semaglutide e tirzepatide produced more average weight loss than in direct head-to-head research., But more weight loss does not automatically mean a medication is better for you., Semaglutide primarily Switching from Semaglutide to Tirzepatide:

Preclinical and clinical studies have uncovered several gastrointestinal effects of metformin, including stimulation of the incretin hormone glucagon-like peptide-1 (GLP-1) [8], slowing of gastric emptying [8], suppression of intestinal glucose absorption [9], inhibition of bile acid resorption [10, 11] and modulation of the gut microbiota [12]

2011 January;46(1):23-9

However, landmark analysis, adjusting the cohort selection period to 2, 6, 9, and 12 months post-transplant, demonstrated consistent beneficial effects of GLP-1 RAs on all-cause mortality, MACEs, and MAKEs (Supplemental Table 13)

Hepatic Impairment: Patients with hepatic impairment have developed with cases of metformin-associated lactic acidosis

doi: 10.1007/s11010-023-04747-7 172 YanJXiaQSunXYangPGaoHPanZet al

My patients have some transient nausea for a day or two, and we treat that with nausea medicines