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Dosing is generally the same, though women may need to monitor side effects like water retention or glucose sensitivity closely

Nevertheless, use of metformin may decrease vitamin B 12 status: a meta-analysis of four short-term intervention trials (up to 4 months duration) in patients with type 2 diabetes found that metformin use decreased serum cobalamin concentrations by 57 pmol/L, which could have clinical implications if such patients have suboptimal vitamin B 12 status (146)

Many patients did not stick with the treatment, and there was a small but notable increase in risk for acute pancreatitis

There is no equivalent dose of Rybelsus for Ozempic 1 mg