Ozempic alternatives: What can I take instead of Ozempic?

Top Ozempic alternatives | Comparison | Victoza | Trulicity | Metformin | Rybelsus | Jardiance | Natural alternatives | How to switch meds

Ozempic is a prescription drug used along with diet and exercise to improve blood glucose, or blood sugar, control in adults with Type 2 diabetes. Type 2 diabetes is also known as Type 2 diabetes mellitus or T2D. Ozempic is given by subcutaneous injection. In addition to improving glycemic control, Ozempic can be used to lower the risk of major cardiovascular events (such as stroke, heart attack, or cardiovascular death) in adults who have both T2D and heart disease. Ozempic is a brand-name medication made by Novo Nordisk. There is no generic available for Ozempic at this time. 

Ozempic contains the ingredient semaglutide. Semaglutide is part of a diabetes drug class called glucagon-like peptide-1 (GLP-1) receptor agonists. Ozempic is not insulin. It works in 3 ways:

• By helping the pancreas release insulin when blood sugar levels are high (insulin helps to lower blood sugar).
• By helping move sugar out of the blood and into other body tissues where it is used for energy. 
• By slowing the movement of food through the stomach (this may decrease appetite and promote weight loss).

Ozempic may be taken alone or in combination with other medications for Type 2 diabetes.

Common side effects of Ozempic include stomach problems like nausea, vomiting, diarrhea, and stomach pain. Sometimes, these side effects may be too bothersome. 

Or, a serious side effect could occur, such as kidney problems, pancreatitis, gallstones, or a severe allergic reaction. 

Some people cannot take Ozempic at all. Ozempic has a boxed warning, which is the strongest warning required by the FDA. According to the prescribing information, the ingredient in Ozempic, semaglutide, has caused thyroid C-cell tumors in animal studies. It is unknown if Ozempic can cause thyroid cancer in humans. Ozempic should not be used in people who have a history or a family history of medullary thyroid carcinoma (MTC) or in people with multiple endocrine neoplasia syndrome type 2 (MEN 2).

In some cases, the price of Ozempic may be too high due to insurance copays. Whatever the reason, there are alternatives to Ozempic that are available to people with Type 2 diabetes. 

What can I take in place of Ozempic?

The table below compares Ozempic with common alternatives. All of the drugs listed are prescription diabetes medications that are approved by the U.S. Food and Drug Administration (FDA). 

*General dosing is listed. Dosing may vary. People with certain medical conditions may require dosage adjustment. 

Related: Ozempic vs. Trulicity | Ozempic vs. Victoza

Other alternatives to Ozempic

The following drugs are injectable drugs that are similar to Ozempic but have different indications:

• Saxenda (liraglutide) is indicated for chronic weight management (along with diet and exercise) in adults and children 12 years and older who fit certain BMI/bodyweight requirements
• Wegovy (semaglutide) has the same ingredient as Ozempic. It is indicated for chronic weight management (along with diet and exercise) in adults who fit certain BMI/body weight requirements.

Single-ingredient oral alternatives to Ozempic include:

• Actos (pioglitazone)
• Amaryl (glimepiride)
• Glucotrol (glipizide)
• Glyset (miglitol)
• Micronase (glyburide)
• Nesina (alogliptin)
• Prandin (repaglinide)
• Precose (acarbose)
• Starlix (nateglinide)
• Steglatro (ertugliflozin)

In addition to injectable drugs and oral drugs that contain one ingredient, there are also various oral combination medications:

• Actoplus Met (metformin/pioglitazone)
• Duetact (glimepiride/pioglitazone)
• Glucovance (metformin/glyburide)
• Glyxambi (linagliptin/empagliflozin)
• Invokamet (metformin/canagliflozin)
• Janumet (sitagliptin and metformin)
• Jentadueto (metformin/linagliptin)
• Kazano (metformin/alogliptin)
• Kombiglyze XR (metformin/saxagliptin)
• Oseni (alogliptin/pioglitazone)
• Synjardy (metformin/empagliflozin)
• Trijardy XR (metformin/linagliptin/empagliflozin)
• Xigduo XR (metformin/dapagliflozin)

Victoza

Victoza (liraglutide) is an injectable drug that, like Ozempic, is part of the GLP-1 receptor agonist drug class. Victoza works the same way as Ozempic. 

Victoza is indicated to improve blood sugar control in adults and children 10 years and older with Type 2 diabetes. It can also be used to lower the risk of major heart events in adults with both T2D and heart disease. Sometimes, it is prescribed off-label for weight loss. The adult dosage of Victoza is 1.2 or 1.8 mg SQ every day. 

Some common side effects of Victoza are nausea, vomiting, diarrhea, low blood sugar, headache, decreased appetite, indigestion, common cold symptoms, constipation, back pain, and injection site reactions. Serious side effects can include allergic reactions, kidney failure, pancreatitis, or gallstones. 

Like Ozempic, Victoza cannot be used in people with a history or family history of MTC or in people with MEN 2.

Trulicity

Trulicity (dulaglutide) is another injectable drug that is part of the GLP-1 agonist drug class. Trulicity works the same way as Ozempic and Victoza. 

Trulicity is indicated to improve blood sugar control in adults with Type 2 diabetes. It can also be used to reduce the risk of major heart events in adults with both T2D and heart disease or multiple risk factors. Sometimes, Trulicity is prescribed off-label for weight loss. The adult dosage of Trulicity is 0.75 to 4.5 mg SQ every week. 

Some common side effects of Trulicity are nausea, vomiting, diarrhea, stomach pain, low blood sugar, decreased appetite, indigestion, and fatigue. Serious side effects include allergic reactions, kidney failure, pancreatitis, or gallstones. 

Like Ozempic and Victoza, Trulicity cannot be used in people with a history or family history of MTC or in people with MEN 2.

Metformin

Metformin is in a drug class called biguanides. Metformin is a generic drug—the brand name is Glucophage. It is taken by mouth. Metformin works by decreasing the amount of sugar absorbed from food, decreasing glucose production in the liver, and increasing the body’s response to insulin. Metformin is used in combination with diet and exercise to improve blood sugar control in adults and children 10 years or older with Type 2 diabetes. A typical daily dosage of metformin for adults is 850 to 1000 mg twice daily with meals, after slowly increasing the dose over several weeks. 

The most common side effects of metformin are stomach-related. They include nausea, vomiting, diarrhea, gas, abdominal discomfort, and indigestion. 

Patients taking metformin should be aware of a serious side effect called lactic acidosis. Patients having symptoms of lactic acidosis should seek emergency treatment in the hospital right away. Symptoms of lactic acidosis may include feeling unwell, stomach and muscle pain, difficulty breathing, and sleepiness.

Rybelsus

Rybelsus contains the ingredient semaglutide, like Ozempic. However, Rybelsus is a tablet that is taken by mouth. People who tolerate Ozempic well but would prefer an oral medication rather than an injection may want to try Rybelsus. Rybelsus is indicated to improve blood sugar control in adults with T2D, along with diet and exercise. 

The dosage of Rybelsus is seven to 14 mg by mouth daily, 30 minutes before the first food, drink, or other medication of the day. Common side effects of Rybelsus are similar to  Ozempic and include nausea, vomiting, diarrhea, stomach pain and bloating, constipation, indigestion, decreased appetite, reflux, and gas. Serious side effects can include allergic reactions, kidney failure, pancreatitis, or gallstones. 

Like Ozempic, Victoza, and Trulicity, Rybelsus cannot be used in people with a history or family history of MTC or in people with MEN 2.

Jardiance

Jardiance is a brand-name drug that contains the ingredient empagliflozin. Jardiance is in a drug class called sodium-glucose co-transporter 2 (SGLT2) inhibitors. SGLT2 inhibitors work by helping the kidney eliminate sugar from the body in the urine. Jardiance can be used:

• To improve blood sugar control in adults with T2D, along with diet and exercise
• To reduce the risk of cardiovascular death in adults with both T2D and heart disease
• To reduce the risk of cardiovascular death or hospitalization for heart failure in adults with heart failure and reduced ejection fraction

The typical dose is 10 or 25 mg by mouth once daily in the morning.

The most common side effects of Jardiance are URI, UTI, increased urination, genital fungal infection, high cholesterol, joint pain, and nausea. Serious side effects can include an allergic reaction, kidney injury, serious UTI, and ketoacidosis. Orthostatic hypotension (a drop in blood pressure when standing up) is also a potentially serious side effect. Another serious side effect is Fournier gangrene, which can be life-threatening. Diabetes patients taking an SGLT2 inhibitor with symptoms of pain or tenderness, redness, or swelling in the genital or perianal area, as well as fever and feeling unwell, should seek emergency treatment. 

Natural alternatives to Ozempic

Patients may want to look at over-the-counter (OTC) drugs or vitamins for a solution to help lower their blood sugar. However, according to the American Diabetes Association (ADA), when considering a vitamin or supplement, there is a possibility of drug interactions and potential effects on blood sugar (for example, causing blood sugar to get too low or too high). Some supplements can have drug interactions or cause troublesome side effects. The ADA notes that “research on many supplements is inconclusive.” Consult your healthcare provider before adding any vitamins or supplements to your regimen.

Making some diet and lifestyle modifications can help control blood sugar. However, dietary and lifestyle changes are not a replacement for your prescription medication. Ask your healthcare provider which diet plan is best for you. A healthy diet should include a variety of fruits and vegetables, lean protein, whole grains, and low-fat dairy. Exercise can help to control blood sugar as well. Talk to your healthcare provider if you need help determining what type of exercise will be safe and effective for you. Be sure to discuss when to test blood sugar in relation to exercise—and how to avoid and treat hypoglycemia (low blood sugar). You can use this chart as a guideline but show it to your healthcare provider to make sure it is appropriate for you. 

Other lifestyle modifications that may help control your blood sugar include managing weight, lowering stress, and getting enough sleep. All of these can be helpful, but do not replace the medication your healthcare provider ordered for you. Always consult your provider for medical advice or questions or concerns about your health.

How to switch to an Ozempic alternative

If you are interested in switching to an Ozempic alternative, you can:

• Contact your insurance provider if the price is a concern. Ask which Ozempic alternatives are covered, and what the copay would be for each alternative. Ask if your deductible has been met, or if you are still paying towards your deductible. 
• Reach out to your healthcare provider. He or she may want you to make an appointment before switching your medication. Review your medical conditions and history, and discuss alternative medications (along with potential drug interactions and side effects) with your provider. If your healthcare provider decides to prescribe an Ozempic alternative, he or she can send the prescription to your pharmacy. Tell the pharmacist that you are switching from Ozempic to the new medication, so your file can be updated properly.
• Search SingleCare for prescription coupons. You can save up to 80% on drug prices, and the coupons can be applied to refills as well.