| Diabetes Mellitus, Non-Insulin-Dependent
Januvia vs Synjardy
Side-by-side clinical, coverage, and cost comparison for diabetes mellitus, non-insulin-dependent.Deep comparison between: Januvia 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 Januvia based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Synjardy but not Januvia, including UnitedHealthcare
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Category
Januvia
Synjardy
At A Glance
Oral
Once daily
DPP-4 inhibitor
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 100 mg orally once daily, with or without food.
Renal impairment (eGFR 30 to <45 mL/min/1.73 m2) 50 mg once daily.
Severe renal impairment or ESRD (eGFR <30 mL/min/1.73 m2) 25 mg once daily; may be administered without regard to the timing of dialysis.
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
- History of a serious hypersensitivity reaction to sitagliptin, 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%) Nasopharyngitis, upper respiratory tract infection, headache.
Serious 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, acute pancreatitis, worsening renal function, acute renal failure, tubulointerstitial nephritis, severe arthralgia, bullous pemphigoid, constipation, vomiting, myalgia, pain in extremity, back pain, pruritus, mouth ulceration, stomatitis, rhabdomyolysis.
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 levels in a glucose-dependent manner; it is selective for DPP-4 and does not inhibit DPP-8 or DPP-9 activity at therapeutic concentrations.
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
Januvia
- Covered on 5 commercial plans
- PA (1/12) · Step Therapy (9/12) · Qty limit (12/12)
Synjardy
- Covered on 5 commercial plans
- PA (0/12) · Step Therapy (9/12) · Qty limit (11/12)
UnitedHealthcare
Januvia
- 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
Januvia
- 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 Januvia.
No savings programs available for Synjardy.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.