Short answer: Synjardy combines empagliflozin, the drug in Jardiance, with metformin.12 Jardiance is 10 mg once each morning and is also approved for heart failure and chronic kidney disease in adults. Synjardy is taken twice daily, or once daily as Synjardy XR, and all its uses are in type 2 diabetes. Only Synjardy has a boxed warning, for lactic acidosis.
| Jardiance | Synjardy | |
|---|---|---|
| What it contains | Empagliflozin, an SGLT2 inhibitor1 | Empagliflozin and metformin2 |
| Approved for | Blood sugar in adults and children 10 and older with type 2 diabetes; heart death and hospital stays in adults with heart failure; kidney decline and related outcomes in adults with chronic kidney disease; heart death in adults with type 2 diabetes and heart disease1 | Blood sugar in adults and children 10 and older with type 2 diabetes (Synjardy XR adults only); in adults with type 2 diabetes, heart death with heart disease, heart death and hospital stays with heart failure, and kidney decline with chronic kidney disease2 |
| How taken | 10 mg once daily in the morning, with or without food1 | Synjardy twice daily with meals; Synjardy XR once daily with a morning meal2 |
| Maximum daily dose | 25 mg, for blood sugar control only1 | Empagliflozin 25 mg and metformin 2,000 mg2 |
| Kidney limits | Use for blood sugar not recommended with an eGFR below 301 | Not used with an eGFR below 30; starting not recommended below 452 |
| Side effects in label trials | Pooled trials: urinary tract infection 9.3% on 10 mg vs 7.6% on placebo, female genital yeast infection 5.4% vs 1.5%1 | Same pool, plus added to metformin and a sulfonylurea: low blood sugar 15.6% on 10 mg vs 9.8% on placebo2 |
| Boxed warning | None1 | Lactic acidosis2 |
Both labels carry the empagliflozin warnings: ketoacidosis even with blood sugar below 250 mg/dL, fluid loss and low blood pressure, urinary and genital infections including Fournier's gangrene, low blood sugar with insulin or a sulfonylurea, lower limb amputation and serious allergic reactions.12 Synjardy adds the metformin warnings: lactic acidosis and lower vitamin B12, with stops around some contrast scans.2 Both say to hold it for at least 3 days, if possible, before surgery with long fasting.12
Which, if either, fits is for your prescriber. More detail: Jardiance side effects, Synjardy side effects, the Jardiance and Synjardy dosing schedules, the Jardiance missed-dose page, and Synjardy vs Xigduo XR: how do the two SGLT2 and metformin tablets differ?.