| Diabetes Mellitus, Non-Insulin-Dependent
Janumet XR vs Synjardy
Side-by-side clinical, coverage, and cost comparison for diabetes mellitus, non-insulin-dependent.Deep comparison between: Janumet vs Synjardy with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsSynjardy has a higher rate of injection site reactions vs Janumet based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Synjardy but not Janumet, including UnitedHealthcare
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Category
Janumet
Synjardy
At A Glance
Oral
Once daily
DPP-4 inhibitor / biguanide
Oral
Once or twice daily
SGLT2 inhibitor / biguanide
Indications
- Diabetes Mellitus, Non-Insulin-Dependent
- Diabetes Mellitus, Non-Insulin-Dependent
- Cardiovascular Diseases
- Congestive heart failure
- Chronic Kidney Diseases
Dosing
Diabetes Mellitus, Non-Insulin-Dependent Take once daily with a meal; recommended starting dose is 100 mg sitagliptin and 1000 mg metformin HCl extended-release once daily; maximum daily dose is 100 mg sitagliptin and 2000 mg metformin HCl; dose of sitagliptin component limited to 50 mg once daily if eGFR falls below 45 mL/min/1.73 m2; do not split, crush, or chew tablets.
Diabetes Mellitus, Non-Insulin-Dependent SYNJARDY: empagliflozin 10 mg/day (may increase to 25 mg/day) plus metformin HCl up to 2,000 mg/day, taken orally twice daily with meals; SYNJARDY XR: once daily with morning meal; not recommended if eGFR <45 mL/min/1.73 m2.
Cardiovascular Diseases, Congestive heart failure, Chronic Kidney Diseases Empagliflozin 10 mg/day component as part of SYNJARDY or SYNJARDY XR, taken orally; not recommended if eGFR <45 mL/min/1.73 m2.
Contraindications
- Severe renal impairment (eGFR below 30 mL/min/1.73 m2)
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis
- History of a serious hypersensitivity reaction to JANUMET XR, sitagliptin, or metformin, such as anaphylaxis or angioedema
- Severe renal impairment (eGFR <30 mL/min/1.73 m2)
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis
- Hypersensitivity to empagliflozin, metformin HCl, or any excipient in SYNJARDY or SYNJARDY XR
Adverse Reactions
Most common (>=5%) Diarrhea, upper respiratory tract infection, headache (from sitagliptin and metformin coadministration studies); nasopharyngitis (sitagliptin monotherapy); hypoglycemia, diarrhea, nausea (extended-release metformin added to glyburide)
Serious Lactic acidosis, pancreatitis, heart failure, acute renal failure, vitamin B12 deficiency, hypoglycemia with insulin or insulin secretagogues, hypersensitivity reactions, severe and disabling arthralgia, bullous pemphigoid
Postmarketing Anaphylaxis, angioedema, rash, urticaria, cutaneous vasculitis, Stevens-Johnson syndrome, hepatic enzyme elevations, fatal and non-fatal hemorrhagic and necrotizing pancreatitis, worsening renal function including acute renal failure, tubulointerstitial nephritis, severe and disabling arthralgia, bullous pemphigoid, constipation, vomiting, myalgia, rhabdomyolysis, cholestatic and hepatocellular liver injury
Most common (>=5%) Hypoglycemia (with sulfonylurea), urinary tract infection, nasopharyngitis, diarrhea, nausea/vomiting, flatulence, abdominal discomfort, indigestion, asthenia, headache
Serious Lactic acidosis, diabetic ketoacidosis, volume depletion, urosepsis, pyelonephritis, necrotizing fasciitis of the perineum (Fournier's gangrene), hypersensitivity reactions, vitamin B12 deficiency, lower limb amputation
Postmarketing Constipation, necrotizing fasciitis of the perineum, urosepsis, pyelonephritis, ketoacidosis, acute kidney injury, angioedema, rash, urticaria, cholestatic/hepatocellular liver injury
Pharmacology
JANUMET XR combines sitagliptin, a selective DPP-4 inhibitor that slows inactivation of incretin hormones (GLP-1 and GIP) to increase insulin release and decrease glucagon in a glucose-dependent manner, and metformin, a biguanide that decreases hepatic glucose production, reduces intestinal glucose absorption, and improves peripheral insulin sensitivity without altering insulin secretion.
Empagliflozin is an SGLT2 inhibitor that reduces renal reabsorption of filtered glucose, lowers the renal threshold for glucose, and increases urinary glucose excretion; metformin HCl is a biguanide antihyperglycemic agent that decreases hepatic glucose production, reduces intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization.
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Most Common Insurance
Anthem BCBS
Janumet
- Covered on 5 commercial plans
- PA (0/12) · Step Therapy (9/12) · Qty limit (11/12)
Synjardy
- Covered on 5 commercial plans
- PA (0/12) · Step Therapy (9/12) · Qty limit (11/12)
UnitedHealthcare
Janumet
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (2/8)
Synjardy
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (7/8)
Humana
Janumet
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · Qty limit (3/3)
Synjardy
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Janumet.
No savings programs available for Synjardy.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.