| Diabetes Mellitus, Non-Insulin-Dependent
Rybelsus vs Synjardy
Side-by-side clinical, coverage, and cost comparison for diabetes mellitus, non-insulin-dependent.Deep comparison between: Ozempic 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 Ozempic based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Synjardy but not Ozempic, including UnitedHealthcare
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Category
Ozempic
Synjardy
At A Glance
Oral
Daily
GLP-1 receptor agonist
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 Starting dose 1.5 mg orally once daily for 30 days (not effective for glycemic control); escalate to 4 mg once daily days 31-60; maintain at 4 mg or increase to 9 mg once daily if additional glycemic control is needed. Take on an empty stomach in the morning with up to 4 oz water; wait at least 30 minutes before eating, drinking, or taking other oral medications.
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
- Personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
- Prior serious hypersensitivity reaction to semaglutide or any excipient in OZEMPIC tablets
- 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%) nausea, abdominal pain, diarrhea, decreased appetite, vomiting, constipation
Serious risk of thyroid C-cell tumors, acute pancreatitis, diabetic retinopathy complications, hypoglycemia with concomitant insulin secretagogues or insulin, acute kidney injury due to volume depletion, severe gastrointestinal reactions, hypersensitivity reactions, acute gallbladder disease, pulmonary aspiration during general anesthesia or deep sedation
Postmarketing acute and necrotizing pancreatitis, ileus, intestinal obstruction, anaphylaxis, angioedema, rash, urticaria, cholecystitis, cholelithiasis requiring cholecystectomy, dizziness, dysesthesia, dysgeusia, headache, pulmonary aspiration, acute kidney injury, alopecia
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
Semaglutide is a GLP-1 receptor agonist (GLP-1 analogue with 94% sequence homology to human GLP-1) that selectively binds to and activates the GLP-1 receptor, stimulating glucose-dependent insulin secretion and inhibiting glucagon secretion to lower blood glucose, with a minor delay in early postprandial gastric emptying; its long half-life results from albumin binding and stabilization against DPP-4 degradation.
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
Ozempic
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (10/12) · Qty limit (11/12)
Synjardy
- Covered on 5 commercial plans
- PA (0/12) · Step Therapy (9/12) · Qty limit (11/12)
UnitedHealthcare
Ozempic
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (8/8)
Synjardy
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (7/8)
Humana
Ozempic
- Covered on 0 commercial plans
- PA (3/3) · 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 Ozempic.
No savings programs available for Synjardy.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.