metformin/empagliflozin
Brand names: Synjardy
Synjardy is a drug that combines empagliflozin and metformin. It helps lower blood sugar in people with type 2 diabetes, along with diet and exercise.
Drug Pricing (NADAC)
Brand Price
$9.77/unit
Generic Available
No
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
Synjardy is used to treat type 2 diabetes in adults and children 10 years and older.
Common side effects
Urinary tract infections, Yeast infections of the vagina, Diarrhea
Key warnings
Metformin can cause a serious side effect called lactic acidosis.
How It Works
Synjardy contains two medicines that work in different ways. Empagliflozin helps your kidneys remove sugar from your blood through urine. Metformin lowers the amount of sugar your liver makes and helps your body use insulin better.
How to Take It
Take Synjardy twice daily with meals. If you are taking Synjardy XR, take it once a day with a morning meal. Swallow the tablets whole; do not crush, split, or chew them. Your doctor may adjust your dose over time to find what works best for you. Make sure to have your kidney function and volume status checked before starting Synjardy.
Pregnancy & Breastfeeding
Synjardy may harm your unborn baby, especially during the second and third trimesters. Talk to your doctor if you are pregnant or plan to become pregnant. It is not recommended to breastfeed while taking Synjardy.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and take your next dose at the regular time.
Storage
Store Synjardy at room temperature, between 68°F and 77°F.
Side Effects (from patient reports)
Based on 171,728 FDA adverse event reports.
Serious Warnings
Metformin can cause a serious side effect called lactic acidosis. This is a buildup of lactic acid in your blood. It can be life-threatening. Get medical help right away if you have symptoms like feeling very weak, muscle pain, trouble breathing, stomach pain, dizziness, or a slow or irregular heartbeat.
Known Drug Interactions
Drugs that Reduce Metformin Clearance Clinical Impact Concomitant use of drugs that interfere with common renal tubular transport systems involved in the renal elimination of metformin (e.g., organic cationic transporter-2 [OCT2] / multidrug and toxin extrusion [MATE] inhibitors such as ranolazine, vandetanib, dolutegravir, and cimetidine) could increase systemic exposure to metformin and may increase the risk for lactic acidosis [see Clinical Pharmacology (12.3) ] . Alcohol Clinical Impact Alcohol is known to potentiate the effect of metformin on lactate metabolism. ( 7 ) Drugs that Reduce...
Mechanism: Taking substances that interfere with how the kidneys remove metformin can cause the drug to build up to dangerous levels. This increases the risk of a serious condition where too much acid builds up in the blood.
What to do: Your doctor may need to adjust your dose and check your kidney function regularly.
Drugs that Reduce Metformin Clearance Clinical Impact Concomitant use of drugs that interfere with common renal tubular transport systems involved in the renal elimination of metformin (e.g., organic cationic transporter-2 [OCT2] / multidrug and toxin extrusion [MATE] inhibitors such as ranolazine, vandetanib, dolutegravir, and cimetidine) could increase systemic exposure to metformin and may increase the risk for lactic acidosis [see Clinical Pharmacology (12.3) ] .
Mechanism: Dolutegravir blocks the specific pumps in the kidneys that remove metformin from the body. This can cause metformin levels to rise, increasing the risk of a dangerous acid buildup.
What to do: Your doctor should monitor you closely and may need to lower your metformin dose.
Drugs that Reduce Metformin Clearance Clinical Impact Concomitant use of drugs that interfere with common renal tubular transport systems involved in the renal elimination of metformin (e.g., organic cationic transporter-2 [OCT2] / multidrug and toxin extrusion [MATE] inhibitors such as ranolazine, vandetanib, dolutegravir, and cimetidine) could increase systemic exposure to metformin and may increase the risk for lactic acidosis [see Clinical Pharmacology (12.3) ] .
Mechanism: Ranolazine stops the kidneys from filtering metformin out of the blood as quickly as they should. This can lead to high levels of metformin and a higher risk of side effects.
What to do: Your healthcare provider may need to adjust your dosage and watch for signs of metformin toxicity.
Drugs that Reduce Metformin Clearance Clinical Impact Concomitant use of drugs that interfere with common renal tubular transport systems involved in the renal elimination of metformin (e.g., organic cationic transporter-2 [OCT2] / multidrug and toxin extrusion [MATE] inhibitors such as ranolazine, vandetanib, dolutegravir, and cimetidine) could increase systemic exposure to metformin and may increase the risk for lactic acidosis [see Clinical Pharmacology (12.3) ] .
Mechanism: Cimetidine interferes with the way your kidneys get rid of metformin, which can cause the drug to stay in your body longer. This increases the chance of developing a serious condition called lactic acidosis.
What to do: Your doctor should monitor you for side effects and may consider changing your dose.
7 DRUG INTERACTIONS See Table 4 for clinically relevant interactions with SYNJARDY or SYNJARDY XR. Table 4 Clinically Relevant Interactions with SYNJARDY or SYNJARDY XR Carbonic Anhydrase Inhibitors Clinical Impact Topiramate or other carbonic anhydrase inhibitors (e.g., zonisamide, acetazolamide or dichlorphenamide) frequently causes a decrease in serum bicarbonate and induce non-anion gap, hyperchloremic metabolic acidosis. Concomitant use of these drugs with SYNJARDY or SYNJARDY XR may increase the risk of lactic acidosis.
Mechanism: Taking certain medications like topiramate along with your diabetes medicine can lower your blood's ability to balance acid. This increases the risk of a serious condition called lactic acidosis.
What to do: Your doctor should monitor your blood work closely to check for signs of too much acid.
Common Questions
What should I do if I experience severe stomach pain?
Can I drink alcohol while taking Synjardy?
Will Synjardy cause me to lose weight?
How often will my doctor check my kidneys?
Can Synjardy be used for type 1 diabetes?
What if I need surgery?
Does Synjardy interact with other medications?
What are the symptoms of low blood sugar?
How does Synjardy affect my heart?
Can children take Synjardy?
What are the common side effects of metformin/empagliflozin?
Does metformin/empagliflozin interact with other medications?
What drug class is metformin/empagliflozin?
Is metformin/empagliflozin safe during pregnancy?
Related Medications in Biguanide / SGLT2 Combination
Other drugs grouped near metformin/empagliflozin — same-class peers and common alternatives.
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bromocriptine
Cycloset
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canagliflozin
Invokana
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Compare with metformin/empagliflozin →
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What the FDA Data Shows for metformin/empagliflozin
The FDA label for metformin/empagliflozin (sold under brand names such as Synjardy) classifies it as a prescription-only medication in the Biguanide / SGLT2 Combination class. Synjardy is used to treat type 2 diabetes in adults and children 10 years and older. Official labeling lists 10 commonly reported side effects, including Urinary tract infections, Yeast infections of the vagina, Diarrhea.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 171,728 voluntary reports. The database also lists 9 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. NADAC pricing from CMS.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: January 30, 2026
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages