| Diabetes Mellitus, Non-Insulin-Dependent

Synjardy vs Welchol

Side-by-side clinical, coverage, and cost comparison for diabetes mellitus, non-insulin-dependent.
Deep comparison between: Synjardy vs Welchol with Prescriber.AI
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Safety signalsWelchol has a higher rate of injection site reactions vs Synjardy based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Welchol but not Synjardy, including UnitedHealthcare
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Synjardy
Welchol
At A Glance
Oral
Once or twice daily
SGLT2 inhibitor / biguanide
Oral
Daily
Bile acid sequestrant
Indications
  • Diabetes Mellitus, Non-Insulin-Dependent
  • Cardiovascular Diseases
  • Congestive heart failure
  • Chronic Kidney Diseases
  • Familial hyperlipidemia
  • Familial hypercholesterolemia - heterozygous
  • Diabetes Mellitus, Non-Insulin-Dependent
Dosing
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.
Familial hyperlipidemia, Familial hypercholesterolemia - heterozygous 3.75 grams daily; 6 tablets once daily or 3 tablets twice daily with a meal and liquid, or one packet oral suspension once daily with a meal.
Diabetes Mellitus, Non-Insulin-Dependent 3.75 grams daily; 6 tablets once daily or 3 tablets twice daily with a meal and liquid, or one packet oral suspension once daily with a meal.
Contraindications
  • 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
  • Serum TG concentrations >500 mg/dL
  • History of hypertriglyceridemia-induced pancreatitis
  • History of bowel obstruction
Adverse Reactions
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
Most common (>=2%) Constipation, dyspepsia, nausea, asthenia, pharyngitis, myalgia (primary hyperlipidemia); constipation, dyspepsia, nausea, hypertension, back pain (type 2 diabetes)
Serious Hypertriglyceridemia, pancreatitis, gastrointestinal obstruction, vitamin K and fat-soluble vitamin deficiencies
Postmarketing Bowel obstruction, dysphagia, esophageal obstruction, fecal impaction, pancreatitis, hypertriglyceridemia, increased transaminases
Pharmacology
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.
Colesevelam hydrochloride is a non-absorbed bile acid sequestrant that binds bile acids in the intestine, depletes the bile acid pool, upregulates hepatic cholesterol 7-alpha-hydroxylase, increases LDL receptor expression, and thereby lowers serum LDL-C; the mechanism by which it improves glycemic control in type 2 diabetes is unknown.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Synjardy
  • Covered on 5 commercial plans
  • PA (0/12) · Step Therapy (9/12) · Qty limit (11/12)
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Welchol
  • Covered on 5 commercial plans
  • PA (10/12) · Step Therapy (0/12) · Qty limit (9/12)
View full coverage details ›
UnitedHealthcare
Synjardy
  • Covered on 4 commercial plans
  • PA (0/8) · Step Therapy (0/8) · Qty limit (7/8)
View full coverage details ›
Welchol
  • Covered on 4 commercial plans
  • PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
View full coverage details ›
Humana
Synjardy
  • Covered on 0 commercial plans
  • PA (1/3) · Step Therapy (1/3) · Qty limit (3/3)
View full coverage details ›
Welchol
  • Covered on 0 commercial plans
  • PA (1/3) · Step Therapy (0/3) · Qty limit (2/3)
View full coverage details ›
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Synjardy.
No savings programs available for Welchol.
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SynjardyView full Synjardy profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.