Mounjaro vs Metformin for Diabetes

Key Takeaways

Besides promoting insulin sensitivity, metformin regulates blood sugar levels by reducing glucose absorption in the stomach and intestines while lowering glucose production in the liver. Mounjaro manages blood sugar control by increasing insulin and decreasing glucagon.
Metformin is usually the first-line treatment for type 2 diabetes because it has been well-studied for safety and efficacy, and metformin’s generic products are very affordable. Mounjaro and other diabetes medications are added when metformin monotherapy does not achieve blood sugar control.
There is a considerable difference in the cost of Mounjaro vs metformin. Mounjaro is a brand name product that can cost around $1,200 for a month’s supply, while the cost of generic metformin ranges between $15-$20 per month for most people.

If you have been diagnosed with type 2 diabetes mellitus, depending on your blood glucose levels, your healthcare provider may prescribe diabetes medications to lower blood sugar levels in addition to lifestyle modifications with healthy diets and regular exercises.

Metformin and Mounjaro are two medications used to treat type 2 diabetes. While Mounjaro’s cardiovascular benefits have not been confirmed, having your blood sugar under control helps lower the risk of cardiovascular disease and other diabetes-related complications in the long run.

However, these two medications work differently to manage diabetes. They have different routes of administration and can cause different side effects and drug interactions.

Please continue reading to learn more about Mounjaro vs metformin for treating diabetes.

How does metformin regulate blood sugar levels?

Metformin is a prescription medication that belongs to the drug class biguanides to treat type-2 diabetes. It is prescribed alone or with other medications to regulate blood sugar levels. Metformin reduces glucose absorption in the stomach and intestines and lowers glucose production in the liver. It also improves insulin sensitivity.

How does Mounjaro help with blood sugar control?

Mounjaro is a brand name product for the generic medication tirzepatide. It belongs to a group called glucose-dependent insulinotropic polypeptide (GIP) receptor and glucagon-like peptide-1 (GLP-1) receptor agonists. Mounjaro works by increasing insulin and decreasing glucagon (these are natural hormones involved in blood sugar control). What’s unique about Mounjaro is that it activates both GIP and GLP-1 receptors. Therefore, it can be potentially more effective at controlling than GLP-1 receptor agonists such as Ozempic, Trulicity, and Victoza.

Which is better: Mounjaro vs metformin?

Metformin is usually the first-line treatment for type 2 diabetes. Mounjaro and other diabetes medications are added when metformin monotherapy does not achieve glycemic control (blood sugar control) or if you have severe kidney disease or a history of lactic acidosis. Here are some of the key differences between Mounjaro vs metformin.

Administration

Metformin comes as oral tablets and liquid suspension. Metformin is available as an immediate-release or extended-release oral tablet. Metformin immediate-release is to be taken by mouth two to three times daily with food, while the extended-release formulation allows once-daily dosing.

Mounjaro comes as an injection solution in a prefilled pen to inject subcutaneously (under the skin) once a week, without regard to meals.

Some people prefer oral medications such as metformin, while others prefer the convenience of once-weekly dosing with Mounjaro.

Medical conditions

In addition to type 2 diabetes mellitus, metformin is also used off-label to treat conditions such as gestational diabetes and polycystic ovary syndrome. However, metformin may not be safe for people with kidney problems or metabolic acidosis.

Mounjaro may not be safe for people with pancreatic problems, kidney disease, digestive or stomach issues, diabetic retinopathy, and thyroid cancer.

Side effects

Common side effects of metformin include stomach upset, stomach pain, gas, bloating, nausea, and diarrhea.

Possible side effects of Mounjaro include injection site discomfort, stomach upset, nausea, vomiting, diarrhea, constipation, and decreased appetite.

Risks

Taking metformin is associated with an increased risk of lactic acidosis, a potentially life-threatening condition. Taking Mounjaro can increase the risk of developing thyroid C-cell tumors.

Drug interactions

Both metformin and Mounjaro can interact with other medications. Drug interactions can increase the risk of serious adverse events. Give your doctor a complete list of medications and check with them before starting any new medication while on metformin or Mounjaro.

Cost

There is a considerable difference in the cost of Mounjaro vs metformin. Mounjaro is a brand name product that contains the generic drug tirzepatide. It can cost around $1,200 for a month’s supply. In contrast, the cost of generic metformin ranges between $15-$20 per month for most people.

What medication is replacing metformin?

No medication is replacing metformin. It has been around for decades and continues to be the first choice for treating diabetes. However, your doctor may prescribe other diabetes medications such as Mounjaro if your blood glucose levels are not controlled on metformin alone.

Why is metformin preferred?

Metformin is preferred because it has been well-studied for safety and efficacy and is very affordable. Also, metformin is less likely to cause hypoglycemia (low blood sugar) and weight gain compared to some other anti-diabetic drugs.

Does metformin help with weight loss?

Yes, metformin can lead to moderate weight loss when used with a healthy diet and exercise. Keep in mind that metformin is not approved by the FDA for weight management.

Mounjaro clinical trials have also shown that it can cause clinically significant weight loss. Tirzepatide, the active ingredient in Mounjaro, has been FDA-approved for chronic weight management under the trade name Zepbound.

Why do doctors not recommend metformin?

Doctors may not recommend metformin due to various factors, such as:

Your blood sugar levels are well controlled with lifestyle measures, and you do not need to take an anti-diabetes medication.
Metformin alone cannot treat type 2 diabetes mellitus adequately.
You have severe symptoms and cannot tolerate metformin side effects.
You have a contraindication, such as severe kidney problems or severe allergy to metformin.
You are at a higher risk of complications such as metformin-associated lactic acidosis.

If you want to consider Mounjaro vs metformin, talk to your healthcare provider about which medication is best for you.

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