Short answer: Both contain empagliflozin and linagliptin.12 Trijardy XR adds extended-release metformin, so it carries a boxed warning for lactic acidosis and a stricter kidney limit for starting. Glyxambi has no boxed warning. Both are taken once each morning and held 3 days before surgery with long fasting. Neither label reports a trial of one product against the other.
| Trijardy XR | Glyxambi | |
|---|---|---|
| What is in it | Empagliflozin, linagliptin and extended-release metformin1 | Empagliflozin and linagliptin2 |
| Approved for | Blood sugar control in adults with type 2 diabetes; the empagliflozin part also lowers heart death in adults with established heart disease1 | The same two uses2 |
| How taken | Once daily with a morning meal, swallowed whole; two strengths are taken as two tablets1 | Once daily in the morning, with or without food2 |
| Maximum daily dose | Empagliflozin 25 mg, linagliptin 5 mg and metformin 2,000 mg1 | Empagliflozin 25 mg and linagliptin 5 mg2 |
| Kidney limits | Starting not recommended with an eGFR below 45; not used below 301 | Not recommended with an eGFR below 302 |
| Before surgery | Held at least 3 days, if possible1 | Held at least 3 days, if possible2 |
| Side effects in label trials | 52 weeks: upper respiratory infection 10.3% and 8.0%, urinary tract infection 9.6% and 10.2%1 | Up to 52 weeks: urinary tract infection 12.5% and 11.4%, upper respiratory infection 7.0%2 |
| Missed dose | Take as soon as possible; do not double1 | Take as soon as possible; do not double2 |
| Boxed warning | WARNING: LACTIC ACIDOSIS1 | None2 |
The Trijardy XR label's main trial gave empagliflozin 10 or 25 mg with linagliptin 5 mg "as a fixed dose combination tablet" to people already on metformin, and compared it with each drug alone. At 24 weeks the pair lowered HbA1c more than either part alone. The label does not name Glyxambi.1 The side-effect table in each label comes from its own trials. These numbers come from separate trials with different people, lengths and methods, so they are not a head-to-head comparison.
Both labels list the empagliflozin and linagliptin warnings: ketoacidosis even with blood sugar below 250 mg/dL, pancreatitis, fluid loss, urinary and genital infections including Fournier's gangrene, lower limb amputation, severe joint pain, bullous pemphigoid and heart failure seen with two other DPP-4 inhibitors.12 Trijardy XR adds the metformin warnings: lactic acidosis, stopping around some contrast scans, and lower vitamin B12, with blood counts checked yearly and B12 every 2 to 3 years.1
Which, if either, fits is for your prescriber. More detail: Trijardy XR side effects, Glyxambi side effects, the Trijardy XR and Glyxambi dosing schedules and Glyxambi vs Janumet: how do the two diabetes combination tablets differ?.