Rybelsus vs Metformin

Metformin is recommended as the first-line treatment for Type 2 diabetes mellitus by the American Diabetes Association. Metformin is a generic diabetes treatment used as part of a larger treatment plan for Type 2 diabetes. It can be used alone or in combination with other medications.

Rybelsus is the brand name for a prescription diabetes drug containing semaglutide, also used to help with blood sugar control in adults with type 2 diabetes mellitus. It belongs to a class of drugs called glucagon-like peptide-1 (GLP-1) agonists.

Here we will explain how they work, their similarities and differences, their side effects, and more. This should provide you with the basics to better understand your options.

What is Rybelsus?

Rybelsus (oral semaglutide) is an FDA (U.S. Food and Drug Administration) approved medication manufactured by Novo Nordisk Inc. It is given to adults with type 2 diabetes to help lower their blood sugar (glucose) when used with exercise and diet changes.

Common, serious, long-term complications of type 2 diabetes are cardiovascular disease, which can lead to problems like heart attack, stroke, and even death. People with type 2 diabetes are at twice the risk of cardiovascular disease as people without diabetes.

Rybelsus is a non-insulin medication that causes your pancreas to produce more insulin, helping to lower your blood sugar levels. You take Rybelsus in tablet form, usually once a day when you first wake up but make sure you always use your Rybelsus as directed by your doctor or pharmacist.

The active ingredient in Rybelsus is called semaglutide. It’s a non-insulin drug that can help lower your blood glucose levels by stimulating the cells in your pancreas that produce insulin (called beta cells). Rybelsus belongs to a class of drugs called glucagon-like peptide-1 receptor agonists (GLP-1 agonists). When you take Rybelsus, semaglutide molecules attach to beta cells in your pancreas at sites called glucagon-like peptide-1 receptors (it is classed as a GLP-1 receptor agonist). The semaglutide stimulates these receptors, which makes the beta cells produce more insulin, helping to lower your blood sugar after you’ve eaten.

Semaglutide also encourages the growth of more beta cells in your pancreas, allowing your pancreas to produce higher levels of insulin, reversing any declines in your body’s insulin production.

Rybelsus dosage

Rybelsus is available in tablet form, in the following doses: 3 mg, 7 mg, and 14 mg dose.

Take Rybelsus at least 30 minutes before your first food, beverage, or other oral medications of the day with not more than 4 ounces of water only. Swallow the tablets whole. Do not cut, crush, or chew the tablets. The starting dosage is 3 mg once daily for 30 days, followed after 30 days by an increase to 7 mg once daily. The dose may be increased to 14 mg once daily after another 30 days if needed.

Read the full prescribing information and always speak with a healthcare professional for medical advice about any changes to your dose so they can monitor and evaluate your condition.

What is metformin?

Metformin is an FDA (U.S. Food and Drug Administration) approved medication manufactured by various generic manufacturers. Metformin is in the drug class of biguanide, used as a first-line treatment for diabetes because of its mode of action in increasing your body’s insulin sensitivity. Also, metformin does not cause weight gain. Metformin effectively lowers fasting blood sugar and hemoglobin A1c levels.

It is used in combination with changes to diet and exercise to improve glycemic control in adults and pediatric patients with type 2 diabetes mellitus. It works by reducing the amount of glucose absorbed from your intestines, decreasing how much glucose is made in your liver, and improving your insulin sensitivity.

Metformin dosage

Metformin is available as an immediate release or extended-release oral tablet, or as an oral suspension.

Metformin is taken with a meal unless your doctor tells you otherwise. Do not crush, chew, or break the extended-release tablet. Swallow it whole. Your doctor may prescribe a glucagon injection kit in case you have severe hypoglycemia. You may also be prescribed extra vitamin B12 while you are taking this medicine.

Common side effects of Rybelsus and metformin

The most common side effects of Rybelsus in clinical trials compared to placebo include:

• Nausea, vomiting
• Abdominal pain
• Constipation
• Diarrhea
• Decreased appetite
• Weight loss

More serious side effects of Rybelsus include:

• An increased risk of thyroid tumors, including cancerous tumors
• Inflammation of your pancreas (pancreatitis)
• Diabetic retinopathy and other vision problems
• Very low blood sugar (hypoglycemia)
• Severe allergic reactions to the medication that can cause itching, rashes, swelling, and difficulties breathing

The most common side effects of metformin in clinical trials include:

• Low blood sugar
• Nausea
• Diarrhea

More serious side effects of metformin include

• Unusual muscle pain
• Trouble breathing
• Dizziness, feeling faint
• Feeling tired
• Stomach pain
• Vomiting
• Slow or irregular heart rate
• Lactic acidosis – symptoms include unusual muscle pain, difficulty breathing, stomach pain, dizziness, feeling cold, or feeling very weak or tired

These aren’t all the side effects Rybelsus or metformin can cause. You can find more details in the patient leaflet that comes with your medication. If you have any concerns about side effects, talk to your physician or pharmacist.

Rybelsus and metformin drug interactions

Rybelsus can interact with other medications. These include:

• Insulin – Rybelsus can be used alongside insulin, but your doctor may change the dose of insulin you take and/or how often you take insulin
• Any other medications taken to treat type 2 diabetes, like sulfonylureas
• Any medications you take by mouth to reduce the risk of blood clots (oral anticoagulants) like warfarin
• Diuretics, taken to make you lose water and salt, usually to treat high blood pressure – bumetanide, furosemide
• Corticosteroids such as cortisone and prednisolone
• Beta 2-stimulants, taken to treat asthma – salmeterol
• Antipsychotics – clozapine
• Estrogen-containing drugs including birth control and hormone replacements

Metformin can interact with other medications. These include:

• Antibiotics
• Diuretics
• NSAIDs
• Corticosteroids
• ACE inhibitors
• Antipsychotics
• Anticonvulsants
• Blood thinners

Rybelsus and metformin can interact with other medications. This can change how Rybelsus and metformin and other medications work and can make side effects more likely. Tell your prescribing physician about all your drugs, including vitamins and dietary supplements.

Rybelsus and metformin contraindications

You should not use Rybelsus if you:

• Are allergic to the active ingredient semaglutide
• Are allergic to any of the other ingredients in Rybelsus
• Have had a type of thyroid cancer called medullary thyroid carcinoma (MTC)
• Have an endocrine system condition called multiple endocrine neoplasia syndrome type 2 (MEN 2)
• Have pancreatitis (inflammation of your pancreas)
• Have type 1 diabetes (Rybelsus is for type 2 diabetes only)
• Are under 18 years of age

Talk to your doctor before taking Rybelsus if you:

• Are taking any of the medications that could interact with Rybelsus
• Have had any problems with your pancreas
• Have kidney disease
• Have or have ever had any problems with your eyes, including cataracts or glaucoma
• Are pregnant or are planning to become pregnant
• Are breastfeeding or are planning to breastfeed

You should not use metformin if you:

• Are allergic to metformin
• Have severe kidney disease
• Have metabolic acidosis or diabetic ketoacidosis
• Are younger than 10 years old
• Are breastfeeding or are planning to breastfeed

Talk to your doctor before using metformin if you:

• Have kidney disease
• Have high ketone levels in your blood or urine
• Have heart disease, or congestive heart failure
• Have liver disease
• Use insulin or other oral diabetes medications
• Have a severe infection
• Have chronic alcoholism
• Are 65 or older
• Are pregnant or are planning to become pregnant

Other treatment options for diabetes

• Byetta
• Glucophage
• Januvia (sitagliptin)
• Ozempic
• Victoza
• Saxenda
• Trulicity
• Wegovy

If you have any concerns about Rybelsus or metformin side effects, or your diabetes care, talk to your physician, or pharmacist for medical advice. Also inform your healthcare provider about any medical conditions, supplements, and over-the-counter meds you are taking. You are also encouraged to report side effects to the FDA: visit http://www.fda.gov/medwatch or call 1-800-FDA-1088.