Alternatives to Xigduo XR If You Can't Fill Your Prescription

Running out of Xigduo XR — or not being able to fill it at all — is stressful, especially when you depend on it to manage your blood sugar, protect your heart, or slow kidney disease progression. The good news: several strong alternatives exist, and with your doctor's guidance, switching doesn't have to be complicated.

This guide covers your best options when you can't fill Xigduo XR, ranked from closest match to more distant alternatives.

Option 1: Generic Dapagliflozin/Metformin ER (Same Drug, Lower Cost)

The closest possible alternative is the generic version of Xigduo XR itself. In early 2026, the FDA approved generic dapagliflozin/metformin hydrochloride extended-release tablets from manufacturers including Aurobindo and Lupin. These are bioequivalent to brand Xigduo XR — the same active ingredients, same dosage forms, same therapeutic effect.

If your pharmacy has the brand but not the generic, or vice versa, ask your pharmacist to substitute. If neither is available, this is the first call to make to a different pharmacy. Using a GoodRx coupon, the generic can cost as little as $168 for a 30-day supply — significantly less than the brand's $574+ retail price.

Option 2: Dapagliflozin (Farxiga) + Metformin XR Separately

The exact same two active ingredients in Xigduo XR can be prescribed as two separate pills — Farxiga (or generic dapagliflozin) plus generic metformin extended-release. This is often the most accessible option because generic metformin XR is stocked at virtually every pharmacy, and generic dapagliflozin has been available since 2025.

Taking two pills instead of one is the only real downside. Your doctor can write two separate prescriptions. This approach can also be significantly cheaper — generic dapagliflozin 10 mg plus generic metformin XR 1000 mg costs less than the combination tablet in many cases.

Option 3: Synjardy XR (Empagliflozin/Metformin ER)

Synjardy XR is made by Boehringer Ingelheim and combines empagliflozin — the active ingredient in Jardiance — with extended-release metformin. It works very similarly to Xigduo XR: both are once-daily SGLT2 inhibitor/metformin combinations taken in the morning with food.

Key differences to discuss with your doctor:

Empagliflozin (EMPA-REG OUTCOME trial) was the first SGLT2 inhibitor to show reduced cardiovascular mortality

Dapagliflozin (DAPA-HF, DAPA-CKD trials) has the broadest FDA approvals spanning heart failure and chronic kidney disease

Synjardy XR is often preferred by insurance plans that require step therapy before approving Xigduo XR brand

Cash price is similar to Xigduo XR brand, roughly $550-$750 per month without a coupon

Option 4: Invokamet XR (Canagliflozin/Metformin ER)

Invokamet XR combines canagliflozin (Invokana) with extended-release metformin. It's another once-daily SGLT2 inhibitor/metformin combination tablet, manufactured by Janssen (Johnson & Johnson).

Important note: Invokamet carries a boxed warning for increased risk of lower limb amputation that Xigduo XR and Synjardy do not. Patients with peripheral vascular disease or a history of amputations should discuss this risk carefully with their doctor before switching. Otherwise, canagliflozin offers similar glucose-lowering and cardiovascular benefits.

Option 5: Jardiance (Empagliflozin) Alone

If you can't tolerate metformin or your insurance makes the combination tablets unaffordable, Jardiance (empagliflozin) alone is a strong single-agent option. It won't provide the additional blood sugar-lowering from metformin, but it delivers the SGLT2 inhibitor benefits — including cardiovascular and kidney protection — in a single pill.

Your doctor would need to manage your metformin separately if this is the approach, either continuing generic metformin XR or considering whether to discontinue it based on your blood sugar trends.

Option 6: Segluromet (Ertugliflozin/Metformin)

Segluromet is the newest SGLT2/metformin combination, combining ertugliflozin (Steglatro) with metformin. It's available as a twice-daily tablet. Ertugliflozin has less long-term cardiovascular outcome data than dapagliflozin or empagliflozin — the VERTIS CV trial did not show a significant reduction in major cardiovascular events, though it did show heart failure benefits.

Segluromet may be preferred on certain insurance formularies and is a reasonable option for blood sugar control if cardiovascular or kidney outcome data is less of a priority.

How to Switch: Practical Guidance

Never switch your diabetes medication without talking to your doctor first. Even medications in the same class can affect you differently. Here's a simple process:

Contact your doctor's office and explain that Xigduo XR is unavailable at pharmacies near you.

Ask if they can prescribe dapagliflozin and metformin XR separately, or switch you to a comparable alternative.

Ask your pharmacist to check insurance coverage for any alternative before your doctor submits the prescription.

Monitor your blood sugar more closely for the first 2-4 weeks after switching.

Finding Your Alternative in Stock

Once you and your doctor decide on an alternative, medfinder can help you find which pharmacies near you stock it. Enter your new medication name and dosage, and medfinder will call pharmacies and text you the results — whether you're looking for Synjardy XR, generic dapagliflozin, or metformin XR separately.

Also check out our post on how to save money on Xigduo XR in 2026 for savings options that may apply to your alternatives as well.