Rybelsus vs Metformin: What’s the Difference?

Key Takeaways

Rybelsus and metformin are both diabetes medications. Metformin manages blood sugar levels by reducing the absorption of glucose in the intestines and decreasing glucose production in the liver while improving insulin sensitivity and decreasing insulin resistance. Rybelsus (semaglutide) increases insulin secretion from the beta cells in the pancreas.
Traditionally, metformin is the first go-to medication for type-2 diabetes. Rybelsus is a brand new diabetes medication that can be used in combination with other diabetes medications, such as metformin.

Rybelsus and metformin are diabetes medications that are used to lower blood sugar levels in diabetic patients. They help reduce the risk of other diabetes-related complications, such as kidney failure and cardiovascular disease.

Both medications come in tablet form. Please continue reading to learn more about Rybelsus vs metformin and find out how Rybelsus and metformin work for diabetes management.

How does metformin help with blood sugar control?

Metformin helps to manage blood sugar levels by reducing the absorption of glucose from food, decreasing glucose production in the liver, decreasing insulin resistance, and improving insulin sensitivity.

Metformin can be used by itself or in combination with other medications to treat type-2 diabetes,

How does Rybelsus help in lowering blood sugar levels?

Rybelsus is a brand name product for the generic drug semaglutide. It is a glucagon-like peptide-1 (GLP-1) receptor agonist and works by increasing insulin secretion from the beta cells in the pancreas. Insulin is a naturally occurring hormone that plays a critical role in lowering blood sugar levels.

Rybelsus is the only oral medication in its class. Other newer diabetes medications are available as injectables.

Which is better: Rybelsus vs metformin?

Traditionally, metformin is a first-line medication for type 2 diabetes mellitus. Rybelsus and other diabetes medications are usually prescribed if metformin alone fails to achieve glycemic control. Here are some of the key differences between Rybelsus vs metformin.

Administration

Metformin is an oral medication that comes as an immediate-release tablet, extended-release oral tablet, and liquid suspension to be taken by mouth 1-2 times a day with meals.

Rybelsus comes as a tablet to take by mouth once a day on an empty stomach first thing in the morning, followed by a snack or meal at least 30 minutes later.

Medical conditions

In addition to type 2 diabetes mellitus, metformin is also used off-label to treat other conditions, such as gestational diabetes and polycystic ovary syndrome. However, it is not used to treat type 1 diabetes. Metformin may not be safe for people with kidney problems or if you have a history of diabetic ketoacidosis or metabolic acidosis.

Rybelsus may not be safe for people with pancreatitis, gallbladder problems, kidney disease, diabetic retinopathy, or thyroid cancer.

Side effects

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

Possible side effects of Rybelsus include abdominal pain, nausea, vomiting, diarrhea, constipation, decreased appetite, and low blood sugar.

Risks

Taking metformin is associated with an increased risk of lactic acidosis, a potentially life-threatening condition in which lactic acid builds in the body. Taking Rybelsus can increase the risk of developing thyroid tumors, including medullary thyroid carcinoma and thyroid C-cell tumors.

Cost and insurance coverage

There is a big difference in the cost of Rybelsus vs metformin. Rybelsus is a brand name product that contains semaglutide. There is no generic equivalent of Rybelsus, and it can cost around $1,200 for a month’s supply. In contrast, metformin is a generic medication and costs $15-$20 per month on average, with low or no copays.

Can you take Rybelsus and metformin together?

Yes, you can take Rybelsus and metformin together if your doctor determines that it is safe and beneficial for you. These prescription medications do not belong to the same drug class and work differently.

Metformin reduces the amount of glucose absorbed from the gut and glucose produced in the liver. It also works by enhancing insulin sensitivity. Rybelsus can increase insulin release from the pancreas.

Taking the two together may help in managing blood sugar levels if one medication has been unsuccessful.

Can you take Rybelsus without metformin to control blood glucose levels?

Yes, you can take Rybelsus without metformin to control blood sugar levels. Your doctor may switch you from metformin to Rybelsus if:

Metformin has failed to improve blood sugar control.
You have severe metformin side effects.
You have a contraindication to taking metformin, such as kidney disease, or you are at an increased risk of metformin-associated lactic acidosis.

What is the new drug replacing metformin?

Metformin has been around for decades and is still the first go-to medication for type 2 diabetes. In other words, your doctor would not prescribe Rybelsus or other new diabetes medication if you just get diagnosed with type-2 diabetes.

However, your healthcare professional may switch you from metformin to another anti-diabetic drug for various reasons, such as if metformin is not controlling blood glucose levels, you have severe side effects, or there are drug interactions between metformin and your other medicines.

Which is better for weight loss: metformin or Ozempic?

Clinical trials have shown that both metformin and Ozempic (semaglutide injection) can lead to modest weight loss when used with diet and exercise.

The FDA has approved semaglutide injection (the same active ingredient as Ozempic) sold under the trade name Wegovy for chronic weight management.

Your healthcare provider may prescribe weight loss medications such as Wegovy (semaglutide) or Zepbound (tirzepatide) to promote weight loss. A weight loss drug can help you lose weight if a healthy diet and exercise have not been successful.

What is the best diabetes medication with the least side effects?

Metformin is widely considered the first go-to diabetes medication. It has been used for many decades, is well-studied for efficacy and safety, and is affordable. The American Diabetes Association recommends metformin as a first-line treatment for type 2 diabetes.

Being available as a lower-cost generic is also another pro of metformin therapy. However, many people cannot tolerate metformin’s gastrointestinal side effects, in addition to the increased risk of kidney injury and lactic acidosis that are associated with metformin therapy.

The best diabetes medication may differ among people. The best diabetes medicine is one that effectively controls your blood sugar while causing the most tolerable levels of side effects. Your doctor will help you to determine the best medication or medication combination for you based on your medical history and other concurrent medications.

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