SYNJARDY XR

EMPAGLIFLOZIN; METFORMIN (EM pa gli FLOE zin; met FOR min) treats type 2 diabetes. It works by decreasing your blood sugar (glucose). Changes to diet and exercise are often combined with this medication.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

Take this medication by mouth with a glass of water. Swallow the tablets whole. Do not cut, crush or chew this medication. Take this medication with food. Follow the directions on the prescription label. Take your doses at regular intervals. Do not take your medication more often than directed. Do not stop taking except on your care team's advice.
A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.
Talk to your care team about the use of this medication in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.

Do not take this medication with any of the following medications:
-Certain contrast medications given before X-rays, CT scans, MRI, or other procedures
-Dofetilide
This medication may also interact with the following medications:
-Acetazolamide
-Alcohol
-Certain antivirals for HIV or hepatitis
-Certain medications for blood pressure, heart disease, irregular heart beat
-Cimetidine
-Dichlorphenamide
-Digoxin
-Diuretics
-Estrogen or progestin hormones
-Glycopyrrolate
-Isoniazid
-Lamotrigine
-Lithium
-Memantine
-Methazolamide
-Metoclopramide
-Midodrine
-Niacin
-Phenothiazines, such as chlorpromazine, prochlorperazine, thioridazine
-Phenytoin
-Ranolazine
-Steroid medications, such as prednisone or cortisone
-Stimulant medications for attention disorders, weight loss, or staying awake
-Thyroid medications
-Topiramate
-Triamterene
-Trospium
-Vandetanib
-Zonisamide

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

Visit your care team for regular checks on your progress.
This medication can cause a serious condition in which there is too much acid in the blood. If you develop nausea, vomiting, stomach pain, unusual tiredness, or breathing problems, stop taking this medication and call your care team right away. If possible, use a ketone dipstick to check for ketones in your urine.
A test called the HbA1C (A1C) will be monitored. This is a simple blood test. It measures your blood sugar control over the last 2 to 3 months. You will receive this test every 3 to 6 months.
Learn how to check your blood sugar. Learn the symptoms of low and high blood sugar and how to manage them.
Always carry a quick-source of sugar with you in case you have symptoms of low blood sugar. Examples include hard sugar candy or glucose tablets. Make sure others know that you can choke if you eat or drink when you develop serious symptoms of low blood sugar, such as seizures or unconsciousness. They must get medical help at once.
Tell your care team if you have high blood sugar. You might need to change the dose of your medication. If you are sick or exercising more than usual, you might need to change the dose of your medication.
Do not skip meals. Ask your care team if you should avoid alcohol. Many nonprescription cough and cold products contain sugar or alcohol. These can affect blood sugar.
This medication may cause ovulation in premenopausal women who do not have regular monthly periods. This may increase your chances of becoming pregnant. You should not take this medication if you become pregnant or think you may be pregnant. Talk with your care team about your birth control options while taking this medication. Contact your care team right away if you think you are pregnant.
If you are going to need surgery, a MRI, CT scan, or other procedure, tell your care team that you are taking this medication. You may need to stop taking this medication before the procedure.
Wear a medical ID bracelet or chain, and carry a card that describes your disease and details of your medication and dosage times.
This medication may cause a decrease in folic acid and vitamin B12. You should make sure that you get enough vitamins while you are taking this medication. Discuss the foods you eat and the vitamins you take with your care team.

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

Side effects that you should report to your care team as soon as possible:
-Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
-Dehydration—increased thirst, dry mouth, feeling faint or lightheaded, headache, dark yellow or brown urine
-Diabetic ketoacidosis (DKA)—increased thirst or amount of urine, dry mouth, fatigue, fruity odor to breath, trouble breathing, stomach pain, nausea, vomiting
-Genital yeast infection—redness, swelling, pain, or itchiness, odor, thick or lumpy discharge
-High lactic acid level—muscle pain or cramps, stomach pain, trouble breathing, general discomfort and fatigue
-Infection or redness, swelling, tenderness, or pain in the genitals, or area from the genitals to the back of the rectum
-Low vitamin B12 level—pain, tingling, or numbness in the hands or feet, muscle weakness, dizziness, confusion, trouble concentrating
-Urinary tract infection (UTI)—burning when passing urine, passing frequent small amounts of urine, bloody or cloudy urine, pain in the lower back or sides
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
-Diarrhea
-Gas
-Headache
-Metallic taste in mouth
-Nausea

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Keep out of the reach of children and pets.
Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medication after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.