Two medicines, side by side
Metformin vs semaglutide
Metformin and semaglutide are both labeled for type 2 diabetes. Drugs@FDA records approvals of metformin since 1995 and of semaglutide since 2017. Pharmacies paid $0.0145 per metformin HCl 500 mg tablet and $331.99 per mL (Ozempic 0.25-0.5 mg/dose (2 mg/3 mL) pen) (NADAC, October 7, 2026); the strengths differ and one is a brand and one a generic, so the two prices are not like for like. In FDA's classes, metformin is a biguanide and semaglutide a glp-1 receptor agonist.
Check it at the source: the metformin FDA label on DailyMed (effective September 3, 2026); the semaglutide FDA label on DailyMed (effective July 30, 2026).
Highlights of the metformin record
Metformin (Glucophage) · label of September 3, 2026
WARNING: LACTIC ACIDOSIS Postmarketing cases of metformin-associated lactic acidosis have resulted in death, hypothermia, hypotension, and resistant bradyarrhythmias. The onset of metformin-associated lactic acidosis is often subtle, accompanied only by nonspecific symptoms such as malaise, myalgias, respiratory distress, somnolence, and abdominal pain.
Used for
From the label: indicationsMetformin hydrochloride extended-release tablets are indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. Metformin hydrochloride extended-release tablets are biguanide indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus
On the market
- Earliest approval on file
- March 3, 1995
- Generic labelers
- 80 labelers
- Pharmacy cost
- $0.0145 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 61
Highlights of the semaglutide record
Semaglutide (Ozempic) · label of July 30, 2026
RISK OF THYROID C-CELL TUMORS
In rodents, semaglutide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures. It is unknown whether OZEMPIC causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans as human relevance of semaglutide-induced rodent thyroid C-cell tumors has not been determined [see Warnings and Precautions ( 5.1 ), Nonclinical Toxicology ( 13.1 )].
Used for
From the label: indicationsOZEMPIC is indicated: • as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. • to reduce the risk of major adverse cardiovascular events (cardiovascular death, non-fatal myocardial infarction or non-fatal stroke) in adults with type 2 diabetes mellitus and established cardiovascular disease. […]
On the market
- Earliest approval on file
- December 5, 2017
- Generic labelers
- none listed
- Pharmacy cost
- $331.99 per mL
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 4
Source: FDA drug labels via openFDA (Metformin label of September 3, 2026, Semaglutide label of July 30, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do metformin and semaglutide differ on the record?
In FDA's classes, metformin is a biguanide and semaglutide a glp-1 receptor agonist.
How each works, in its label's words: Metformin, “Metformin is a biguanide that improves glucose tolerance in patients with type 2 diabetes, lowering both basal and postprandial plasma glucose.”; Semaglutide, “Semaglutide acts as a GLP-1 receptor agonist that selectively binds to and activates the GLP-1 receptor, the target for native GLP-1.”
Both labels carry a boxed warning; the records quote them.
Generics: metformin since 2002; semaglutide none approved (Drugs@FDA).
| Metformin | Semaglutide | |
|---|---|---|
| Labeled for | Type 2 diabetes | Type 2 diabetes, Heart attack and coronary artery disease, Chronic kidney disease, Weight management |
| Pharmacologic class | Biguanide | GLP-1 Receptor Agonist |
| How it works (label) | Metformin is a biguanide that improves glucose tolerance in patients with type 2 diabetes, lowering both basal and postprandial plasma glucose. | Semaglutide is a GLP-1 analogue with 94% sequence homology to human GLP-1. Semaglutide acts as a GLP-1 receptor agonist that selectively binds to and activates the GLP-1 receptor, the target for native GLP-1. |
| Half-life (label) | Following oral administration, approximately 90% of the absorbed drug is eliminated via the renal route within the first 24 hours, with a plasma elimination half-life of approximately 6.2 hours. | n/a |
| Earliest approval on file (Drugs@FDA) | March 3, 1995 | December 5, 2017 |
| First generic approved | January 24, 2002 | none |
| Generic labelers (NDC) | 80 labelers | none listed |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0145 per tablet (Metformin HCl 500 mg tablet) | $331.99 per mL (Ozempic 0.25-0.5 mg/dose (2 mg/3 mL) pen) |
| 12-month price change | -1% | +3% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | A presentation being discontinued |
| Recalls recorded | 61 | 4 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 410,076 | 73,001 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to metformin
- every medicine labeled for the same conditions