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Synjardy XR
Synjardy XR is a combination medication that contains empagliflozin and metformin hydrochloride (extended-release). It is used to help control blood sugar levels in adults with type 2 diabetes mellitus. Empagliflozin belongs to a class of medications called SGLT2 inhibitors, which work by increasing glucose excretion through the urine. Metformin, a biguanide, reduces glucose production in the liver and improves the body’s sensitivity to insulin. Synjardy XR helps lower blood sugar levels in conjunction with diet and exercise, and can also reduce the risk of cardiovascular death in adults with type 2 diabetes and established cardiovascular disease.
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Frequently Asked Questions
Can Synjardy XR help with weight loss?
Yes, empagliflozin (an SGLT2 inhibitor) can contribute to modest weight loss in some patients by promoting glucose excretion in the urine. However, Synjardy XR is primarily used to lower blood sugar in type 2 diabetes.
How should I take Synjardy XR?
Take Synjardy XR once daily with food, preferably in the morning. Swallow the tablet whole, do not crush or chew it.
Can Synjardy XR cause low blood sugar?
Synjardy XR typically does not cause hypoglycemia unless it is used in combination with other medications that lower blood sugar, such as insulin or sulfonylureas.
Is Synjardy XR safe for patients with kidney disease?
Synjardy XR should not be used in patients with severe kidney disease (eGFR below 30 mL/min/1.73 m²). Regular monitoring of kidney function is recommended while using this medication.
What should I do if I miss a dose of Synjardy XR?
If you miss a dose, take it as soon as you remember unless it's almost time for your next dose. Do not take two doses at once to make up for a missed dose.
Comprehensive Drug Guide
How Does Synjardy XR Work?
- Empagliflozin works by inhibiting the SGLT2 protein in the kidneys, which reduces glucose reabsorption and increases the amount of glucose excreted in the urine. This helps lower blood sugar levels.
- Metformin reduces glucose production in the liver, decreases intestinal absorption of glucose, and improves insulin sensitivity, helping the body use glucose more effectively.
Common Dosages
- 10 mg/1000 mg
- 12.5 mg/1000 mg
- 25 mg/1000 mg
7. Typical Dosing
- The usual starting dose is 10 mg empagliflozin / 1000 mg metformin once daily, taken in the morning with food. Dosage may be adjusted based on effectiveness and tolerability, with a maximum dose of 25 mg empagliflozin / 2000 mg metformin per day.
- Synjardy XR should be swallowed whole and not crushed or chewed.
Typical Dosing
FDA Approved Indications
- Type 2 diabetes mellitus in adults, as an adjunct to diet and exercise to improve glycemic control.
- Reducing the risk of cardiovascular death in adults with type 2 diabetes and established cardiovascular disease.
Who Shouldn't Take Synjardy XR?
- Severe kidney impairment (eGFR below 30 mL/min/1.73 m²)
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis
- Hypersensitivity to empagliflozin, metformin, or any components of Synjardy XR
Advice From The Pharmacist
- Take Synjardy XR with food to reduce the risk of gastrointestinal side effects associated with metformin.
- Drink plenty of fluids, as empagliflozin can increase urination and may cause dehydration, especially in hot weather or when exercising.
- Monitor your kidney function regularly, as this medication can affect kidney function, especially in patients with pre-existing kidney disease.
- Be aware of symptoms of lactic acidosis, a rare but serious side effect of metformin, such as unusual muscle pain, trouble breathing, or feeling very weak.
Side Effects of Synjardy XR
Common Side Effects
- Gastrointestinal issues, such as diarrhea, nausea, or upset stomach (due to metformin)
- Increased urination
- Genital yeast infections (due to empagliflozin)
- Weight loss
- Dehydration
Uncommon/Severe Side Effects
- Lactic acidosis: A rare but serious complication from metformin that requires immediate medical attention.
- Ketoacidosis: Though rare, SGLT2 inhibitors like empagliflozin can cause ketoacidosis, even when blood sugar levels are not particularly high.
- Hypoglycemia: Can occur if used with other glucose-lowering agents like insulin or sulfonylureas.
- Acute kidney injury, especially in patients with pre-existing kidney issues.
Risks and Warnings of Synjardy XR
- Lactic Acidosis: This rare but serious condition can occur due to metformin. It is more likely in patients with severe kidney disease, liver impairment, or dehydration. Signs include muscle pain, trouble breathing, or unusual fatigue.
- Ketoacidosis: Empagliflozin can cause euglycemic ketoacidosis (normal blood glucose levels but elevated ketones), a dangerous condition. Watch for symptoms like nausea, vomiting, abdominal pain, or confusion.
- Urinary Tract Infections (UTIs): Empagliflozin can increase the risk of UTIs and genital yeast infections due to the increased glucose in the urine.
Interactions with Synjardy XR
Common Drug Interactions
- Diuretics: Combining Synjardy XR with diuretics can increase the risk of dehydration and hypotension due to excessive urination.
- Insulin or sulfonylureas: When combined, these medications can increase the risk of hypoglycemia (low blood sugar).
- Radiologic contrast studies: Temporary discontinuation of metformin is recommended before undergoing contrast imaging studies, as these procedures can affect kidney function and increase the risk of lactic acidosis.
- Alcohol: Excessive alcohol use can increase the risk of lactic acidosis when combined with metformin.
Alternatives to Synjardy XR
- Jardiance (empagliflozin): A single-agent SGLT2 inhibitor that also helps manage blood glucose and cardiovascular risk in people with type 2 diabetes.
- Janumet XR (sitagliptin/metformin): A combination of a DPP-4 inhibitor and metformin used to lower blood sugar in type 2 diabetes.
- Invokamet XR (canagliflozin/metformin): Another combination of an SGLT2 inhibitor and metformin used to manage blood sugar in type 2 diabetes.
- Glucophage XR (metformin): Extended-release metformin for patients who do not need the combination therapy provided by Synjardy XR.
