Can you take Wegovy and metformin together?

Learn why your healthcare provider may prescribe Wegovy and metformin together for better health outcomes

By Sarah Bradley | Nov. 13, 2024 Medically reviewed by Jesse P. Houghton, MD, FACG

Key takeaways

People with Type 2 diabetes who need to control their blood glucose and lose weight may benefit from taking metformin and Wegovy together.
Metformin and Wegovy are part of different drug classes, and both work differently in the body while providing some overlapping benefits, like increased cardiac health.
It’s generally safe to take both drugs together, but doing so may increase your risk for gastrointestinal side effects or low blood sugar.
There are many factors to consider when choosing between metformin or Wegovy, including how the drugs are taken, their costs, and their accessibility.

In this article:

Can you take Wegovy and metformin together?
Taking Wegovy and metformin together
Is Wegovy or metformin better?
Wegovy vs. metformin: Comparison

In this article

Can you take Wegovy and metformin together?
Taking Wegovy and metformin together
Is Wegovy or metformin better?
Wegovy vs. metformin: Comparison

If you have Type 2 diabetes and also need to lose weight to improve your overall health, your healthcare provider may recommend taking two different drugs to manage your blood sugar and your weight loss. One popular combination is Wegovy and metformin.

Wegovy is a brand-name injectable glucagon-like peptide-1 (GLP-1) receptor agonist that contains the same active ingredient as Ozempic—semaglutide. It’s approved by the Food and Drug Administration for weight management in people with obesity or who are overweight. It’s also approved for the prevention of cardiac events such as heart attack and stroke. Metformin is a generic oral diabetes medication that helps people with Type 2 diabetes control their blood sugar and is often used off-label as a treatment for polycystic ovarian syndrome (PCOS).

RELATED: Ozempic vs. metformin

Using these two drugs together can help you achieve multiple goals: losing weight, improving your blood glucose levels, and decreasing your risk of cardiovascular events. In studies, both Wegovy and metformin have been shown to have protective effects on the heart, especially in people who have Type 2 diabetes or a history of heart disease.

Because Wegovy (semaglutide) and metformin provide many of the same benefits, people often wonder if it’s safe to take these drugs together. Here’s what you should know about combining metformin and Wegovy, including why your healthcare provider might prescribe both drugs and best practices for taking them together.

Can you take Wegovy and metformin together?

Yes, you can take Wegovy and metformin together. “Combined, they may help improve your blood sugar levels more than one drug alone—something that can translate to improved weight loss,” says Erika Gray, Pharm.D., cofounder of Toolbox Genomics.

“Metformin reduces how much glucose your liver produces and how much glucose you absorb from your intestines, but some people still struggle to lower their glucose levels,” she explains, noting that recent clinical trials have found adding semaglutide to metformin treatment further enhances the effects on glucose levels and weight loss.

These trials, including the PIONEER (Peptide Innovation for Early Diabetes Treatment) 2 trial, used oral semaglutide rather than injectable semaglutide and found that standard doses of up to 14 milligrams (mg) of oral semaglutide were safe and effective when combined with daily metformin doses of at least 1,500 mg.

No research has found a significant difference between the safety or effectiveness of the oral and injectable forms of semaglutide. While your healthcare provider is the best person to determine the safest dose of injectable Wegovy for you, it will most likely be the standard dose of either 1.7 mg or 2.4 mg, based on how well you tolerate the drug.

Taking Wegovy and metformin together

Your healthcare provider will give you instructions on when and how to take Wegovy and metformin together. “Most people take between 500 mg and 2,000 mg of metformin orally per day, while Wegovy is taken (by injection) once per week,” Dr. Gray says.

Because they are completely different classes of drugs, metformin and Wegovy don’t interact with one another. In theory, taking any oral medication around the time of your Wegovy injection could affect how the medication is absorbed since Wegovy slows down gastric emptying. But a study published in 2017 found no significant effects, interactions, or safety issues when participants took metformin and semaglutide at the same time. “The more important thing is making sure you take your medications consistently,” Dr. Gray says. In other words, don’t skip or double up on doses.

You should also be aware that taking Wegovy and metformin could increase your risk of side effects. Metformin can cause nausea, diarrhea, and upset stomach; Wegovy can cause nausea, vomiting, loss of appetite, and abdominal pain. Taking them both together may further raise your risk of gastrointestinal (GI) distress. “It can also increase your risk of dehydration if you’re losing a lot of fluids or eating and drinking less,” says Katrina Mattingly, MD, obesity medicine specialist and chief medical officer of physician-supervised weight loss center Options Medical Weight Loss.

RELATED: Metformin side effects

Because both medications lower your blood sugar, there’s also the possibility of hypoglycemia, excessively low blood sugar, according to Dr. Mattingly. Your healthcare provider will want to keep a close eye on your blood sugar levels when you’re first prescribed these drugs together (or when you’re increasing either of the doses).

Is Wegovy or metformin better?

Wegovy and metformin work in different ways and are FDA approved for different uses, so it’s difficult to objectively say which one is better. But there are things to consider, such as side effects, cost, and your overall health, when choosing between the two drugs.

In addition to talking with your healthcare provider, Dr. Mattingly says you should ask yourself the following questions:

Can I reasonably commit to taking a pill once or twice per day, or would I rather take a once-weekly injectable medication?
Can I tolerate injecting myself with a needle?
Do I have other medical conditions, such as heart disease, that would benefit from the use of Wegovy?
Would I be taking either of these drugs off-label (for a use not approved by the FDA)?

Lastly, you should consider the cost of these medications and your insurance coverage. “While metformin is readily available with insurance coverage for a small out-of-pocket cost, the same isn’t true for Wegovy,” Dr. Mattingly says. Wegovy is not only more expensive than metformin but it may also be affected by national semaglutide shortages. “Insurance companies have not been as generous in covering this medication, and paying over $1,000 per month out-of-pocket is not feasible for most patients.”

Wegovy vs. metformin: Comparison
Drug class	GLP-1 receptor agonist	Biguanide
Standard form and dosage	Injection; 1.7 or 2.4 mg weekly	Oral; 500–2,000 mg per day
Notable contraindications	History of kidney, liver, or pancreas disease** Pregnant or breastfeeding History of certain types of thyroid and endocrine cancers History of diabetic retinopathy	History of liver or kidney disease** Pregnant or breastfeeding Excessive or regular alcohol intake
Side effects	Nausea Vomiting Loss of appetite	Nausea Diarrhea GI upset
Average cost without insurance*	$1,808 for 4 pens, a 28-day supply	$178 for 60, 500 mg tablets
SingleCare cost*	$1,193	$3
Learn more	More Wegovy details	More metformin details