Key takeaways
Metformin is a generic medication that’s FDA approved to treat Type 2 diabetes. It’s also used off-label for weight loss.
Metformin isn’t sold over the counter and requires a prescription from a licensed healthcare professional.
There are no exact over-the-counter (OTC) substitutes for metformin. There are OTC treatments that can help manage the symptoms of diabetes. For weight loss, there is one OTC FDA-approved weight-loss pill called Alli (orlistat).
Before starting any new medications, including OTC drugs or natural supplements, be sure to talk with your healthcare provider or pharmacist to see if it’s safe for you.
Metformin hydrochloride is a generic drug approved by the Food and Drug Administration (FDA) to help manage blood sugar levels in people with type 2 diabetes mellitus. It can also be used off-label for weight loss. Healthcare providers typically prescribe metformin along with a healthy diet and regular exercise routine. Often referred to by its brand names Glucophage, Fortamet, and Glumetza, metformin is available as an oral tablet and oral solution. Metformin tablets come in immediate-release or extended-release form.
Metformin is only available by prescription and is not sold over the counter (OTC). Therefore, you will need a prescription from a licensed healthcare provider to obtain the medication.
Read on to learn more about how to access metformin and if it’s available over the counter.
Can you get metformin over the counter?
Unfortunately, metformin isn’t available over the counter or without a prescription in the United States. To get the medication, you will need a metformin prescription from a licensed medical provider. Although it’s rare, metformin can cause serious side effects such as lactic acidosis. Because of this, it isn’t the right choice for everyone. Healthcare providers will typically only prescribe metformin after thoroughly evaluating your medical history.
While metformin isn’t available without a prescription, there are some OTC options that may help with diabetes symptoms or weight management. There are also natural supplements that claim to help with blood sugar levels and weight loss.
OTC substitutes for metformin
There are no exact OTC substitutes for metformin, and there aren’t any FDA-approved OTC medications for diabetes. However, if you’re looking for a metformin alternative for weight loss, there is one OTC weight-loss medication available called Alli (orlistat).
Read on to learn more about OTC substitutes for metformin.
OTC metformin substitutes for diabetes
While there aren’t any OTC equivalents to metformin, there may be some OTC medications that can help with certain symptoms of diabetes. For example, doctors may recommend OTC pain-relieving medications in combination with prescription medications to relieve diabetic neuropathy, a type of nerve damage caused by diabetes. Examples of OTC pain relievers include Motrin (ibuprofen) and Tylenol (acetaminophen). However, antidepressants, anticonvulsants, and topical anesthetics are the first-line treatments for diabetic neuropathy and these are prescription drugs.
OTC metformin substitutes for weight loss
In certain situations, healthcare providers may prescribe metformin off-label for weight loss. In a 2012 study, researchers found the average weight loss was 2.7 kilograms (about 6 pounds) after 1 year of taking metformin. The study also found that while gastrointestinal (GI) side effects were more common in people taking metformin, these side effects declined over time and there were no significant safety issues that occurred.
For weight loss, the only FDA-approved OTC weight-loss pill available is Alli (orlistat). By lowering the amount of fat absorbed by the body, Alli can be used for weight loss in adults 18 years and older along with a reduced-calorie and low-fat diet. In studies, Alli helped people lose 50% more weight than with diet alone. This means if you lost 10 pounds with diet alone, Alli may help you lose 5 additional pounds. Nevertheless, Alli can cause side effects, including digestive symptoms. And although it’s rare, severe liver problems have been reported with Alli.
Whatever the reason is for seeking an OTC substitute for metformin, be sure to check with your healthcare provider or pharmacist before starting a new medication. This can help prevent drug interactions, which can cause medications to be less effective or increase your risk of side effects.
What are some natural alternatives to metformin?
There aren’t any FDA-approved natural alternatives to metformin. That said, some natural supplements claim they can help manage blood glucose levels or weight loss. But it’s important to keep in mind that supplements differ from OTC medications because they contain natural ingredients. They aren’t approved by the FDA for safety or effectiveness before they are sold to the public.
Examples of natural supplements that may lower blood sugar include:
- Berberine: Berberine is a compound found in several plants. It’s commonly used in Chinese medicine for a variety of medical problems, including high blood sugar levels. Research suggests berberine may help lower blood sugar levels in various ways, such as increasing insulin sensitivity and improving insulin release. In a 2008 study, researchers found berberine was safe and effective for the treatment of type 2 diabetes. At a dosage of 1 gram daily, berberine lowered hemoglobin A1C levels by 12%.
- CinSulin: Cinnamon is commonly marketed as a supplement that can help support obesity, diabetes, and high cholesterol. CinSulin is a spray-dried, water extract of cinnamon. In a 2015 study, CinSulin was found to decrease fasting glucose more significantly than a placebo.
The following are examples of natural supplements that may support weight loss.
- Glucomannan: Glucomannan is a soluble fiber that can make you feel fuller, slows digestion in the stomach, and lowers fat and protein absorption. In theory, this may help you lose weight but its effects on weight loss have been inconsistent.
- Green tea and green tea extract: Green tea and green tea extract may speed up breakdown of fat and decrease fat absorption. In a 2016 study, 12 weeks of high-dose green tea extract resulted in significant weight loss, decreases in body mass index (BMI), and waist circumference.
- Probiotics: The evidence is mixed on whether probiotics can support weight loss. But there is some research that says probiotics can help reduce your body weight and fat percentage in comparison to placebo.
Although dietary supplements have their place in the diabetes and weight-loss market, it’s a good idea to discuss their use with a healthcare professional before taking them. Despite their natural ingredients, they come with risks, just as any medications do. A healthcare provider can help you decide if the supplement is right for you, given your medication list and medical conditions.
Sources
- Alli–orlistat capsule, DailyMed (2024)
- Cinnamon extract lowers glucose, insulin, and cholesterol in people with elevated serum glucose, Journal of Traditional and Complementary Medicine (2015)
- Diabetic neuropathy, Mayo Clinic (2022)
- Dietary supplements for weight loss, National Institutes of Health (2022)
- Effects and mechanisms of berberine in diabetes treatment, Acta Pharmaceutica Sinica B (2012)
- Effects of probiotics on body weight, body mass index, fat mass and fat percentage in subjects with overweight or obesity: a systematic review and meta-analysis of randomized controlled trials, Obesity Reviews (2017)
- Facts about dietary supplements, Food and Drug Administration (2023)
- FDA drug safety communication: Completed safety review of Xenical/Alli (orlistat) and severe liver injury, Food and Drug Administration (2018).
- Frequently asked questions, Alli
- Long-term safety, tolerability, and weight loss associated with metformin in the diabetes prevention program outcomes study, American Diabetes Association (2012)
- Metformin hydrochloride tablets, Food and Drug Administration (2012)
- Peripheral neuropathy, National Institute of Diabetes and Digestive and Kidney Diseases (2018)
- The glycaemic outcomes of Cinnamon, a review of the experimental evidence and clinical trials, Nutrition Journal (2015)
- Therapeutic effect of high-dose green tea extract on weight reduction: a randomized, double-blind, placebo-controlled clinical trial, Clinical Nutrition (2016)
- Treatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine, Journal of Clinical Endocrinolog