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Synjardy
Synjardy is a combination medication containing empagliflozin and metformin, used to help control blood sugar levels in adults with type 2 diabetes mellitus. Empagliflozin is a SGLT2 inhibitor, while metformin is a biguanide. Together, these medications help reduce blood sugar levels by different mechanisms: empagliflozin works by preventing the kidneys from reabsorbing glucose, leading to its excretion in the urine, and metformin reduces glucose production in the liver and improves insulin sensitivity. Synjardy is often used in combination with lifestyle changes, such as diet and exercise, to help manage type 2 diabetes.
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Frequently Asked Questions
How long does it take for Synjardy to start working?
You may begin to see improvements in blood sugar levels within a few days to a few weeks of starting Synjardy. Full effects may take longer, and regular monitoring is essential.
Can I take Synjardy with other diabetes medications?
Yes, Synjardy is often used alongside other diabetes medications. However, care must be taken to avoid the risk of low blood sugar (hypoglycemia) when combined with insulin or sulfonylureas.
What should I do if I miss a dose of Synjardy?
If you miss a dose, take it as soon as you remember. If it is close to your next scheduled dose, skip the missed dose and take the next one at your usual time. Do not double up on doses.
Can Synjardy cause weight loss?
Some patients may experience mild weight loss while taking Synjardy, primarily due to the empagliflozin component, which helps remove excess glucose through urine.
Is Synjardy safe for long-term use?
Yes, Synjardy is generally considered safe for long-term use in patients with type 2 diabetes, as long as regular monitoring of blood sugar, kidney function, and other vital signs is performed.
Comprehensive Drug Guide
How Does Synjardy Work?
- Empagliflozin: Inhibits SGLT2, a protein in the kidneys that reabsorbs glucose back into the bloodstream. By blocking this action, empagliflozin increases the excretion of glucose in the urine, lowering blood sugar levels.
- Metformin: Decreases glucose production in the liver and increases insulin sensitivity, which helps cells use glucose more effectively and reduces the amount of sugar in the blood.
Together, these mechanisms help improve glycemic control in individuals with type 2 diabetes.
Common Dosages
- 5 mg empagliflozin / 500 mg metformin
- 5 mg empagliflozin / 1000 mg metformin
- 12.5 mg empagliflozin / 500 mg metformin
- 12.5 mg empagliflozin / 1000 mg metformin
Typical Dosing
- The usual starting dose of Synjardy is 5 mg/500 mg twice daily.
- The dose may be increased gradually, with the maximum recommended dose being 12.5 mg/1000 mg twice daily, based on individual tolerability and response to treatment.
- Synjardy should be taken with meals to reduce gastrointestinal side effects, such as nausea or stomach upset, associated with metformin.
Typical Dosing
FDA Approved Indications
- Adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
- Reduction of cardiovascular risk: Empagliflozin (a component of Synjardy) has been shown to reduce the risk of cardiovascular death in patients with type 2 diabetes and cardiovascular disease.
Who Shouldn't Take Synjardy?
- Severe kidney impairment (eGFR below 30 mL/min/1.73 m²).
- Metabolic acidosis, including diabetic ketoacidosis.
- Hypersensitivity to empagliflozin, metformin, or any components of the formulation.
Advice From The Pharmacist
- Take Synjardy twice daily with meals to reduce gastrointestinal discomfort associated with metformin.
- Stay hydrated while taking Synjardy, as empagliflozin can increase urination, which may lead to dehydration or low blood pressure.
- Monitor blood sugar levels regularly, especially when starting Synjardy or adjusting the dose.
- Avoid alcohol consumption, as it can increase the risk of developing lactic acidosis, a serious side effect of metformin.
- If you experience symptoms such as muscle pain, difficulty breathing, or unusual fatigue, contact your healthcare provider immediately, as these may be signs of lactic acidosis.
- Maintain good foot care and watch for signs of infection, as individuals with diabetes are more prone to infections and complications.
Side Effects of Synjardy
Common Side Effects
- Urinary tract infections
- Increased urination
- Nausea or vomiting
- Diarrhea
- Abdominal discomfort
- Headache
Uncommon/Severe Side Effects
- Lactic acidosis: A serious condition associated with metformin, characterized by symptoms such as muscle pain, fatigue, difficulty breathing, and stomach discomfort.
- Dehydration: Due to increased urination from empagliflozin, which may lead to low blood pressure and dizziness.
- Genital infections: Empagliflozin can increase the risk of fungal infections in the genital area.
- Ketoacidosis: A serious condition that may occur in individuals with type 2 diabetes, even when blood sugar levels are not elevated.
Risks and Warnings of Synjardy
- Lactic acidosis: Metformin, one of the components of Synjardy, can rarely cause lactic acidosis, a serious and potentially fatal condition. Symptoms include muscle pain, breathing difficulties, stomach discomfort, and weakness. If these symptoms occur, seek immediate medical attention.
- Dehydration and low blood pressure: Empagliflozin can cause dehydration due to increased urination, leading to low blood pressure and dizziness. Staying hydrated is essential.
- Increased risk of genital infections: Empagliflozin may increase the risk of fungal infections in the genital area. Symptoms such as itching, burning, or unusual discharge should be reported to a healthcare provider.
- Kidney function monitoring: Synjardy should not be used in patients with severe kidney impairment, and kidney function should be monitored regularly in all patients using the medication.
Interactions with Synjardy
Common Drug Interactions
- Diuretics: The use of diuretics with Synjardy may increase the risk of dehydration and low blood pressure.
- Alcohol: Alcohol can increase the risk of lactic acidosis when taken with metformin. Limit or avoid alcohol while using Synjardy.
- Insulin or insulin secretagogues: When used with insulin or sulfonylureas, Synjardy may increase the risk of hypoglycemia (low blood sugar).
- Cationic drugs: Medications such as cimetidine can increase metformin concentrations and the risk of lactic acidosis.
Alternatives to Synjardy
- Jardiance (empagliflozin): Empagliflozin alone, used to lower blood sugar in type 2 diabetes and reduce cardiovascular risk.
- Glucophage (metformin): Metformin alone, commonly used to improve insulin sensitivity and reduce glucose production in the liver.
- Invokana (canagliflozin): Another SGLT2 inhibitor used to lower blood sugar in type 2 diabetes.
- Xigduo XR (dapagliflozin/metformin): A combination of another SGLT2 inhibitor and metformin, similar to Synjardy.
