Can Metformin Be Combined With Mounjaro For Diabetes & Weight Loss?

Understanding Mounjaro and Metformin

Mounjaro (tirzepatide) and metformin are two commonly prescribed medications for people with type 2 diabetes. As more people start taking Mounjaro, a new glucose-lowering injection, questions arise about combining it with other diabetes medications like metformin.

Metformin is an oral medication that has been used for decades as a first-line treatment for high blood sugar in people with type 2 diabetes. It works by reducing glucose production in the liver, delaying glucose absorption, and improving insulin sensitivity.

Mounjaro, on the other hand, is an injection containing the active ingredient tirzepatide. It was approved by the FDA in 2022 as an adjunct treatment to improve blood sugar control in adults with type 2 diabetes. It works by mimicking the effects of two hormones - GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) - which helps stimulate insulin production and lower blood sugar levels.

Benefits of Combination Therapy

Using Mounjaro and metformin together may offer greater blood sugar lowering effects compared to either medication alone. The combination takes advantage of their complementary mechanisms of action.

In clinical trials, adults taking both Mounjaro and metformin saw significant A1C reductions. A1C provides an average of your blood sugar over a 2 to 3 month period. Lowering your A1C closer to non-diabetic levels (below 5.7%) helps minimize diabetes complications.

Taking the medications together also allows the potential to use lower doses of each, reducing side effects. Combining oral medications like metformin with new injectable treatments is a common adjustment when adding additional diabetes therapy.

Metformin Benefits for Weight Loss

Metformin is sometimes prescribed "off-label" to people without diabetes specifically to spur modest weight loss. How does metformin promote weight loss? Primarily through:

• Suppressing appetite - Metformin reduces appetite-signaling hormones like ghrelin
• Limiting calorie absorption - It slows digestion allowing fewer calories to be absorbed from food
• Increasing fat utilization - It improves insulin sensitivity and shifts the body towards using fat for energy

However, uncontrolled diabetes leads to weight gain for most due to lack of energy to exercise so optimizing blood sugar levels with medication in general helps halt and reverse weight gain tendencies.

Mounjaro Approved for Weight Loss

Beyond improving blood sugar control, Mounjaro was also approved in 2022 as the first GLP-1 drug officially permitted for chronic weight management. In clinical trials, adults without diabetes were able to lose on average 12-25% of their body weight over 68 weeks.

Mounjaro aids weight loss through similar mechanisms as metformin by:

• Slowing stomach emptying and bowel movements to reduce calorie absorption from food
• Increasing feelings of fullness and satisfaction after eating
• Mimicking key gut hormones to optimize fat and carbohydrate metabolism

Therefore taking Mounjaro and metformin together offers complementary weight loss effects that may exceed what is seen with either medication on its own.

Are There Any Side Effects?

When first starting treatment with Mounjaro, metformin, or both - some temporary gastrointestinal issues can occur. Up to 20% experience nausea, vomiting or diarrhea that typically resolves within a month. These are the most common side effects seen in clinical trials.

To help minimize discomfort, health providers recommend:

• Beginning with very low medication doses and slowly increasing every 1-2 weeks
• Avoiding large, high-fat meals to not overwhelm the digestive system
• Staying hydrated and active to keep the GI system moving
• Taking anti-nausea medication if vomiting occurs

In clinical studies of up to 2 years, combining both Mounjaro and metformin did not result in any additional safety concerns or side effects beyond temporary GI issues.

What About Lactic Acidosis?

Metformin has long carried a "black box" warning about the rare side effect lactic acidosis. However, recent major reviews have calculated the incidence of lactic acidosis is no more likely in metformin patients compared to other diabetes medications.

Lactic acid buildup remains a concern primarily when metformin is taken inappropriately by someone with poor kidney function. As long as your kidneys work properly, there is very low risk.

Key Takeaways on Using Metformin and Mounjaro Together

Combining the blood sugar lowering effects of metformin with the new GLP-1 medication Mounjaro provides complementary effects that enhance glucose control and weight loss for many patients.

This combo or using each medication on its own does commonly lead to temporary nausea, vomiting or diarrhea that typically resolves within one month. Starting low and going slow with dosage increases can minimize discomfort.

For most, adding Mounjaro injections to background metformin therapy offers superior blood sugar management, weight loss, and the potential for reduced medication doses and costs.

As always, discuss options with your healthcare provider to determine if this new injection treatment is appropriate for your health history and diabetes management plan.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.