, improve blood sugar control, and help with weight loss. If you’re interested in finding an alternative to metformin, chat with a provider to learn more.
Examples of medications used to manage type 2 diabetes include:
Dipeptidyl peptidase 4 (DPP-4) inhibitors:
Januvia® (sitagliptin)
Nesina® (alogliptin)
Onglyza® (saxagliptin)
Tradjenta® (linagliptin)
Injectable glucagon-like peptide 1 (GLP-1) receptor agonists:
Adlyxin® (lixisenatide)
Bydureon® (exenatide extended-release)
Byetta® (exenatide)
Ozempic® (semaglutide)
Trulicity® (dulaglutide)
Victoza® (liraglutide)
The oral GLP-1 receptor agonist Rybelsus® (semaglutide)
The injectable dual GLP-1/gastric inhibitory peptide (GIP) receptor agonist Mounjaro® (tirzepatide)
Sodium-glucose cotransporter 2 (SGLT2) inhibitors:
Brenzavvy® (bexagliflozin)
Farxiga® (dapagliflozin)
Invokana® (canagliflozin)
Jardiance® (empagliflozin)
Steglatro® (ertugliflozin)
Amaryl® (glimepiride)
Diabeta®, Glynase®, and Micronase® (glyburide)
Glucotrol® and Glucotrol XL® (glipizide)
Thiazolidinediones (TZDs):
Actos® (pioglitazone)
Avandia® (rosiglitazone)
Insulin
Examples of other medications used to help with weight loss include:
Wegovy® (semaglutide)
Contrave® (naltrexone-bupropion)
Qsymia® (phentermine-topiramate)
Saxenda® (liraglutide)
Xenical® or Alli® (orlistat)
Metformin is approved by the FDA to help manage type 2 diabetes, but it’s also prescribed off-label for weight loss. There’s no set amount of time when it comes to how quickly metformin works for weight loss and results vary from person to person, but research indicates you may notice weight loss within three and six months of starting the medication.
There’s not one best time to take metformin, but providers usually recommend taking the drug at the same time each day (to avoid missing or doubling up on doses) and taking the medication with a meal to reduce the risk of gastrointestinal side effects.
When it comes to metformin vs. Ozempic, there are some key differences to know. Metformin is an oral medication typically prescribed to help manage blood sugar levels in folks with type 2 diabetes. It decreases glucose production in the liver and increases insulin sensitivity.
Ozempic, on the other hand, contains the active ingredient semaglutide. It’s typically prescribed to help improve blood sugar control in people with type 2 diabetes and reduce the risk of major cardiovascular events in folks with heart disease. Ozempic works by mimicking the hormone GLP-1, which increases insulin secretion, decreases glucagon release, and slows gastric emptying.
Drinking alcohol while taking metformin can be risky because alcohol may cause a decrease in blood sugar, increasing your risk of hypoglycemia. Rarely, alcohol and metformin can lead to a serious complication called lactic acidosis in which lactic acid builds up in the bloodstream, which can be deadly. The risk of lactic acidosis is higher if you drink excessively. Tell your provider about your drinking habits and ask how much alcohol is safe to drink while you’re taking metformin.
*This information is from the metformin hydrochloride label used by Epic Pharma, LLC. See the Full Prescribing Information for more complete information. Metformin may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient metformin.
American Diabetes Association. (2024). What are my options for type 2 diabetes medications? https://diabetes.org/health-wellness/medication/oral-other-injectable-diabetes-medications
Collins L, et al. (2024). Glucagon-like peptide-1 receptor agonists. https://www.ncbi.nlm.nih.gov/books/NBK551568/
GoodRx. (2024). How much is metformin without insurance? https://www.goodrx.com/metformin/how-much-is-metformin-without-insurance
Kujawska-Łuczak M., et al. (2017). The effect of orlistat versus metformin on body composition and insulin resistance in obese premenopausal women: 3-month randomized prospective open-label study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5510517/
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Padda IS, et al. (2023). Sodium-glucose transport protein 2 (SGLT2) inhibitors. https://www.ncbi.nlm.nih.gov/books/NBK576405/
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