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Hands holding Rx pills and pill bottle: Alternatives to Synjardy
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Synjardy alternatives: What can I take instead of Synjardy?

Synjardy doesn't work for everyone. Synjardy XR, Glyxambi, Trijardy XR, Ozempic, and Janumet are some Synjardy alternatives. Get the full list here.
Chad Shaffer, MD, medical writer and reviewer for SingleCare
By | Oct. 13, 2022

Compare Synjardy alternatives | Synjardy XR | Glyxambi | Trijardy XR | Ozempic | Janumet | Natural alternatives | How to switch meds

Elevated blohttp://3synjardy-xrod sugar in Type 2 diabetes mellitus arises from multiple mechanisms, including both low levels of natural insulin production and low responsiveness to it. Using multiple mechanisms to treat the disease makes perfect sense. Doing so with one drug seems ideal. Synjardy does so by combining empagliflozin and metformin in a pill taken twice daily. While it sounds great, it may not be the perfect fit for you. Side effects from either component drug could have you searching for other options, or your other medications or health problems may prohibit Synjardy’s use. Since Synjardy is only available as a brand name product and may not have preferred formulary status with your insurance coverage, cost concerns are another reason you may need an alternative. Whatever your reason for wanting to know about Synjardy alternatives, read on to familiarize yourself with a few, and then talk to your healthcare provider about your ideas.

What can I take in place of Synjardy?

Metformin is a biguanide, aimed at lowering blood glucose levels by reducing the liver’s production of glucose and increasing body tissue’s utilization of glucose. Empagliflozin is a sodium-glucose cotransporter 2 (SGLT2) inhibitor, which reduces blood sugar levels by enhancing the excretion of glucose in the urine. Putting those two mechanisms together in Synjardy can provide a powerful treatment for Type 2 diabetes. However, it is not the only diabetic combination pill, and they are not the only diabetic drug classes that are available in such combinations. Dipeptidyl peptidase-4 (DPP-4) inhibitors and sulfonylureas are often coupled with metformin too. Even a couple of injectable glucagon-like peptide-1 (GLP-1) agonists are found in dual mechanism products, combined with insulin. Let’s look over the list of some options for you to consider and then delve into greater detail on a few common ones.

RELATED: What are normal blood sugar levels?

Compare Synjardy alternatives
Drug name Uses Dosage Savings options
Synjardy (empagliflozin/metformin) Type 2 diabetes mellitus 5 mg/500 mg to 12.5 mg/1000 mg twice daily Synjardy coupons
Synjardy XR (empagliflozin/metformin ER) Type 2 diabetes mellitus 5 mg/1000 mg to 25 mg/1000 mg once daily Synjardy XR coupons
Jardiance (empagliflozin) Type 2 diabetes mellitus, cardiovascular event risk reduction in Type 2 diabetes mellitus, heart failure risk reduction in those with reduced cardiac ejection fractions 10-25 mg once daily Jardiance coupons
Metformin Type 2 diabetes mellitus, polycystic ovarian syndrome (off-label) 500-1000 mg twice daily Metformin coupons
Glyxambi (empagliflozin/linagliptin) Type 2 diabetes mellitus 10 mg/5 mg to 25 mg/5 mg once daily Glyxambi coupons
Trijardy XR (empagliflozin/linagliptin/metformin ER) Type 2 diabetes mellitus 5 mg/2.5 mg/1000 mg to 25 mg/5 mg/1000 mg once daily Trijardy XR coupons
Janumet (sitagliptin/metformin) Type 2 diabetes mellitus 50 mg/500 mg to 50 mg/1000 mg twice daily Janumet coupons
Trulicity (dulaglutide) Type 2 diabetes mellitus, cardiovascular event risk reduction in those with Type 2 diabetes and cardiovascular disease or multiple risk factors 0.75-4.5 mg subcutaneous (under the skin) injection once weekly Trulicity coupons
Ozempic (semaglutide) Type 2 diabetes mellitus, cardiovascular event risk reduction in those with Type 2 diabetes and cardiovascular disease 0.5-1 mg subcutaneous injection once weekly Ozempic coupons
Rybelsus (semaglutide) Type 2 diabetes mellitus 7-14 mg once daily Rybelsus coupons
Victoza (liraglutide) Type 2 diabetes mellitus, cardiovascular event risk reduction in those with Type 2 diabetes and cardiovascular disease 1.2-1.8 mg subcutaneous injection once daily Victoza coupons
Mounjaro (tirzepatide) Type 2 diabetes mellitus 5-15 mg subcutaneous injection once weekly Mounjaro coupons
Farxiga (dapagliflozin) Type 2 diabetes mellitus, heart failure risk reduction in Type 2 diabetes mellitus with heart disease or multiple cardiovascular risk factors, heart failure risk reduction in those with reduced cardiac ejection fractions, heart failure and kidney disease progression risk reduction in those with chronic renal disease 5-10 mg once daily Farxiga coupons
Xigduo XR (dapagliflozin/metformin extended-release [ER]) Type 2 diabetes mellitus 2.5 mg/1000 mg to 10 mg/1000 mg once daily Xigduo XR coupons
Lantus Solostar (insulin glargine) Type 2 diabetes mellitus, Type 1 diabetes mellitus Individualized dose injected subcutaneously once daily Lantus Solostar coupons
Soliqua (insulin glargine/lixisenatide) Type 2 diabetes mellitus 15 to 60 units injected subcutaneously once daily Soliqua coupons

Other alternatives to Synjardy

Top 5 Synjardy alternatives

The following are some of the most common alternatives to Synjardy.

1. Synjardy XR

Metformin, the generic of brand-name Glucophage, is the standard first medication ordered for Type 2 diabetes, and it typically remains on board throughout treatment as other medications are added when needed. That being said, it has some flaws, namely a penchant for causing diarrhea and nausea as well as for increasing the risk of lactic acidosis (a build-up of lactic acid in the blood). Substituting extended-release metformin for the regular-release drug can cut the incidence of these gastrointestinal side effects dramatically. That is where Synjardy XR may be in order for you, if you are suffering from metformin’s adverse abdominal effects. It does not avoid metformin’s potential for reducing vitamin B12 absorption or its contraindication in the setting of advanced kidney disease or for those with kidney problems or on dialysis, but the possibility of less diarrhea and nausea could still be worth the change. 

RELATED: Metformin side effects and how to avoid them 

2. Glyxambi

Diarrhea and nausea, while less common, are not rare side effects of extended-release metformin. If no form of metformin agrees with you, then you may be looking to combine a SGLT2 inhibitor with some other class of diabetic medication. Glyxambi keeps the empagliflozin component of Synjardy, ditches the metformin, and instead pulls in linagliptin. Linagliptin is a DPP-4 drug. This class is better tolerated from a gastrointestinal standpoint than metformin. Unfortunately, DPP-4 medications are not very potent reducers of blood glucose levels.

3. Trijardy XR

If you need more glucose-lowering power than what Synjardy or other two-drug combination pills can get you, Trijardy XR may be worth a look. It harnesses the effects of empagliflozin, extended-release metformin, and linagliptin. The idea is to gain additive potency, the convenience of taking less pills per day, and the cost savings of a reduced number of prescription drug copayments. Keeping empagliflozin in the mix maintains the advantages it offers. In its standalone formulation, brand named Jardiance, empagliflozin is also indicated by the Food and Drug Administration (FDA) for reducing cardiovascular event risk in those with Type 2 diabetes, as well as congestive heart failure risk in those with reduced cardiac ejection fraction (a measure of the strength of heart squeeze). 

The thought of having a lower risk of heart attack and heart failure is no doubt appealing, but SGLT2 inhibitors like empagliflozin can cause genital and urinary adverse effects as a result of increasing the sugar content of urine. Urinary frequency, urinary tract infections, and genital yeast infections are all more common with SGLT2 drugs, including Jardiance, Invokana, Farxiga, and Steglaro, not to mention all the combination products that include this class, such as Trijardy XR. They function similar to diuretics, so hypotension (low blood pressure) can also be a concern. Another concern is their ketogenic potential which has led to warnings about diabetic ketoacidosis (an abnormally high level of ketones), a potentially dangerous complication of diabetes. 

4. Ozempic

If genitourinary side effects have you looking for alternatives to Synjardy, then consider a GLP-1 agonist like injectable Ozempic. Now before you recoil at the idea of injecting yourself with medication, keep in mind that it only has to be given once a week. An oral form of semaglutide, Rybelsus, is available too. You may find it worthwhile in any form by knowing that it has an additional FDA indication for reducing the risk of cardiovascular events such as heart attacks in those with diabetes and cardiovascular disease. A very real chance exists that a GLP-1 agonist could help you to lose weight as well. 

If your insurance formulary does not favor Ozempic, Victoza or Trulicity may be options instead. If a GLP-1 agonist alone is not doing enough for your diabetic control, some are even found in combination products (Soliqua and Xultophy) that include long-acting insulin. 

Keep in mind that Ozempic—none of the GLP-1 agonists for that matter—should be used by anyone with a personal or family history of medullary thyroid cancer or a history of multiple endocrine neoplasia syndrome Type 2 (MEN 2). They all can cause significant problems with nausea too, so GLP-1 agonists are not the answer for everyone.

5. Janumet

A way to avoid Synjardy’s empagliflozin-based adverse effects on the urinary system and maintain its metformin-based advantage of slowing the progression of diabetes is to find a combination product with metformin and a DPP-4. Janumet presents you with that combo. It even comes as Janumet XR if you need help reducing metformin’s ill effects on the intestinal tract.

The problem with Janumet, Synjardy, and many of the alternatives may be cost. Brand name drugs like these can be pricey. Getting a SingleCare discount card and presenting it at your local pharmacy could be the solution to this issue.

RELATED: Janumet side effects and how to avoid them

Natural alternatives to Synjardy

Getting your diabetes under control can spare you from complications in the years to come. That control is typically assessed by a measurement called an A1C, which gives you an idea of what your blood glucose has averaged over the preceding three months. While natural alternatives may not fully replace Synjardy and other prescription treatments, they can be a highly effective method for reaching your treatment goals. Diet, exercise, and weight loss are proven elements that are challenging but well worth the effort. In fact, those efforts have the potential to be curative for some. Added to these types of lifestyle changes, dietary supplements may offer some assistance in lowering your A1C. Cinnamon, dietary fiber, berberine, turmeric, and apple cider vinegar all have at least a little evidence to support their use.

How to switch to a Synjardy alternative

Now that you have done your homework on finding an alternative to Synjardy, you should gather up your list of dietary supplements, over-the-counter medicines, and prescription drugs and take it to an appointment with your healthcare provider. Some diabetes drugs used in conjunction with Synjardy can add an increased risk of hypoglycemia (low blood sugar). A healthcare professional can help you review the list of Synjardy alternatives, listen to your concerns, and discuss the options to give you the right medical advice on whether to make a change to your drug regimen.