Synjardy XR (Empagliflozin/Metfromin hcl)

Do’s

• Before starting to take Synjardy XR, read the Medication Guide provided by your pharmacist and consult your healthcare provider if you have any questions. 
• The dosage of Synjardy XR is based on your medical condition, response to treatment, and other medications you may be taking. Your healthcare provider may direct you to start this medication at a low dose and gradually increase your dose to reduce the risk of side effects such as diarrhea and nausea.
• Synjardy XR should be taken by mouth as directed by your healthcare provider, usually once daily with the morning meal. Swallow the tablets whole.
• Drink plenty of fluids while taking this medication unless otherwise directed by your healthcare provider.
• Take this medication regularly at the same time each day to get the most benefit from it. 
• If a dose of Synjardy XR is missed, it should be taken as soon as remembered.
• Follow your healthcare provider's instructions carefully and inform them if your condition does not improve or worsens (e.g. if your blood sugar is too high or too low).

Don’ts

• Do not crush, dissolve, or chew the tablets, as doing so can release all of the drug at once, increasing the risk of side effects. 
• Do not double the next dose to catch up on the missed dose.

• Lactic acidosis
• Digestive side effects, such as diarrhea, nausea, vomiting, indigestion, flatulence, and abdominal discomfort
• Urinary tract infections
• Genital yeast infections
• Low blood sugar, leading to drowsiness and dizziness

This is not an exhaustive list of possible side effects, and others may occur. Consult your healthcare provider for additional information about side effects.

There is a risk of metformin-associated lactic acidosis, particularly in patients with certain high-risk conditions. If lactic acidosis is suspected, immediate discontinuation of Synjardy XR and the institution of general supportive measures in a hospital setting is recommended. Prompt hemodialysis may also be necessary.

Prior to undergoing surgery or any type of x-ray or CT scan using a dye injected into the veins, it may be necessary to temporarily stop taking Synjardy XR. Inform your healthcare providers in advance about the use of this medication in such situations.

Before initiating Synjardy XR and as clinically indicated, renal function should be assessed. Additionally, in patients with volume depletion, this condition should be corrected before starting Synjardy XR.

Synjardy XR is contraindicated in patients with severe renal impairment (eGFR less than 30 mL/min/1.73 m2) or in patients on dialysis. It should also be discontinued at the time of, or prior to, an iodinated contrast imaging procedure in certain patient groups.

Synjardy XR may interact with other drugs. Provide healthcare providers with a comprehensive list of all medicines, herbs, non-prescription drugs, or dietary supplements being used.

Synjardy XR is not recommended for use to improve glycemic control in patients with type 1 diabetes mellitus. 

Consult a healthcare provider before taking any drug, changing any diet, or commencing or discontinuing any course of treatment. For more detailed information, refer to the full prescribing information for Synjardy XR or consult your healthcare provider.