Semaglutide
medicationA GLP-1 medication that reduces appetite, approved for weight management and type 2 diabetes.
24 providers
No. 005medication
Metformin
Metformin is a medication that is FDA-approved, prescription only.
Also known as Glucophage, Glumetza, Fortamet
Metformin is a first-line medication for type 2 diabetes that lowers the liver's glucose output. It is sometimes prescribed off-label for prediabetes or weight, and it is widely discussed as a potential longevity drug, which has not been proven.
Is Metformin FDA-approved?
Approved by the FDA. A licensed clinician has to decide it is right for you and prescribe it. FDA-approved prescription drug for type 2 diabetes. Use for weight, prediabetes or aging is off-label and at a clinician's discretion.
As of September 23, 2026.
Key takeaways
- Metformin is a cheap, decades-old pill that is first-line treatment for type 2 diabetes.
- In the Diabetes Prevention Program, it lowered the chance of developing diabetes by about 31% over three years in high-risk adults. Lifestyle changes lowered it by 58%.
- Weight loss on metformin is modest, and it is not approved as a weight-loss or anti-aging drug.
- It can lower vitamin B12 over time and is not safe with severe kidney disease.
How does Metformin work?
Metformin lowers blood sugar mainly by reducing how much glucose your liver releases. It also cuts the glucose absorbed from your gut and helps your muscles use insulin better.
It does not make your pancreas release more insulin, so on its own it rarely causes low blood sugar.
What does the evidence say about Metformin?
Moderate human evidenceStrong evidence for blood sugar control and for delaying type 2 diabetes in high-risk adults (Diabetes Prevention Program); weight effects are modest and longevity benefits are unproven in humans.
What to expect
What trials and prescribing information measured over time. Everyone responds differently.
- First weeks
Diarrhea, nausea and stomach upset are the most common side effects and are most likely early on.
- About 3 years
In the Diabetes Prevention Program, the reduction in diabetes risk was measured over about three years.
- Up to 15 years
In the long-term follow-up, metformin still delayed diabetes by about 18% compared with placebo at 15 years.
What do clinicians say about Metformin?
Clinicians consider metformin a proven, low-cost drug for diabetes and diabetes prevention in high-risk adults. Its use for weight or longevity is off-label and less supported.
The ADA Standards of Care say metformin should be considered to prevent type 2 diabetes in high-risk adults with prediabetes, especially those under 60, with a BMI of 35 or more, or with a history of gestational diabetes.
ADA Standards of Care 2026, Section 3: Prevention or delay of diabetesIn the NIH-funded Diabetes Prevention Program, metformin cut the risk of developing type 2 diabetes by 31% and an intensive lifestyle program by 58%, compared with placebo, over about three years.
NIDDK: Diabetes Prevention Program (DPP)The USPSTF recommends screening adults aged 35 to 70 with overweight or obesity for prediabetes and type 2 diabetes, and notes lifestyle programs outperformed metformin for prevention.
USPSTF: Screening for prediabetes and type 2 diabetes (2021)The metformin label carries a boxed warning for lactic acidosis, a rare but serious complication, with higher risk in kidney or liver impairment, heavy alcohol use and around contrast imaging.
DailyMed: Metformin prescribing information
Summaries of published guidelines, drug labels, regulators and reviews, each attributed to its source. DiscoverMedica does not employ clinicians.
Is Metformin right for you, and who should avoid it?
Often considered for
- Adults and children 10 and older with type 2 diabetes
- Adults with prediabetes at high risk of progressing, where guidelines say it can be considered
- Some clinicians prescribe it off-label for weight or insulin resistance
Not a fit, or needs extra care
- Severe kidney disease (the label sets a kidney function cut-off below which it should not be used)
- Metabolic acidosis, including diabetic ketoacidosis
- Heavy alcohol use or significant liver disease, which raise lactic acidosis risk
- Tell your clinician before any imaging with contrast dye or surgery; it may need to be paused
Only a licensed clinician who knows your history can decide whether it is right for you.
What are the risks and side effects of Metformin?
- Boxed warning: lactic acidosis, a rare but serious risk that is higher with kidney impairment, heavy alcohol use, liver disease or iodinated contrast dye.
- Stomach upset and diarrhea are common, especially at the start.
- Long-term use can lower vitamin B12 levels.
- Some research suggests it may blunt some of the fitness gains from exercise, which matters to people using it for "longevity".
What should you ask a clinician about Metformin?
- Does my blood sugar or kidney function make metformin a reasonable option?
- Should my B12 be checked while I take it?
- Is there a good reason to take it if I do not have diabetes or prediabetes?
These save with the compound when you add it to My Journal, so they’re on the printout for your visit.
How do people get Metformin through telehealth?
Complete an online health questionnaire, including your kidney health and other medications.
A licensed clinician reviews it, usually asynchronously.
Labs may be requested: at minimum, a kidney function test before starting.
If prescribed, the pills ship to you or go to a local pharmacy. Generic metformin is inexpensive.
Check in periodically for kidney function and, over time, vitamin B12.
Labs you may be asked for
- Kidney function (eGFR) before starting and periodically after
- A1C or fasting glucose
- Vitamin B12 over time
Check your levels first
Some services let you order common lab tests yourself, so the results are ready for your visit. Your clinician decides which labs, if any, you need, and what the results mean.
- Function HealthAnnual membership for broad lab panels, drawn at Quest sites or at home.Visit
- Quest HealthOrder individual lab tests from Quest Diagnostics online, without a doctor’s visit.Visit
From each service’s own site, checked September 23, 2026.
How some providers do it
- AgelessRxFully online with in-house licensed providers and unlimited messaging. Positions metformin for metabolic health and longevity, says that use is off-label, and mentions B12 monitoring.
- Mochi HealthOffers generic metformin alongside its GLP-1 programs, with live online visits.
- NurxOffers metformin as part of its weight management service; oral medications ship to your home.
- Amazon PharmacyFills a metformin prescription from your own clinician.
From each provider’s own site, checked September 23, 2026. Programs change, so confirm the details before you sign up.
Where can I get Metformin?
12 providers list Metformin on DiscoverMedica, lowest listed price first.
From $13listed price†
Start at Mochi Health $25/mo + membershiplisted price†
Start at Hone Health MuselyThe Age Well Pill (compounded metformin blend)
Compounded, not FDA-approvedClinician consult required
$45/molisted price†
Start at Musely $69 to start, then $99/molisted price†
Start at Noom Med see site
Start at Amazon Pharmacy Walmart PharmacyMetformin and metformin ER tablets (generic), low-cost program
Clinician consult required
see site
Start at Walmart Pharmacy see site
Start at WeightWatchers Med+ † Prices as listed by the provider when we checked; they change.
How much does Metformin cost?
Listed prices run from $15 to $99 a month across 6 providers, as checked October 7, 2026.
Prices as listed by the provider when we checked; they change. Membership or consult fees may be separate; see each provider.
Metformin: questions, answered
Will metformin help me lose weight?
Modestly, for some people. It is not approved for weight loss, and average weight change in studies is small compared with GLP-1 drugs.
Is metformin an anti-aging drug?
That has not been shown in people. It is being studied, but longevity use is off-label and unproven.
Why does it upset my stomach?
GI side effects are common at the start. Clinicians often use extended-release forms or start low to reduce them. Talk to your prescriber rather than adjusting on your own.
Do I need my B12 checked?
The label lists low vitamin B12 as a possible effect of long-term use, so periodic checks are common.
Can I get it through telehealth?
Yes. Several telehealth providers prescribe it, and mail-order pharmacies fill it.
Important safety information
Key risks
- Boxed warning: lactic acidosis, a rare but serious risk that is higher with kidney impairment, heavy alcohol use, liver disease or iodinated contrast dye.
- Stomach upset and diarrhea are common, especially at the start.
- Long-term use can lower vitamin B12 levels.
- Some research suggests it may blunt some of the fitness gains from exercise, which matters to people using it for "longevity".
Talk to a clinician first, or avoid it, if
- Severe kidney disease (the label sets a kidney function cut-off below which it should not be used)
- Metabolic acidosis, including diabetic ketoacidosis
- Heavy alcohol use or significant liver disease, which raise lactic acidosis risk
- Tell your clinician before any imaging with contrast dye or surgery; it may need to be paused
This is not a complete list of risks. Read the full prescribing information and any Medication Guide, and talk to a licensed clinician or pharmacist about your own situation. If you have a severe reaction, call 911. You can report side effects to the FDA through MedWatch at 1-800-FDA-1088.
Sources
- DailyMed: Metformin prescribing information
- Diabetes Prevention Program: Lifestyle intervention or metformin (NEJM 2002)
Also checked for this guide
- NIDDK: Diabetes Prevention Program (DPP)
- USPSTF: Screening for prediabetes and type 2 diabetes (2021)
- ADA Standards of Care 2026, Section 3: Prevention or delay of diabetes
- AgelessRx: Metformin
- Mochi Health: FAQs
- Nurx: Weight management
- Amazon Pharmacy
Guide reviewed September 23, 2026.
Educational information only, not medical advice. It does not replace a conversation with a licensed clinician.
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