| Diabetes Mellitus, Non-Insulin-Dependent
Trijardy XR vs Welchol
Side-by-side clinical, coverage, and cost comparison for diabetes mellitus, non-insulin-dependent.Deep comparison between: Trijardy Xr vs Welchol 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 signalsWelchol has a higher rate of injection site reactions vs Trijardy Xr based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Welchol but not Trijardy Xr, including UnitedHealthcare
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Category
Trijardy Xr
Welchol
At A Glance
Oral
Daily
SGLT2i / DPP-4i / biguanide
Oral
Daily
Bile acid sequestrant
Indications
- Diabetes Mellitus, Non-Insulin-Dependent
- Familial hyperlipidemia
- Familial hypercholesterolemia - heterozygous
- Diabetes Mellitus, Non-Insulin-Dependent
Dosing
Diabetes Mellitus, Non-Insulin-Dependent Individualize starting dose based on current regimen; maximum 25 mg empagliflozin / 5 mg linagliptin / 2,000 mg metformin HCl once daily; take orally once daily with morning meal, swallow whole. Not recommended for initiation if eGFR <45 mL/min/1.73 m2; contraindicated if eGFR <30 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 less than 30 mL/min/1.73 m2)
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis
- Hypersensitivity to empagliflozin, linagliptin, metformin HCl, or any excipient (anaphylaxis, angioedema, exfoliative skin conditions, urticaria, or bronchial hyperreactivity have occurred)
- Serum TG concentrations >500 mg/dL
- History of hypertriglyceridemia-induced pancreatitis
- History of bowel obstruction
Adverse Reactions
Most common (>=5%) Upper respiratory tract infection, urinary tract infection, nasopharyngitis, diarrhea, constipation, headache, gastroenteritis
Serious Lactic acidosis, diabetic ketoacidosis, pancreatitis, volume depletion, genitourinary infections (urosepsis, pyelonephritis, Fournier's gangrene, genital mycotic infections), hypoglycemia with insulin or insulin secretagogues, lower limb amputation, hypersensitivity reactions, vitamin B12 deficiency, severe and disabling arthralgia, bullous pemphigoid, heart failure
Postmarketing Acute pancreatitis (including fatal), mouth ulceration, stomatitis, anaphylaxis, angioedema, exfoliative skin conditions, necrotizing fasciitis of the perineum, urosepsis, pyelonephritis, ketoacidosis, rhabdomyolysis, acute kidney injury, bullous pemphigoid, rash, urticaria, cholestatic and 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
TRIJARDY XR combines three complementary mechanisms: empagliflozin (SGLT2 inhibitor) reduces renal glucose reabsorption and increases urinary glucose excretion; linagliptin (DPP-4 inhibitor) increases active incretin hormones (GLP-1, GIP) to stimulate glucose-dependent insulin release and reduce glucagon; and metformin HCl (biguanide) decreases hepatic glucose production, reduces intestinal glucose absorption, and improves peripheral insulin sensitivity.
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.
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Most Common Insurance
Anthem BCBS
Trijardy Xr
- Covered on 5 commercial plans
- PA (4/12) · Step Therapy (5/12) · Qty limit (11/12)
Welchol
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (9/12)
UnitedHealthcare
Trijardy Xr
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (6/8)
Welchol
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Trijardy Xr
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · Qty limit (3/3)
Welchol
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Trijardy Xr.
No savings programs available for Welchol.
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Trijardy XrView full Trijardy Xr profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.