Synjardy is a diabetes medication that works to control high blood sugar in patients with type 2 diabetes when used alongside a healthy diet and exercise routine. Synjardy is also known as empagliflozin-metformin because it contains a combination of empagliflozin and metformin.

Empagliflozin and metformin are also used separately to treat type 2 diabetes. Empagliflozin prompts your kidneys to remove extra sugar from your blood. The kidneys typically remove sugar from blood and plasma. When blood sugar is too high, the kidneys can’t absorb all the glucose. This leads to glucose in the urine, a typical trait of type 1 and type 2 diabetes.

Metformin treats insulin resistance, which is a hallmark of type 2 diabetes. Insulin is typically released when you have high blood sugar. It prompts your cells to absorb sugar from your blood and either transform it into immediate energy or store it for later use. However, during insulin resistance, your body is less responsive to insulin. Metformin helps your cells become more responsive to your body’s insulin production and prompts them to absorb sugar from the blood. Metformin also reduces the amount of sugar absorbed during digestion and the amount of glucose your liver produces.

Synjardy combines the effects of empagliflozin and metformin for a multi-pronged approach to blood sugar maintenance. It increases the body’s insulin response as well as increasing the amount of sugar removed by the kidneys, decreasing the amount of sugar absorbed during digestion, and decreasing the amount of glucose produced in the urine. When combined with diet, exercise, and other lifestyle changes, Synjardy can help manage blood sugar.

Synjardy Precautions and Warnings

Synjardy is only for patients with type 2 diabetes. Do not take this medicine if you have type 1 diabetes.

Don’t use Synjardy if you are allergic to empagliflozin, metformin, or any of the drug’s inactive ingredients. Tell your doctor about all your allergies and negative drug reactions to make sure Synjardy is the right choice for you.

Discuss your overall medical history, including any diabetes complications you may have experienced. Your medical team needs to know about:

  • Asthma or COPD
  • Heart disease including a history of heart attack
  • Blood disorders
  • Anemia
  • Kidney disease
  • Liver disease
  • Pancreatitis
  • Genital yeast infections
  • Dehydration
  • Narrow or blocked blood vessels, especially in the legs
  • Nerve issues or diabetic neuropathy
  • Foot wounds, ulcers, or sores
  • Amputations
  • Alcohol or drug use

Synjardy Side Effects

Synjardy patients may experience side effects, especially while adjusting to their prescriptions.

Common Side Effects

The following side effects are common but usually fade after a few weeks:

  • Headache
  • Nausea
  • Vomiting
  • Runny nose
  • Sore throat

Serious Side Effects

More serious side effects include:

  • Urinary tract infections
  • Kidney problems such as changes in the amount of urine
  • Genital yeast infections
  • Genital or anal bacterial infections


Taking Synjardy can make it hard for your body to manage your blood sugar levels when you are stressed, ill, or recovering from surgery or an injury. Low blood sugar levels are rare but can occur while using Synjardy, especially if you haven’t eaten enough, are physically strained, or are dehydrated. Carry glucose tablets or gel in case of hypoglycemic episodes. Your doctor may ask you to monitor your blood sugar levels while taking Synjardy. Don’t drive or operate heavy machinery until you know how Synjardy affects you.

Reproductive Cycle

Synjardy can affect the reproductive cycle. This medication can promote ovulation which makes it easier for patients taking Synjardy to get pregnant. Discuss your birth control plans with your doctor before starting Synjardy. Pregnancy can make diabetes worse, or in prenatal diabetes, trigger the condition. Your doctor may change your treatment plan during pregnancy. Some Synjardy ingredients can pass to breastmilk so parents should discuss their infant feeding plans with their doctor while on this medication.

Lactic Acidosis

Patients who have liver or kidney disease, heart failure, heavy alcohol use, or are dehydrated are more likely to experience lactic acidosis. Older patients and patients undergoing surgery, or scans using iodinated contrast, are also more likely to experience this condition. Finally, taking certain other drugs alongside metformin also increases your lactic acidosis risk. Get medical help immediately if you notice the following lactic acidosis symptoms:

  • Unusual fatigue, tiredness, or drowsiness
  • Chills
  • Blue or cold skin, lips, or nails
  • Muscle pain
  • Fast or labored breathing
  • Irregular or slow heart rate
  • Stomach pain accompanied by nausea, vomiting, or diarrhea

Drug Interactions with Synjardy

Synjardy can interact with other substances, including other prescriptions, over-the-counter drugs, vitamins, supplements, herbs, alcohol, and recreational drugs. Talk to your doctor about all your medications to make sure you’re using Synjardy safely.

Synjardy is known to interact with the following types of drugs:

Alternatives to Synjardy

Both empagliflozin and metformin are available as separate prescriptions. Another alternative to Synjardy is taking these drugs separately, instead of combined in one tablet. However, since a 30-day supply of empagliflozin costs around $700, this method is unlikely to reduce the price.

Other combination diabetes treatments include:

Questions About Synjardy 

What is Synjardy used for?

Synjardy treats type 2 diabetes by reducing blood sugar levels.

How long does it take for Synjardy to work?

Synjardy starts working right away, with your first dose. It may take a few weeks or longer to see the full effects.

How long does Synjardy stay in your system?

Synjardy stays in your body for around 4 days after your last dose.

What’s the difference between Synjardy and Synjardy XR?

Synjardy and Synjardy XR contain the same medicine. Synjardy XR is an extended-release formulation which means its coating takes longer to be dissolved. Synjardy XR can typically be taken once a day instead of twice a day thanks to this coating.

How Does Synjardy Work?

Synjardy is a combination of the diabetes drugs empagliflozin and metformin, both of which reduce blood sugar. Empagliflozin triggers the kidneys to remove more sugar from the blood. Metformin improves insulin response to increase the amount of blood sugar absorbed by cells. It also reduces the amount of sugar absorbed during digestion and therefore the amount of glucose made by the liver.

Who makes Synjardy?

Synjardy is made by Boehringer Ingelheim.

What do I need to know about how to take Synjardy?

Take Synjardy according to your doctor’s instructions. Patients typically take Synjardy twice a day or Synjardy XR once a day. Take the medicine with food to prevent an upset stomach. If you miss a dose, take it as soon as you remember. Don’t take a double dose to make up for a skipped dose.

What is the difference between Jardiance and Synjardy?

Jardiance is the name brand for empagliflozin. The main difference between Jardiance and Synjardy is that Synjardy also includes metformin.

Active ingredientsEmpagliflozinEmpagliflozin and metformin
TreatsType 2 diabetes; heart failure; chronic kidney diseaseType 2 diabetes
OutcomesLower A1C; reduced risk of death from cardiovascular diseaseLower A1C; lower blood sugar levels; potential weight loss
Empagliflozin doses10 and 25mg5, 10, 12.5, and 25mg
How often to takeOnce dailyOnce or twice daily
ManufacturerBoehringer IngelheimBoehringer Ingelheim
Available versionsImmediate-releaseImmediate-release and extended-release

When is the best time to take Synjardy?

Take Synjardy as your doctor prescribes. Typically it’s best to take Synjardy at the same time each day. Take it in the morning and evening, or only in the morning for Synjardy XR. Take the medicine with food to prevent upset stomach.

How Much Does Synjardy Cost in America?

A 60-tablet prescription for empagliflozin 12.5mg/metformin 1000mg Synjardy costs around $725 in America. Insurance benefits, discount cards, coupons, and patient assistance programs may help you lower the cost.

What are the Strengths and Dosages of Synjardy?

Your doctor will determine your best Synjardy dose based on your symptoms, response, and tolerance. The maximum dose of Synjardy immediate-release and Synjardy extended-release is empagliflozin 25mg/day and metformin 2000mg/day.

IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.

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