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Ozempic or Mounjaro with metformin or insulin: how do they fit together?

Where Ozempic and Mounjaro sit among prescription medication for type 2 diabetes in India. What the guidelines say, what happened to insulin doses in trials, and which combination pens India has.

GLP Guidebook teamPublished 5 Oct 202612 min read24 sourcesWritten from published sources

Written for India. Reading from the US? US versionComing soon

The short answer

Metformin usually comes first. India's RSSDI-ESI guideline usually adds other tablets next, then a GLP‑1 medicine such as Ozempic (semaglutide) or Mounjaro (tirzepatide), or insulin. For overweight people, it allows a GLP‑1 medicine as the second step. With insulin or a sulfonylurea, lows become more likely, so the labels tell doctors to consider lowering those doses.

Key takeaways

  • India's RSSDI-ESI 2020 guideline starts metformin at diagnosis and calls GLP‑1 medicines a second- or third-line option when blood sugar stays high.4
  • The ADA's 2026 Standards prefer a GLP‑1 medicine to insulin for adults without very high sugar, and recommend adding one whenever insulin is used.6
  • The Ozempic and Mounjaro labels tell doctors to consider lowering an insulin or sulfonylurea dose when the GLP‑1 medicine starts, because lows become more likely.1,2
  • In the SUSTAIN 5 trial, adding Ozempic to basal insulin lowered HbA1c by 1.4 to 1.8 points, but 11% to 17% felt sick, vs 5% on a dummy.9
  • Two pens combine basal insulin with a GLP‑1 medicine: Soliqua, sold in India by Sanofi in two pen strengths, and Xultophy, which appears on Indian pharmacy listings.17,24
Before you go further
  • GLP‑1 medicines are prescription-only in India. A government statement on 1 Apr 2026 said only endocrinologists, internal-medicine specialists and cardiologists can prescribe them.19 CDSCO expert-committee minutes attach a similar condition to some approvals (endocrinologist or internal-medicine specialist), but we found no rule covering every brand.20
  • This post describes what guidelines, labels and trials say. It is not a plan for changing your own medicines or doses.
  • Side effects and serious risks are covered in Guide 5, Side effects and risks.
On this page
  1. Where do GLP‑1 injections sit among prescription medication for type 2 diabetes in India?
  2. Can you take Ozempic or Mounjaro with metformin?
  3. Why do metformin and a GLP‑1 medicine fit together?
  4. Does metformin affect vitamin B12?
  5. Can a GLP‑1 medicine be added to insulin?
  6. What happened in the combination trials?
  7. What do the labels say about the insulin dose?
  8. What are the insulin-plus-GLP‑1 pens, and are they sold in India?
  9. What about glimepiride and other sulfonylureas?
  10. Can it be taken with an SGLT2 or DPP-4 tablet?
  11. Questions people ask
  12. How we researched this
  13. Sources

Where do GLP-1 injections sit among prescription medication for type 2 diabetes in India?

Usually after tablets. India's RSSDI-ESI guideline starts with metformin, adds other tablets, then brings in a GLP‑1 medicine or insulin.4

  • First: metformin, with diet and exercise, from diagnosis.4
  • Second: if sugar stays high, one more tablet. The options include a sulfonylurea (such as glimepiride), a gliptin (DPP‑4 inhibitor) or a gliflozin (SGLT2 inhibitor).4
  • Third: if two medicines aren't enough, a third tablet, or insulin, or a GLP‑1 medicine.4
  • After three tablets: the guideline says to consider a GLP‑1 medicine or insulin.4

Weight changes the order. For overweight people, the guideline allows a GLP‑1 medicine as the second step when metformin isn't enough.4 If metformin can't be tolerated, it allows one first.4

All of these are prescription medicines, and the guideline says to fit the choice to each person's other illnesses.4

Can you take Ozempic or Mounjaro with metformin?

Yes. India's RSSDI-ESI guideline starts metformin at diagnosis. It lists GLP‑1 medicines as a second- or third-line add-on when sugar stays high.4

RSSDI-ESI 2020 is a joint guideline. It comes from the Research Society for the Study of Diabetes in India and the Endocrine Society of India.4

It says metformin "should be initiated" with lifestyle changes "at the time of diagnosis", unless it can't be used.4 It calls GLP‑1 medicines "viable second-line or third-line options" when blood sugar stays high.4

RSSDI's 2022 update keeps that wording. For people with obesity, it says GLP‑1 medicines and SGLT2 tablets "should be preferred" as add-ons to metformin.5

The American Diabetes Association (ADA) calls metformin the medicine that "historically has been the first-line treatment". It describes it as effective, safe and cheap.6

Some people have heart disease, high heart risk, heart failure or kidney disease. For them, the ADA recommends a GLP‑1 or SGLT2 medicine with proven heart benefit, "with or without metformin use".6

HbA1c is your average blood sugar over the last 2 to 3 months.23 In the SURPASS-2 trial, all 1,879 people already took metformin.8

After 40 weeks, HbA1c fell 1.86 points on Ozempic 1 mg, and 2.01 to 2.30 on Mounjaro.8 Nausea hit 18% on Ozempic and 17% to 22% on Mounjaro; the trial was funded by Eli Lilly, Mounjaro's maker.8

India note: US labels used here. We could not find India's prescribing information for these brands online, so label figures come from the US labels. In India, Ozempic was launched for type 2 diabetes, and Mounjaro for diabetes and obesity.21,22 Mounjaro vs Ozempic compares the two.

Why do metformin and a GLP-1 medicine fit together?

They act in different places. Metformin works mainly on the liver, gut and insulin response. GLP‑1 medicines make the pancreas release insulin, mainly when sugar is high.1,3

The US metformin label says it makes the liver release less sugar and the gut absorb less. It also helps the body respond better to its own insulin (insulin sensitivity).3

The Ozempic label says semaglutide raises insulin and lowers glucagon "in a glucose-dependent manner".1 Glucagon is a hormone. India's RSSDI-ESI guideline says GLP‑1 hormones suppress it and lower the liver's sugar production.4

Semaglutide also slightly slows how fast the stomach empties after a meal. The Mounjaro label describes tirzepatide the same way.1,2

Both can upset the stomach. The ADA names bloating, stomach discomfort and diarrhoea as metformin's main side effects.6

For the GLP‑1 side, see why semaglutide and Mounjaro cause nausea, and our guide on what GLP‑1 medicines do. A short answer on taking metformin and Ozempic together is on the way.

Does metformin affect vitamin B12?

It can. In 29-week trials, B12 fell below normal in about 7% of people, says the US metformin label. It asks for a B12 test every 2 to 3 years.3

The label says low B12 may cause anaemia, but seems to reverse quickly with B12 or with stopping metformin.3 People who get or absorb little B12 or calcium seem more prone, it adds. It asks for a blood count every year as well.3

The ADA's 2026 Standards link metformin to low B12 and worse nerve symptoms (neuropathy), and suggest "periodic testing".6 India's RSSDI-ESI guideline lists a B12 test among the checks when nerve damage is assessed.4 The B12 point belongs to metformin, so it still applies after a GLP‑1 medicine is added.

Can a GLP-1 medicine be added to insulin?

Yes. The ADA's 2026 Standards recommend adding a GLP‑1 medicine whenever insulin is used. They prefer one to insulin unless sugar is very high.6

The ADA says to consider insulin when HbA1c is above 10%, sugar is 300 mg/dL or more, or high-sugar symptoms appear.6 Otherwise it says GLP‑1-based medicines are "preferred to insulin" as a first or add-on treatment.6 If insulin is used, it recommends adding one for better sugar control, weight and fewer lows.6

Basal insulin is long-acting background insulin, such as glargine or degludec.4,16 India's RSSDI-ESI guideline says basal insulin may be started together with a GLP‑1 medicine.4 It also describes adding one to basal insulin when high insulin doses aren't enough, or bring weight gain or lows.4

The ADA adds that "cost, accessibility, and tolerability are important considerations" for these medicines.6 Guide 6 covers the brands sold in India and their prices.

What happened in the combination trials?

In each trial, HbA1c fell further than on the comparison. Stomach side effects were more frequent than on a dummy or insulin alone, and similar on Mounjaro and Ozempic. Lows were more frequent than on a dummy injection, but not more frequent than with extra insulin.8,9,10,11,12,13

Added toTrial and medicineHbA1c fallWeightLowsNausea or stomach
MetforminSURPASS-2: Ozempic 1 mg vs Mounjaro 5–15 mg, 40 weeks1.86 points vs 2.01–2.3081.9–5.5 kg more lost on Mounjaro8Below 54 mg/dL: 0.4% vs 0.2–1.7%8Nausea 18% vs 17–22%8
Basal insulinSUSTAIN 5: Ozempic 0.5 or 1 mg vs dummy, 30 weeks1.4–1.8 points vs 0.193.7–6.4 kg lost vs 1.4 kg9Severe or confirmed: 8.3–10.7% vs 5.3%9Nausea 11–17% vs 5%9
Basal insulin (glargine)SURPASS-5: Mounjaro 5–15 mg vs dummy, 40 weeks2.11–2.40 points vs 0.86105.4–8.8 kg lost vs 1.6 kg gained10Below 54 mg/dL: 14–19% vs 13%2Nausea 13–18% vs 3%10
Basal insulin (glargine)SURPASS-6: Mounjaro 5–15 mg vs mealtime insulin 3 times a day, 52 weeks2.1 points vs 1.1119.0 kg lost vs 3.2 kg gained110.4 vs 4.4 per person per year11Nausea 14–26% on Mounjaro11
Glargine and metforminDUAL V: switch to Xultophy vs raising glargine, 26 weeks1.81 points vs 1.13121.4 kg lost vs 1.8 kg gained12Confirmed: 2.2 vs 5.1 per person per year12More stomach side effects on Xultophy12
Basal insulinLixiLan-L: switch to Soliqua vs glargine, 30 weeks1.1 points vs 0.6130.7 kg lost vs 0.7 kg gained13With symptoms: similar13More stomach side effects on Soliqua13
An SGLT2 tabletSUSTAIN 9: Ozempic 1 mg vs dummy, 30 weeks1.42 points more than dummy183.8 kg more lost than dummy18Severe or confirmed: 2.7% on Ozempic18Stomach side effects 37% vs 13%18

Averages from each trial's published summary. Lows and nausea are the share of people with at least one episode, unless given per person per year. The SURPASS trials were funded by Eli Lilly; SUSTAIN 5 and 9 by Novo Nordisk. DUAL V had Novo Nordisk staff among its authors, and LixiLan-L had Sanofi staff. SURPASS-2, SURPASS-6, DUAL V and LixiLan-L were open-label: people knew which treatment they had. Trials differ in people and length, so compare within a row, not across rows.

Even on the dummy, 13% in SURPASS-5 and 5.3% in SUSTAIN 5 had a low.2,9 Much of the risk comes from the insulin itself, and the GLP‑1 medicine adds to it.1,2 More people stopped treatment early on Mounjaro in SURPASS-5: 10% to 18%, vs 3% on the dummy.10

SURPASS-6 compared two ways of stepping up from basal insulin. One group added weekly Mounjaro; the other added mealtime insulin lispro 3 times a day.11

The Mounjaro group had fewer lows and lost weight. But 14% to 26% felt sick, and 5% to 13% vomited.11

RisksThe risks, in brief
  • Stomach effects lead the list. In SURPASS-5, 13% to 18% on Mounjaro felt sick (nausea), vs 3% on a dummy.10 Vomiting or diarrhoea can dry you out, and kidney injury has been reported.1
  • More lows with insulin or a sulfonylurea. Severe or confirmed lows: 8.3% to 10.7% on Ozempic with basal insulin, vs 5.3% on a dummy.9
  • Pancreatitis and gallbladder. Severe stomach pain that won't go away, sometimes spreading to the back, is the pancreatitis warning sign.1 In the US Mounjaro label's placebo-controlled trials, 0.6% had acute gallbladder disease (such as gallstones), vs 0%.2 Sanofi India's Soliqua information lists its signs: upper stomach pain, fever, nausea, vomiting and yellow skin (jaundice).24
  • Eyes. In a 2-year trial, diabetic eye complications (retinopathy) were more frequent on Ozempic: 3.0% vs 1.8%. With retinopathy already present, 8.2% vs 5.2%.1
  • Thyroid warning. The US label rules it out for anyone with a personal or family history of medullary thyroid cancer (MTC), or with MEN 2 (multiple endocrine neoplasia type 2). Tell your doctor if this applies.1
  • Pregnancy. The Ozempic label says to stop at least 2 months before a planned pregnancy. The Mounjaro label says it can make the contraceptive pill less reliable for 4 weeks after starting and after each dose rise.1,2
Full detail in Guide 5: Side effects and risks → Ozempic side effects →

What do the labels say about the insulin dose?

They tell doctors to consider lowering it when the GLP‑1 medicine starts. No label we read gives one fixed amount for everyone.1,2

The Ozempic and Mounjaro labels say a lower insulin or sulfonylurea dose "may" lower the risk of a low.1,2 The ADA says the insulin dose "should be reassessed" when a GLP‑1 medicine is added. The same applies at each dose rise.6

India's RSSDI-ESI guideline says "dose reduction of insulin may be needed".4

In SUSTAIN 5 and SURPASS-5, people with HbA1c at 8.0% or below cut basal insulin by 20% at the start.1,2 That was a trial rule, not a rule for anyone else.

SURPASS-5 then adjusted insulin glargine to a fasting sugar target below 100 mg/dL.2 People started on 32 to 35 units a day.2 On Mounjaro, the dose went up much less than on the dummy injection, and fell on 15 mg:

SURPASS-5Daily insulin glargine dose, start to week 40

Average change in units a day, from the US Mounjaro label (August 2026). Trial averages, not a guide to any one person's dose.2

Mounjaro 5 mg and 10 mg4 more
Mounjaro 15 mg6 fewer35 to 29
Dummy injection26 more33 to 59

The Ozempic and Mounjaro labels also ask doctors to warn patients about lows and teach them the signs.1,2 Our post on GLP‑1 medicines and low blood sugar lists those signs.

Get help now: call 112. Call if someone with low sugar is not alert or can't take sugar by mouth. Sugar by mouth is only for someone who is alert.23 See when to call 112 on a GLP‑1 medicine.
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What are the insulin-plus-GLP-1 pens, and are they sold in India?

Two once-daily pens hold basal insulin and a GLP‑1 medicine in a fixed ratio. Sanofi sells Soliqua in India; Xultophy appears on Indian pharmacy listings.14,16,17,24

  • Xultophy combines insulin degludec with liraglutide, a GLP‑1 medicine.14 Our post on liraglutide, Saxenda and Victoza in India covers liraglutide on its own.
  • Soliqua combines insulin glargine with lixisenatide, another GLP‑1 medicine.24

"Fixed ratio" means each unit of insulin comes with a set amount of the GLP‑1 medicine. On the US Xultophy label, each unit holds 1 unit of degludec and 0.036 mg of liraglutide.14 One dose setting changes both.

Sanofi India's prescribing information for Soliqua, revised April 2026, lists two pens.24 The 10-40 pen holds 100 units of glargine and 50 mcg of lixisenatide per mL. The 30-60 pen holds 100 units and 33 mcg.24

Its Indian indication covers adults whose type 2 diabetes isn't controlled on metformin, alone or with another tablet, or on basal insulin or a GLP‑1 medicine.24 Soliqua is then used "in addition to metformin with or without SGLT2 inhibitors".24 Sanofi announced the Indian launch on 25 Apr 2024, after CDSCO authorisation.16

For Xultophy, two Indian pharmacy listings name Novo Nordisk India as marketer. Both showed it unavailable or out of stock on 5 Oct 2026, and we found no launch announcement.17

Sanofi India's document says basal insulin or a GLP‑1 medicine "should be discontinued" before Soliqua starts.24 The US Xultophy label says the same.14 So a pen is not taken alongside Ozempic or Mounjaro.

Both pens' US labels advise against combining them with another GLP‑1 medicine. Neither pen has been studied with mealtime insulin.14,15 The Indian Soliqua document adds that it hasn't been studied with gliptins, sulfonylureas or pioglitazone.24

The ADA lists these pens, or a separate GLP‑1 medicine, as a step to consider before mealtime insulin.6 India's RSSDI-ESI guideline called GLP‑1 medicines with basal insulin "extremely useful" for stepping up, naming both combinations.4 Nausea was reported in 8% on Xultophy in its US label's pooled trials.14 In Sanofi India's document, 8.4% had treatment-related nausea on Soliqua in two pooled 30-week trials.24

What about glimepiride and other sulfonylureas?

Sulfonylureas can cause lows on their own. The Ozempic and Mounjaro labels warn that adding a GLP‑1 medicine raises that risk.1,2,4

Sulfonylureas are diabetes tablets such as glimepiride and gliclazide. India's RSSDI-ESI guideline lists lows and weight gain as their main problems.4 With a sulfonylurea, 17.3% to 24.4% on Ozempic had a low with symptoms in its US label trials.1

When any new diabetes medicine starts, the ADA says to reassess the need for, and dose of, sulfonylureas, meglitinides and insulin.6 The US metformin label says the same about adding metformin to insulin or a sulfonylurea.3 Can GLP‑1 medicines cause low blood sugar? has the full numbers, signs and treatment.

Can it be taken with an SGLT2 or DPP-4 tablet?

With an SGLT2 tablet, yes. The ADA describes that pairing for people at high heart risk. With a DPP-4 tablet, the ADA advises against it.6

SGLT2 tablets, such as dapagliflozin, empagliflozin and remogliflozin, make the kidneys pass sugar into the urine.4 India's RSSDI-ESI guideline lists genital fungal infections and passing more urine as their drawbacks.4 The ADA describes GLP‑1 and SGLT2 "combination therapy" for people with, or at high risk of, heart disease.6

In SUSTAIN 9, 302 people on an SGLT2 tablet added Ozempic 1 mg or a dummy injection for 30 weeks.18 HbA1c fell 1.42 points more on Ozempic. But 37% had stomach side effects, vs 13% on the dummy; Novo Nordisk funded the trial.18

DPP-4 tablets (gliptins, such as sitagliptin, vildagliptin and teneligliptin) raise the body's own active GLP‑1.4 The ADA says using one with a GLP‑1 medicine "is not recommended", because it adds no further sugar lowering.6

Questions people ask

Can metformin and Ozempic be taken together?

Yes. India's RSSDI-ESI guideline lists GLP‑1 medicines as an add-on to metformin. In the SURPASS-2 trial, everyone on Ozempic also took metformin.4,8

Will my insulin dose go down if I start Mounjaro?

Not always. In SURPASS-5, the average glargine dose rose by 4 units a day on Mounjaro 5 mg and 10 mg, and fell by 6 units on 15 mg. On the dummy, it rose by 26 units. The label tells doctors to consider a lower insulin dose at the start.2

Can a GLP-1 medicine replace insulin?

The ADA prefers a GLP‑1 medicine to starting insulin, unless sugar is very high. Once insulin is used, the ADA recommends adding a GLP‑1 medicine and reassessing the insulin dose.6

Is Soliqua the same as Ozempic plus insulin?

No. Soliqua contains insulin glargine and lixisenatide, a different GLP‑1 medicine from semaglutide. Sanofi India's prescribing information says a GLP‑1 medicine is stopped before Soliqua starts. Its US label says not to use it with any other GLP‑1 medicine.15,24

Do I need a vitamin B12 test on metformin?

The US metformin label asks for a B12 test every 2 to 3 years. In its 29-week trials, about 7% of people developed low B12. The ADA also suggests periodic testing.3,6

Can I take Ozempic with an SGLT2 tablet?

The ADA describes that combination for people at high heart risk. In SUSTAIN 9, HbA1c fell 1.42 points more with Ozempic. Stomach side effects: 37% vs 13% on a dummy.6,18

How we researched this

On 5 October 2026 we read India's RSSDI-ESI 2020 guideline and RSSDI's 2022 summary. We also read section 9 of the ADA's 2026 Standards of Care.

We read the US labels for Ozempic, Mounjaro, Xultophy, Soliqua and metformin. Trial numbers come from each trial's published summary, and the insulin doses from the Mounjaro label.

For India, we read Sanofi India's Soliqua prescribing information (revised April 2026) and its launch release. We checked two pharmacy listings for Xultophy, searched for a Xultophy launch announcement and found none.

We left out Sanofi's launch "therapy cost" for Soliqua, because it is not an MRP. We describe what labels say about doses but give no dose changes.

Before you move on

  • Indian and US guidelines describe a GLP‑1 medicine as an add-on to metformin.
  • With insulin or a sulfonylurea, labels tell doctors to consider lower doses.
  • Insulin-plus-GLP‑1 pens are not used with Ozempic or Mounjaro.
  • Metformin's B12 check still applies after a GLP‑1 medicine is added.
Side effects and risksDoctors and medicines in IndiaDoctor questions

More from the India blog

INIndiaCan Ozempic, Mounjaro and other GLP‑1 medicines cause low blood sugar? INIndiaMounjaro vs Ozempic: how do they differ in India? INIndiaLiraglutide, Saxenda and Victoza: the older GLP‑1 in India
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An independent guide to GLP‑1 medicines. We don't sell medicines, take drug-company money or earn clinic commissions. Once a month: new brands, price changes, approvals and recalls. How we write

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Sources

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  2. Eli Lilly. Mounjaro (tirzepatide) injection, US prescribing information, revised August 2026. Sections 5.3, 5.8, 6.1 (Table 2), 7.1, 7.2 and 14 (SURPASS-5 insulin doses) (US label, not the Indian one). PDF
  3. Metformin hydrochloride tablets, US prescribing information (DailyMed), revised July 2026. Sections 5.2, 5.3 and 12.1 (US label). Link
  4. Chawla R, Madhu SV, Makkar BM, et al. RSSDI-ESI clinical practice recommendations for the management of type 2 diabetes mellitus 2020. Indian J Endocrinol Metab. 2020;24(1):1–122. Joint guideline of RSSDI and the Endocrine Society of India. Oral agents, injectables, neuropathy and drug tables. DOI · Full text
  5. Research Society for the Study of Diabetes in India. RSSDI clinical practice recommendations 2022: summary document for training. Injectables and obesity chapters. PDF
  6. American Diabetes Association. 9. Pharmacologic approaches to glycemic treatment: Standards of Care in Diabetes 2026. Diabetes Care. 2026;49(Suppl 1):S183–S215. Recommendations 9.17–9.22 and text. Declared interests: 2 of the 20 Professional Practice Committee members declare ties to Novo Nordisk and 1 to Eli Lilly (source 7). DOI · Full text
  7. American Diabetes Association Professional Practice Committee. Disclosures: Standards of Care in Diabetes 2026. Diabetes Care. 2026;49(Suppl 1):S358–S362. Full text
  8. Frías JP, et al. Tirzepatide versus semaglutide once weekly in patients with type 2 diabetes (SURPASS-2). N Engl J Med. 2021;385:503–15. 1,879 people, all on metformin, 40 weeks. Funded by Eli Lilly. DOI · PMID 34170647
  9. Rodbard HW, et al. Semaglutide added to basal insulin in type 2 diabetes (SUSTAIN 5). J Clin Endocrinol Metab. 2018;103(6):2291–2301. 397 people, 30 weeks. Funded by Novo Nordisk. DOI · PMID 29688502 · Full text
  10. Dahl D, et al. Effect of subcutaneous tirzepatide vs placebo added to titrated insulin glargine on glycemic control in patients with type 2 diabetes (SURPASS-5). JAMA. 2022;327(6):534–545. 475 people, 40 weeks. Sponsored by Eli Lilly. DOI · PMID 35133415
  11. Rosenstock J, et al. Tirzepatide vs insulin lispro added to basal insulin in type 2 diabetes (SURPASS-6). JAMA. 2023;330(17):1631–1640. 1,428 people, 52 weeks, open-label. Sponsored by Eli Lilly. DOI · PMID 37786396
  12. Lingvay I, et al. Effect of insulin glargine up-titration vs insulin degludec/liraglutide on glycated hemoglobin levels in patients with uncontrolled type 2 diabetes (DUAL V). JAMA. 2016;315(9):898–907. 557 people, 26 weeks, open-label; two authors from Novo Nordisk. DOI · PMID 26934259
  13. Aroda VR, et al. Efficacy and safety of LixiLan, a titratable fixed-ratio combination of insulin glargine plus lixisenatide, in type 2 diabetes inadequately controlled on basal insulin and metformin (LixiLan-L). Diabetes Care. 2016;39(11):1972–1980. 736 people, 30 weeks, open-label; three authors from Sanofi. DOI · PMID 27650977
  14. Novo Nordisk. Xultophy 100/3.6 (insulin degludec and liraglutide) injection, US prescribing information, revised October 2025. Sections 1, 2.2 and 6.1 (US label). PDF
  15. Sanofi. Soliqua 100/33 (insulin glargine and lixisenatide) injection, US prescribing information (DailyMed), revised March 2026. Sections 1 and 2.2 (US label; the Indian pens are in source 24). Link
  16. Sanofi India. Sanofi's diabetes drug Soliqua now available in India. Press release, Mumbai, 25 April 2024. PDF
  17. Tata 1mg and PharmEasy product listings for Xultophy, marketer and stock status, checked 5 October 2026 (pharmacy listings, not linked).
  18. Zinman B, et al. Semaglutide once weekly as add-on to SGLT-2 inhibitor therapy in type 2 diabetes (SUSTAIN 9). Lancet Diabetes Endocrinol. 2019;7(5):356–367. 302 people, 30 weeks. Funded by Novo Nordisk. DOI · PMID 30833170
  19. Press Information Bureau (PIB Research). GLP-1 Drugs: Use, Risks, and Regulation. Government backgrounder, 1 April 2026. PDF
  20. CDSCO. Recommendations of the Subject Expert Committee (Endocrinology & Metabolism): meeting of 20–21 April 2023, item 1 (tirzepatide), and meeting of 13–14 February 2024, items 3–4 (semaglutide). Committee minutes. April 2023 PDF (archived copy) · February 2024 PDF (archived copy)
  21. Business Standard. Novo Nordisk launches Ozempic in India at ₹2,200/week amid patent battles. 12 December 2025. Link
  22. Business Standard. Eli Lilly launches Mounjaro in India. 20 March 2025. Link
  23. American Diabetes Association. 6. Glycemic goals, hypoglycemia, and hyperglycemic crises: Standards of Care in Diabetes 2026. Diabetes Care. 2026;49(Suppl 1). HbA1c definition and hypoglycaemia treatment text. DOI · Full text
  24. Sanofi India. Soliqua SoloStar (fixed ratio combination of insulin glargine + lixisenatide), Indian prescribing information, revised April 2026. Sections 3, 4.1, 4.2, 4.4 (acute gallbladder disease) and 4.8. PDF

Last checked 5 Oct 2026 · Next review due 5 Oct 2027 · Report an error

How this post was made. Written by the GLP Guidebook team from the sources above. It's general information, not medical advice. Talk to a qualified doctor before starting, stopping or changing any medicine. How we write