Janumet, Synjardy, and More: 7 Metformin Combinations to Consider for Diabetes

If you’re living with Type 2 diabetes, metformin is often one of the first medications you’re prescribed. It helps reduce the amount of sugar (glucose) your body absorbs and makes. And it also helps your body use insulin more effectively. But sometimes metformin isn’t enough.

Your healthcare provider may decide to prescribe another oral diabetes medication along with metformin. But all of these pills and prescription costs can start to add up. If this sounds like your situation, combination pills may be an option to consider.

Many combination diabetes pills contain metformin with another medication. For some people, these products mean fewer daily pills and lower costs. But what should you know before making the switch? Let’s review a few popular combinations.

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1. Janumet

Janumet (sitagliptin/metformin) has been available in the U.S. for at least 15 years. It combines sitagliptin (Januvia) and metformin into a twice-daily tablet. Janumet XR is the extended-release (ER) version that you take once a day.

Sitagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor, or simply a “gliptin” medication. It works by blocking the hormone DPP-4, which helps your pancreas release insulin. It also prevents your liver from making extra glucose. This combined action works to help balance your blood glucose.

If you aren’t able to achieve your blood sugar goals on metformin alone, your healthcare provider may add on a DPP-4 inhibitor. These medications can be a good option for people who want to minimize the risk of low blood sugar (hypoglycemia).

Availability and ways to save 

Janumet and Janumet XR are only available as brand-name medications. The same is true for Januvia. Lower-cost generics for all three medications may be available mid-2026.

Until then, you may be able to save on your Janumet or Janumet XR prescription with a copay savings card from the manufacturer. If you’re eligible, you could pay as little as $5 for your prescription. Patient assistance programs are also available that provide the medications free of charge for eligible people who are uninsured or underinsured.

2. Jentadueto

Jentadueto (linagliptin/metformin) is similar to Janumet. It combines a DPP-4 inhibitor with metformin. The DPP-4 inhibitor in this combination is linagliptin (Tradjenta). It’s also taken twice daily. The ER version, Jentadueto XR, is taken once daily.

There doesn’t appear to be significant differences between how well Janumet and Jentadueto work. So, your healthcare provider will decide which is best for you based on availability, cost, and other factors.

Availability and ways to save

Jentadueto and Jentadueto XR are both brand-name medications. It’ll likely be several years before generic versions are available. Tradjenta is also only available as a brand-name product.

There are a few ways to save on Jentadueto and Jentadueto XR in the meantime. For example, you can pay as little as $10 for your prescription with a copay savings card. A patient assistance program is also available.

3. Kombiglyze XR

Our final DPP-4 inhibitor combination is Kombiglyze XR (saxagliptin/metformin). It combines saxagliptin (Onglyza) with metformin in a once-daily ER tablet. Kombiglyze XR works the same way as Janumet and Jentadueto.

Your healthcare provider will determine if Kombiglyze XR is a good option for you. One factor they may consider is drug interactions. Certain medications can increase the amount of saxagliptin in your blood. When taken together, these combinations require a lower Kombiglyze XR dose. Other DPP-4 inhibitors don’t have these same interactions.

Availability and ways to save

Kombiglyze XR is only available as a brand-name medication. But a generic version may hit the market as soon as 2023. This is also the case for Onglyza.

Before a generic is available, there are other ways to save on Kombiglyze XR. For example, you could pay as little as $0 per month with a copay savings card. Or you may qualify for the medication’s patient assistance program.

4. Synjardy

Synjardy (empagliflozin/metformin) is a combination of empagliflozin (Jardiance) and metformin. It’s typically taken twice daily. The ER version, called Synjardy XR, is taken once daily.

Empagliflozin blocks a protein called sodium-glucose cotransporter 2 (SGLT2) in the kidneys. This results in your kidneys removing excess glucose and sodium through your urine. Empagliflozin and similar medications are referred to as SGLT2 inhibitors or “flozin” medications.

Beyond controlling diabetes, SGLT2 inhibitors have other uses. Empagliflozin, in particular, also has heart-related benefits. If you have heart disease, your healthcare provider may add empagliflozin to help lower your risk of death from heart disease.

Availability and ways to save

Both Synjardy and Synjardy XR are only available as brand-name medications. Generic versions of both medications have been approved, but it’ll likely be a few years before they’re available. Jardiance also doesn’t have a generic version.

If you’re eligible, you could pay as little as $10 for your Synjardy or Synjardy XR prescription with a copay savings card. Patient assistance programs are also available.

5. Xigduo XR

Next, we have Xigduo XR (dapagliflozin/metformin). It combines dapagliflozin (Farxiga) with metformin in a once-daily ER tablet.

Like empagliflozin, dapagliflozin is an SGLT2 inhibitor. But it has different heart-related benefits, so it may be preferred in certain situations. For example, if you have heart disease (or heart disease risk factors), it can help lower the risk of hospitalization from heart failure. And if you have kidney problems, dapagliflozin can help them from getting worse.

Availability and ways to save

Xigduo XR is only available as a brand-name medication. And we still have several years before a generic version will be available. Farxiga doesn’t have a generic version, either.

Xigduo XR’s manufacturer offers a copay savings card that can make your prescription more affordable. If you’re eligible, you could pay as little as $0 for your prescription. The same is true if you qualify for their patient assistance program.

6. Invokamet

Invokamet (canagliflozin/metformin) is another SGLT2 inhibitor combined with metformin in a twice-daily tablet. In this case, canagliflozin (Invokana) is the SGLT2 inhibitor. It’s also available as a once-daily ER product called Invokamet XR.

Like the other SGLT2 inhibitors we’ve covered, canagliflozin has additional benefits. If you have heart disease, your healthcare provider may add it to help lower your risk of heart attack and stroke. Like dapagliflozin, canagliflozin also has kidney-related benefits.

Availability and ways to save

Invokamet and Invokamet XR are only available as brand-name medications. This is also the case for Invokana. It may be several years before we’ll see generic versions available.

If you’re eligible, you could pay as little as $0 for your Invokana or Invokana XR prescription with a copay savings card. A patient assistance program is also available.

7. Segluromet

The last combination pill we’ll review is Segluromet (ertugliflozin metformin). It combines the SGLT2 inhibitor ertugliflozin (Steglatro) with metformin. The combination is similar to Synjardy, Xigduo, and Invokamet. It’s typically taken twice daily.

Ertugliflozin is the newest SGLT2 inhibitor to be approved. It has been studied for potential heart-related benefits, but isn’t approved for additional uses yet.

Availability and ways to save

Segluromet is only available as a brand-name medication. The same is true for Steglatro. Since it has been approved more recently, we won’t see a generic for a while.

Segluromet’s manufacturer has a copay savings card that can help you save on your prescription. If eligible, you could pay as little as $0 per prescription.

Who can benefit from combination diabetes pills?

Combination diabetes pills aren’t right for everyone. But they may be a good fit for you based on a few factors:

• Convenience. You may be able to cut down the number of daily pills you’re taking with a combination product. Several products also have a once-daily dosing option.

• Adherence. Fewer pills may make it easier to stick with your treatment plan.

• Cost. You may be able to save on your prescription costs by paying only one copay, especially if you’re eligible for a copay savings card.

However, you don’t have as much dosing flexibility with combination products. That’s because each pill contains fixed doses of each medication. If you’re not stable on each medication separately, it may be more difficult to switch to a combination product.

If you think you may benefit from a combination diabetes medication, speak with your healthcare provider. They can determine if it’s an option for you.

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Written by:

Brian Leonard, PharmD, BCACP, BCGP

Brian Leonard earned his doctorate in pharmacy from the University of Florida College of Pharmacy and is board certified in Ambulatory Care and Geriatric Pharmacy.

Edited by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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