| Diabetes Mellitus, Non-Insulin-Dependent
Janumet 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
Twice daily
DPP-4 inhibitor / biguanide combination
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 50 mg sitagliptin/500 mg metformin HCl twice daily with meals as starting dose for patients not on metformin; for patients on metformin HCl 850 mg twice daily, start at 50 mg sitagliptin/1000 mg metformin HCl twice daily; max 100 mg sitagliptin/2000 mg metformin HCl daily; do not split or divide 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, 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, nasopharyngitis, nausea/vomiting, flatulence, abdominal discomfort, indigestion, asthenia
Serious Lactic acidosis, pancreatitis, heart failure, acute renal failure, hypoglycemia (with sulfonylurea or insulin), 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, acute renal failure, tubulointerstitial nephritis, rhabdomyolysis, constipation, myalgia, back pain, pruritus, mouth ulceration, 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
Sitagliptin is a DPP-4 inhibitor that slows inactivation of incretin hormones GLP-1 and GIP, increasing insulin release and decreasing glucagon in a glucose-dependent manner; metformin is a biguanide that decreases hepatic glucose production, reduces intestinal glucose absorption, and improves peripheral insulin sensitivity by increasing glucose uptake and utilization.
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 (1/12) · 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.