Trijardy XR is a combination medication used with diet and exercise to help lower blood sugar in adults with Type 2 diabetes (T2D). It combines empagliflozin (a SGLT2 inhibitor), linagliptin (a DPP-4 inhibitor), and metformin (a biguanide) into a single tablet. One of these, empagliflozin, also lowers the risk of death from heart problems in people with T2D and heart disease. The dosage of Trijardy XR depends on the doses of your previous diabetes medications, but typically take it once daily with breakfast. Some common side effects include urinary tract infection (UTI) and diarrhea.
Type 2 diabetes (T2D) in adults (when taken along with nutritious diet and regular exercise)
To lower risk of death from heart problems in adults with T2D and heart disease
Trijardy XR is a combination of three diabetes medications that work together to lower your blood sugar:
Empagliflozin is a sodium glucose cotransporter 2 (SGLT2) inhibitor. It allows your body to get rid of excess sugar through the urine by lowering the amount of sugar that gets absorbed back into your kidneys.
Linagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor that raises the amount of insulin your body makes.
Metformin is a biguanide that lowers the amount of sugar your liver makes, lowers the amount of sugar your stomach absorbs, and helps you respond better to insulin.
Source: DailyMed
Side effects that you should report to your care team as soon as possible:
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
Three medications combined into one pill for convenience
Taken once daily
Can lower the risk of death from heart disease for people with both Type 2 diabetes and heart problems
Must be taken with food
Still need to continue proper diet and exercise routine
Not a good option for people with liver or severe kidney problems
Take Trijardy XR in the morning with a meal to lower the chance of upset stomach. Make sure to continue a healthy diet and exercise routine to get the best results.
Swallow Trijardy XR whole. Don't split, crush, dissolve, or chew the tablets. Doing so can cause the medication to be released too fast in your body, which can raise your risk of side effects.
Drink enough fluids while taking Trijardy XR to avoid getting dehydrated. Dehydration can raise the risk of low blood pressure, make kidney problems worse, and can make you feel dizzy, faint, lightheaded, or weak.
It's best to avoid drinking alcohol while taking Trijardy XR because doing so can raise the risk of lactic acid or ketones building up in your body, which can be life-threatening.
Stomach upset is one of the side effects of Trijardy XR, but it could also be a sign of more serious issues, such as pancreatitis (inflammation of the pancreas) or ketoacidosis (buildup of ketones in your body). If you have other symptoms along with your stomach pain, such as shortness of breath, nausea, vomiting, and back pain, or if your stomach pain is severe and doesn't go away, stop taking Trijardy XR and let your prescriber know right away.
Talk with your healthcare team if you're pregnant or breastfeeding. More research is needed to understand how Trijardy XR might affect babies during pregnancy or nursing. Your care team can talk with you about safer options for treating high blood sugar levels during pregnancy or while breastfeeding.
Let your prescriber know right away if you're eating less, especially during an illness or fasting, or if you lose more fluids, especially during vomiting, diarrhea, or excessive sweating. These conditions can raise your risk of serious side effects, so your prescriber might have you stop Trijardy XR temporarily.
Tell your prescriber if your body is going through stress, such as fever, injury, infection, or surgery because your dose of Trijardy XR might need to be adjusted.
If you're getting an X-ray procedure done with dye or contrast, or having a major surgery done, you might need to stop taking Trijardy XR temporarily. Ask your healthcare team for instructions on how and when to stop this medication.
Trijardy XR can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Kidney or liver problems | Age 65 or older | Use of contrast dye | Fasting from food or fluids | Low oxygen | Drinking alcohol | Dehydration | Taking other medications that can cause lactic acidosis
Some people taking metformin, one of the medications in Trijardy XR have reported lactic acidosis. This is a condition when lactic acid builds up in your blood. It can lead to serious problems, such as dangerously low body temperature, low blood pressure, low heart rate, and death. Get emergency medical help if you have symptoms of lactic acidosis, which include feeling unwell, muscle pain, difficulty breathing, slow or irregular heartbeat, sleepiness, and feeling cold.
Risk factors: History of pancreatitis | History of alcoholism | Kidney problems | Gallstones | High triglyceride (a type of fat) levels
Linagliptin, one of the medications in Trijardy XR, might raise the risk for inflammation (or swelling) of the pancreas (pancreatitis). Some common symptoms of an inflamed pancreas are upper stomach pain, nausea, and vomiting. If you start to feel any of these symptoms, contact your prescriber right away.
Risk factors: Taking high doses | Lowering your insulin dose | Sudden fever | Lower calorie intake | Surgery | Pancreas problems | Drinking too much alcohol | Fasting for long periods of time
Though rare, empagliflozin in Trijardy XR can raise the risk for a serious condition called ketoacidosis, This is when your body produces high levels of ketones. Stop taking this medication and seek medical help right away if you start experiencing nausea, vomiting, stomach pain, tiredness, and shortness of breath.
Risk factors: Kidney problems | Older adults | Taking loop diuretics
Empagliflozin, a medication in Trijardy XR, can cause fluid loss, which might lead to low blood pressure or kidney damage. Due to this risk, your prescriber might monitor your kidneys during your treatment. Let your prescriber know if you experience dizziness, lightheadedness, tiredness, blurred vision, low urine production, swelling in the legs, nausea, tiredness, or shortness of breath.
Risk factors: History of urinary tract infections | History of genital yeast infections | Uncircumcised males
Trijardy XR can raise the risk of urinary tract infections, genital yeast infections, and flesh-eating bacterial infections in the genital area (called Fournier's gangrene). Fournier's gangrene is a serious, life-threatening infection that can require hospitalization, surgery, and can lead to death. Let your prescriber know right away if you experience symptoms of a urinary tract infection (e.g., pain or burning while urinating, urinating often, blood in your urine, or itching), or genital infections (e.g., fever or itching, pain, tenderness, redness, or swelling in the genital area). Get emergency medical help right away if you develop pain, tenderness, swelling, or redness around your anus or genitals, as well as a fever above 100.4ºF or if you feel very weak, tired, or uncomfortable.
Risk factors: Insulin use | Taking sulfonylureas or glinides | Older adults | Alcohol use | Malnourished
Trijardy XR can cause low blood sugar when taken together with insulin or medications that raise insulin levels (e.g., sulfonylureas or glinides). Symptoms of low blood sugar include headache, sleepiness, hunger, irritation, dizziness, confusion, sweating, shakiness, weakness, or fast heartbeat. Your prescriber might lower the dose of your medications that affect your insulin levels to lower the risk of low blood sugar.
Risk factors: History of heart problems or kidney problems
Linagliptin in Trijardy XR might raise your risk of heart failure, especially in people who have a history of heart or kidney problems. Let your prescriber know if you have shortness of breath, sudden weight gain, or swelling of the feet.
Risk factors: Low vitamin B12 or calcium intake or absorption
Metformin in Trijardy XR can lower your vitamin B12 levels, but your levels can usually return to normal if you start a vitamin B12 supplement, or if you stop taking this medication. Your prescriber might monitor your vitamin B12 levels every 2 to 3 years while you're on this medication.
Trijardy XR might cause severe joint pain, which can go away when the medication is stopped. Joint pain can happen at the start of Trijardy XR or it might show up years after. Tell your care team if you notice any joint pain.
Risk factors: History of amputations | Peripheral artery disease (narrowed blood vessels) | Diabetic foot ulcers
Although rare, some people who took empagliflozin during clinical studies needed foot or leg amputations. The risk for this complication appears higher for people who've previously had an amputation or have blood circulation problems. In studies, the most common reasons for amputations for people who took this medication were peripheral artery disease and diabetic foot ulcers.
Let a healthcare professional know right away if you have any new pain, tenderness, sores, ulcers, or infections on your legs or feet. Your care team can recommend ways to manage these foot problems or treat them before they get worse. If you have diabetes, regularly visit your diabetes care team for foot exams.
Although rare, Trijardy XR might cause serious allergic reactions. Watch out for symptoms of an allergic reaction, including hives, trouble breathing, or swelling in your face or throat.
In some rare cases, people taking linagliptin in Trijardy XR have experienced a condition called bullous pemphigoid, a skin condition that causes large, fluid-filled blisters. This condition might require hospitalization. Stop taking Trijardy XR and let your prescriber know if you develop blisters on your body or if it looks like your skin is breaking down.
Your healthcare team will determine your dose of Trijardy XR based on the doses of your previous diabetes medications.
Adults: Typically, you take your dose by mouth every morning with a meal. Your prescriber might adjust your dose depending on how you respond to the medication. The maximum recommended dose is 25 mg/5 mg/2,000 mg (empagliflozin / linagliptin / metformin) total per day.
Severe kidney problems
End stage kidney disease
Dialysis
High amounts of blood acid in the body (metabolic acidosis), including diabetic ketoacidosis
Type 2 diabetes (T2D) in adults (when taken along with nutritious diet and regular exercise)
To lower risk of death from heart problems in adults with T2D and heart disease
Type 2 diabetes in adults
Type 2 diabetes
Lowering the risk of death due to heart problems in adults with Type 2 diabetes and heart disease
Lowering the risk of hospitalization and death due to heart problems in adults with Type 2 diabetes and heart failure
By signing up, I agree to GoodRx's Terms and Privacy Policy, and to receive marketing messages from GoodRx.
American Diabetes Association. (n.d.). Breastfeeding and diabetes.
American Diabetes Association. (n.d.). Prenatal care.
Baigrie, D., et al. (2023). Bullous pemphigoid. StatPearls.
Boehringer Ingelheim Pharmaceuticals, Inc. (2024). Trijardy XR- empagliflozin, linagliptin, metformin hydrochloride tablet, extended release [package insert]. DailyMed.
Drugs@FDA: FDA-Approved Drugs. (n.d.). Empagliflozin; linagliptin; metformin hydrochloride. U.S. Food and Drug Administration.
Eli Lilly and Company. (2020). US FDA approves only triple-combination tablet with Jardiance® for adults with type 2 diabetes. PRNewswire.
Leslie, S. W., et al. (2023). Fournier gangrene. StatPearls.
Research prescriptions and over-the-counter medications from A to Z, compare drug prices, and start saving.