Is Synjardy a Time-Release Product?
Synjardy (empagliflozin/metformin combination) is available in both immediate-release and extended-release formulations—the standard Synjardy contains immediate-release metformin, while Synjardy XR contains extended-release metformin. 1
Formulation Details
Standard Synjardy combines empagliflozin with immediate-release (IR) metformin, requiring twice-daily dosing to maintain therapeutic metformin levels 2, 3
Synjardy XR combines empagliflozin with extended-release metformin, allowing once-daily administration and potentially improving adherence by reducing pill burden 1
The empagliflozin component itself is not extended-release in either formulation—the time-release property applies only to the metformin component in the XR version 2
Clinical Dosing Evidence
Studies demonstrate that empagliflozin 12.5 mg twice daily combined with metformin IR 1,000 mg twice daily produces superior glycemic control compared to once-daily empagliflozin regimens, with HbA1c reductions of -1.9% to -2.1% versus -1.4% with once-daily dosing 3
The twice-daily immediate-release formulation was used in pivotal trials establishing empagliflozin's cardiovascular benefits, including the 38% reduction in cardiovascular death 4, 5
Bioequivalence studies support that the fixed-dose combination tablets (both IR and XR versions) deliver equivalent therapeutic effects to separate component tablets while reducing pill burden 1
Practical Prescribing Considerations
For patients new to metformin or requiring twice-daily dosing: Standard Synjardy (IR formulation) is appropriate and matches the dosing schedule used in cardiovascular outcomes trials 2, 3
For patients preferring once-daily dosing or with adherence concerns: Synjardy XR provides the convenience of extended-release metformin while maintaining empagliflozin's cardiovascular and renal protective effects 1
The choice between formulations should prioritize the metformin component's tolerability—extended-release metformin typically causes fewer gastrointestinal side effects than immediate-release 1