Dr. Ahmed
Metformin vs Saxenda is a brief discussion about the differences and similarities between the two highly potent diabetes drugs.
Metformin is an orally available diabetes drug that is very cheap, safe, and very effective. It lowers the A1C by as much as 1.2% after 6 to 12 months of using it along with diet and exercise.
The A1C lowering effect of metformin is comparable to Liraglutide (Victoza). Victoza reduces the A1C by 1.1% after 6 to 12 months.
Victoza is Liraglutide. It is similar to Saxenda but the dose used in Victoza is less compared to that used in Saxenda.
Victoza is used to treat diabetes while Saxenda is used to treat obesity.
| A1C and Weight loss | Metformin | Saxenda | Comparison |
| A1C | ⇓ 1.2% | ⇓ 1.1% | Equal ⇔ |
| Weight | 6 lbs | 8 – 11% from baseline | Saxenda is superior |
When comparing metformin to Saxenda for weight loss, it is less effective. Metformin is associated with a weight loss of about 6 pounds in a year while Saxenda is associated with up to 11% weight loss.
Saxenda is an FDA-approved weight loss drug while metformin is approved only for the treatment of diabetes and insulin resistance.
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Metformin Vs Saxenda Comparison
Metformin belongs to the class of drugs called Biguanides. Saxenda is a GLP-1 analog.
Metformin | Saxenda |
Basic Info | |
| One of the most commonly used drugs used in the management of diabetes type 2. The impact of metformin reduces the amount of glucose that is produced by your liver as well as the amount that you take in from food. It also enhances how your body responds to the hormone insulin, which is responsible for naturally controlling blood sugar levels. | Saxenda is a GLP-1 agonist. Glucagon-like peptide-1 (GLP-1) receptor agonists primarily function by inducing feelings of satiety and reducing hunger. This may cause one to consume fewer calories and lose weight. |
Active Ingredients | |
| Metformin is sold under the brand name ‘Glucophage’ and contains metformin hydrochloride as the active ingredient. It belongs to the class Biguanides. | Liraglutide is the active component of this weight-loss drug Saxenda. It is comparable to a hormone called GLP-1 that is naturally produced and released from the gut following a meal. |
Availability | |
| It comes as a liquid that can be ingested with meals, roughly once or twice in a single day. It is also available as a regular tablet which can be taken two or three times, with meals, in a day. The extended-release tablets can only be taken once a day and that too with the evening meal only. | Saxenda is an injectable medicine available in a pen device. It is not available as oral tablets or syrups. |
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Metformin Vs Saxenda: When to use them?
Metformin is widely used in the treatment of diabetes type 2 and gestational diabetes. It is also used as an off-label medicine for the treatment of PCOS, weight loss, infertility, and insulin resistance.
Saxenda is a high-dose Liraglutide. Liraglutide in low doses has been approved for the treatment of Diabetes type 2. However, the high-dose formulation has been approved only for the management of obesity.
Metformin Vs Saxenda Uses | |
| Metformin is used to treat type 2 diabetes. It serves the function of bringing down blood glucose levels in diabetics since their pancreas is unable to function properly. It accomplishes this by stimulating both the liver to decrease glucose synthesis and the stomach to increase the utilization of glucose (also enhance GLP-1 and change the microbiome). [Ref] Metformin does help with weight loss in obese or overweight and insulin-resistant individuals. [Ref] | Saxenda is a weight loss medicine. It helps obese or overweight individuals who also suffer from weight-associated health issues to lose those extra pounds. Children who are 12 to 17 years of age and weigh more than 132 pounds or 60 kg (or obese children) can use Saxenda for weight loss purposes as well. Saxenda is not indicated for treating type 2 diabetes. |
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Metformin Vs Saxenda Dosing Schedule:
Metformin Vs Saxenda Dose | |
| Metformin Dose in Adults: 500 mg orally twice daily or 850 mg orally once daily should be the starting dose for immediate release. Initial doses for extended-release tablets should range from 500 to 1000 mg taken orally once a day. Patients on immediate-release medications may switch to extended-release medications once daily at the same daily maximum dose of up to 2000 mg. Pediatric dose: For children who are 10 years of age or older, the initial dose for immediate-release tablets is 500 mg taken two times a day. And the initial dose for extended-release tablets is 500 mg taken once a day with the evening meal. | 1st week:
2nd week:
3rd week:
4th week:
5th week:
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Prescription | |
| Metformin is not available as an over-the-counter drug. It can only be prescribed by a physician | Saxenda is not available as an over-the-counter drug. It can only be prescribed by a physician |
Overdosing | |
| Lactic acidosis can occasionally arise from using metformin in doses exceeding the recommended dose. Lactic acidosis frequently presents with other severe health conditions that are unrelated to the medicine, such as a heart attack or renal failure, and has severe, rapidly manifesting signs and symptoms. | Hypoglycemia, vomiting, and nausea can occur in case of overdosing on Saxenda. You must contact your healthcare provider immediately in that case. There is a risk of pancreatitis and renal failure as well. |
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Metformin vs Saxenda Warnings:
Metformin and Saxenda are relatively safe drugs. However, there are certain medical conditions when both these drugs need to be used with caution.
Warnings | |
| If you have a severe renal illness, metabolic acidosis, or diabetic ketoacidosis, you shouldn’t use metformin. You may have to briefly quit taking metformin if you are scheduled to have any kind of CT scan or x-ray that uses a dye that is administered into your veins. | Victoza and Saxenda must not be used together. If you have a family or a personal history of medullary thyroid cancer, or diabetic ketoacidosis you must avoid using Saxenda, Do not use it during pregnancy. |
Side effects | |
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Metformin Vs Saxenda: Drug Interactions:
Interactions with other drugs | |
| Numerous medications can interact with metformin, reducing its effectiveness or raising your risk of developing lactic acidosis. This includes vitamins, herbal goods, and prescription and over-the-counter medications. | Saxenda can delay your digestion, which could make it harder for your body to absorb any oral medications. |
In addition, metformin is frequently used with DPP-IV inhibitors like Sitagliptin (Januvia) and Vildagliptin (Galvus). It is even available in fixed-dose combination pills such as Janumet, Galvusmet, and TriJardy XR.
Saxenda or Liraglutide can not be used in combination with DPP-IV inhibitors like Sitagliptin, Vildagliptin, and Linagliptin (Tradjenta)
In Summary:
Metformin and Saxenda are two different drugs with different mechanisms of action. Metformin is used to treat patients with diabetes while Saxenda is a drug used for weight loss.
Saxenda is superior to Metformin in terms of its weight-losing effects. However, their A1C lowering effects are comparable.
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