Synjardy has a boxed warning for the risk of lactic acidosis. This is a serious warning from the Food and Drug Administration (FDA).

Synjardy includes a drug called metformin. While rare, people who take metformin can develop a serious condition called lactic acidosis. This is a buildup of too much lactic acid in your body. This condition has sometimes resulted in death. It needs to be treated immediately in a hospital. Symptoms of lactic acidosis can include trouble breathing, confusion, fruity smelling breath, and jaundice. (This is a yellowing of your skin and the whites of your eyes.) If you experience these symptoms, you should call 911 or seek emergency medical treatment immediately.

Due to this risk, doctors typically will not prescribe Synjardy in people who are more likely to get lactic acidosis. Those with liver or kidney problems are more likely to develop this condition.

If you have type 2 diabetes, your doctor might suggest Synjardy as a treatment option.

It’s a prescription medication used along with a balanced diet and exercise to help lower blood sugar in adults with type 2 diabetes.

It also reduces the risk of death from heart attack and stroke in adults with type 2 diabetes and cardiovascular disease. (This is disease related to the heart and blood vessels.)

Synjardy comes as a tablet you take by mouth. It also comes as an extended-release tablet called Synjardy XR. Both contain the active drugs empagliflozin and metformin. (These are the ingredients that make the drug work.) Metformin belongs to a group of drugs known as biguanides. Empagliflozin is in a drug group called SGLT2 inhibitors.

This article describes the dosages of Synjardy, as well as its forms, strengths, and how to take it. To learn more about Synjardy, see this in-depth article.

Note: This article covers Synjardy’s typical dosages, which are provided by the drug’s manufacturer. But when using Synjardy, always take the dosage your doctor prescribes.

This section covers the typical dosages of Synjardy and Synjardy XR.

What are the forms of Synjardy?

Synjardy comes as a tablet you swallow whole. Synjardy XR is an extended-release tablet that you also swallow whole.

What strengths does Synjardy come in?

Synjardy comes in the following strengths:

  • 5 milligrams (mg) empagliflozin and 500 mg metformin
  • 5 mg empagliflozin and 1,000 mg metformin
  • 12.5 mg empagliflozin and 500 mg metformin
  • 12.5 mg empagliflozin and 1,000 mg metformin

Synjardy XR comes in the following strengths:

  • 5 mg empagliflozin and 1,000 mg metformin
  • 10 mg empagliflozin and 1,000 mg metformin
  • 12.5 mg empagliflozin and 1,000 mg metformin
  • 25 mg empagliflozin and 1,000 mg metformin

What are the typical dosages of Synjardy and Synjardy XR?

The information below describes dosages that are commonly used or recommended. But be sure to take the dosage your doctor prescribes for you. They will determine the best dosage to fit your needs.

You’ll take Synjardy by mouth twice daily. If you’re prescribed Synjardy XR, you’ll take that once daily.

Starting dose

You’ll typically take the dose of Synjardy that has the right starting dose of both empagliflozin and metformin for your condition. If you’re already taking empagliflozin or metformin, your doctor will prescribe a dose of Synjardy that contains the same amount of that drug.

If you already take metformin, your doctor will likely start you on a tablet that contains:

  • 10 mg of empagliflozin per day
  • a similar total daily dose of metformin to what you’re currently taking

If you already take empagliflozin, your doctor will likely start you on a tablet that contains:

  • 1,000 mg of metformin per day
  • a similar total daily dose of empagliflozin to what you’re currently taking

If you’re taking metformin and empagliflozin separately, your doctor will switch you to the appropriate Synjardy dosage.

Your doctor will also determine the best daily dose for you if they switch you from Synjardy to Synjardy XR.

Maximum dose

The Synjardy maximum dose is 12.5 mg empagliflozin and 1,000 mg metformin taken twice daily.

The Synjardy XR maximum dose is 25 mg empagliflozin and 2,000 mg metformin taken once daily. (In this case, it’s taken as two 12.5-mg empagliflozin and 1,000-mg metformin strength tablets once daily.)

Is Synjardy taken long term?

Yes, Synjardy is typically taken as a long-term treatment. If you and your doctor determine that Synjardy is safe and effective for you, you’ll likely take it long term.

If you miss your dose of Synjardy, take it right when you remember. But if it’s close to the time for your next dose, just take the next dose. Do not take a double dose. If you’re not sure whether to take the missed dose or not, talk with your doctor or pharmacist.

If you need help remembering to take your dose of Synjardy on time, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone.

The dosage of Synjardy you’re prescribed may depend on several factors. These include:

  • the type and severity of the condition you’re using it to treat
  • your age
  • the form of Synjardy you’re taking
  • other conditions you may have

Synjardy is a tablet you swallow whole. You should take Synjardy with food to avoid belly pain.

You’ll take Synjardy twice daily. If your doctor prescribes Synjardy XR, you’ll take it once daily in the morning with food.

If you have trouble swallowing tablets, see this article for tips on how to make it easier.

For information on Synjardy expiration, storage, and disposal, see this article.

Accessible drug containers and labels

If you find it hard to read the prescription label on your medication, tell your doctor or pharmacist. Some pharmacies may provide medication labels that:

  • have large print or use braille
  • feature a code you can scan with a smartphone to change the text to audio

Your doctor or pharmacist may be able to recommend pharmacies that offer these accessibility features if your current pharmacy doesn’t.

If you have trouble opening medication bottles, let your pharmacist know. They may be able to supply Synjardy in an easy-open container. Your pharmacist may also have some tips that can help make it simpler to open the drug’s container.

Do not take more Synjardy than your doctor prescribes. Taking more than this can lead to serious side effects. The manufacturer has provided overdose information about metformin, one of the two active ingredients in Synjardy.

Symptoms of metformin overdose

Symptoms caused by an overdose are the symptoms of lactic acidosis and can include:

What to do in case you take too much Synjardy

Call your doctor right away if you think you’ve taken too much Synjardy. You may need a procedure in the hospital to help clear the drug from your body. You can also call 800-222-1222 to reach the American Association of Poison Control Centers or use its online resource. If you have severe symptoms, call 911 (or your local emergency number) immediately or go to the nearest emergency room.

The sections above describe the typical dosages provided by the drug manufacturer. If your doctor recommends Synjardy for you, they’ll prescribe the dosage that’s right for you.

Remember, you should not change your dosage of Synjardy without your doctor’s recommendation. Only take Synjardy as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.

Here are some examples of questions you may want to ask your doctor about your Synjardy dosage:

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Q:

Can I switch between Synjardy and separate pills for metformin and Jardiance if I have some left over?

Anonymous

A:

No, you should not switch between these pills. Synjardy was created to be taken as a combination. If your doctor prescribes Synjardy, you should stop taking your metformin and Jardiance. If you have questions about your Synjardy dosage or how to take your tablets, talk with your doctor or pharmacist.

Dena Westphalen, PharmDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.