Jardiance (Empagliflozin) Oral: Uses, Side Effects, Dosages - Verywell Health
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What Is Jardiance?
Jardiance (empagliflozin) is a newer treatment option for people aged 18 and over with type 2 diabetes. Jardiance can be used on its own as an alternative to another diabetes treatment called metformin or in combination with metformin or other diabetes drugs. It is an oral prescription medication that comes in tablet form.
This medication belongs to a class of drugs called sodium-glucose co-transporter 2 (SGLT-2) inhibitors. It inhibits the reabsorption of glucose (blood sugar) in the kidneys, increasing glucose excretion in urine.
Jardiance delivers other benefits to people living with type 2 diabetes, including enhanced weight loss and improved heart function. It is not used to treat type 1 diabetes.
Drug Facts
- Generic Name: Empagliflozin
- Brand Name(s): Jardiance
- Administration Route(s): Oral
- Drug Availability: Prescription
- Therapeutic Classification: Hypoglycemic
- Available Generically: No
- Controlled Substance: N/A
- Active Ingredient: Empagliflozin
- Dosage Form(s): Tablet
What Is Jardiance Used For?
If you have type 2 diabetes, your healthcare provider may prescribe Jardiance in combination with diet and exercise to help control your blood sugar. Depending on the status of your glycemic control, Jardiance may be used as monotherapy (on its own) or in combination therapy with other diabetes drugs.
SGLT-2 inhibitors like Jardiance offer some advantages over sulfonylureas (another class of diabetes drugs) in that there is a lower risk of hypoglycemia (low blood sugar). SGLT-2 inhibitors are "insulin-independent," meaning they don't affect insulin levels as sulfonylureas do. Because of this, patients taking Jardiance may be able to control their insulin levels without the risk of a "blood sugar crash."
In 2016, the Food and Drug Administration (FDA) recommended using Jardiance to reduce the risk of cardiovascular death in people with type 2 diabetes. This was considered a significant turning point. Type 2 diabetes is associated with a three-fold risk of dying from a heart attack or stroke, and a nearly five-fold risk of death in people hospitalized for heart failure.
Although metformin remains the mainstay of treatment for type 2 diabetes, SGLT-2 inhibitors are increasingly considered a first treatment option for patients with established heart disease.
How to Take Jardiance
Jardiance is approved for use in adults 18 and over. It is available as a 10 milligram (mg) round tablet or a 25 mg oval tablet.
Take Jardiance once a day in the morning with or without food. The tablets need to be swallowed whole. Do not crush, chew, or split the film-coated tablets, which can affect drug absorption.
Storage
Jardiance tablets can be safely stored at room temperature (around 77 F). It is OK to expose the drugs to temperatures between 59 F and 86 F, but avoid keeping the drugs on a sunny windowsill or in your glove compartment where heat exposure can be excessive.
Keep the tablets in their original light-resistant container. Discard any drugs that have expired.
Off-Label Uses
There are no off-label uses for Jardiance. However, it is expected that the drug will soon be approved for the treatment of heart failure regardless of whether you have diabetes or not.
Jardiance is currently licensed for use in the European Union for patients with chronic heart failure with reduced ejection fraction.
In addition, the FDA granted Fast Track designation to Jardiance in 2020 to treat chronic kidney disease (CKD). The Fast Track designation speeds up the FDA's review of research based on promising results from early studies. The complete results of the Jardiance studies are expected in 2022.
How Long Does Jardiance Take to Work?
It can take up to 24 weeks after starting Jardiance to see results.
What Are the Side Effects of Jardiance?
This is not a complete list of side effects and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at www.fda.gov/medwatch or 1-800-FDA-1088.
As with all drugs, Jardiance may cause side effects. Although most are relatively mild, some people—particularly those with pre-existing kidney disease or hypotension (low blood pressure)—may experience potentially severe side effects.
Always advise your healthcare provider about any medical conditions you have before starting Jardiance.
Common Side Effects
The side effects of Jardiance are primarily limited to the genital and urinary tract. Common side effects include (by order of frequency):
Less commonly, Jardiance can cause a drop in blood pressure and symptoms of hypotension (including dizziness, nausea, clammy skin, blurred vision, and fainting). People 65 and over, those on diuretics, and those with pre-existing kidney disease or hypotension are at greatest risk.
Let your healthcare provider know if you have these or other side effects. Yeast infections can often be treated with over-the-counter antifungals, but UTIs may require prescription antibiotics. People who experience Jardiance-induced hypotension may need a dose adjustment or a change of treatment.
Severe Side Effects
Diabetic ketoacidosis (DKA) is a rare but potentially dangerous side effect. DKA occurs when the lack of insulin causes the blood to become dangerously acidic.
Although DKA typically develops along with elevated blood glucose levels, Jardiance can cause a phenomenon known as euglycemic ketoacidosis, in which blood sugar levels are normal. Because of this, Jardiance can "mask" ketoacidosis until symptoms become severe and potentially life-threatening.
Jardiance can also impair kidney function and lead to acute kidney failure, most often in people aged 65 and over or those with pre-existing kidney disease.
Symptoms of acute kidney failure include:
- Decreased urination
- Fluid retention
- Fatigue
- Shortness of breath
- Irregular heartbeat
- Seizures
Kidney failure is usually reversed once treatment is stopped.
Another extremely rare complication is Fournier's gangrene (also known as necrotizing fasciitis of the perineum). Fournier's gangrene occurs when a severe infection of the genitals or perineum (the area between the anus and genital) causes rapid tissue death. Fournier's gangrene is considered a medical emergency requiring aggressive intravenous antibiotics.
Call your healthcare provider right away if you have serious side effects after using Jardiance. Call 911 if your symptoms feel life-threatening or if you think you're having a medical emergency.
These include symptoms of diabetic ketoacidosis, such as:
- Excessive thirst
- Frequent urination
- Stomach pain
- Extreme fatigue
- Nausea or vomiting
- Rapid, shallow breathing
- Fruity-scented breath
- Neck stiffness
- Vision changes
- Confusion
Long-Term Side Effects
Jardiance is intended for the long-term treatment of type 2 diabetes. Although it is generally considered safe for use, it is a relatively new drug with limited long-term safety research. Further studies are needed to address concerns related to the high incidence of genital and urinary tract infections and the potential risk of kidney impairment with long-term use.
Dosage: How Much Jardiance Should I Take?
Drug Content Provided and Reviewed by IBM Micromedex
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
For oral dosage form (tablets):
For type 2 diabetes:
- Adults—At first, 10 milligrams (mg) once a day, taken in the morning. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 25 mg per day.
- Children—Use and dose must be determined by your doctor.
To lower risk of cardiovascular death in patients with type 2 diabetes and heart disease:
- Adults—10 milligrams (mg) once a day, taken in the morning.
- Children—Use and dose must be determined by your doctor.
To lower risk of cardiovascular death and hospitalization in patients with heart failure:
- Adults—10 milligrams (mg) once a day, taken in the morning.
- Children—Use and dose must be determined by your doctor.
Modifications
Jardiance is used cautiously in people with kidney disease. Even those without kidney disease need to have their renal function regularly monitored to avoid possible kidney injury. If you have kidney disease, your healthcare provider may have you take a blood test known as the estimated glomerular filtration rate (eGFR).
Jardiance can be used as prescribed in people with mild to moderate kidney disease, defined as an eGFR of 45 or over. Anyone whose eGFR drops and remains persistently below 45 should stop taking Jardiance.
Missed Dose
As with all chronic medications, consistent use is associated with better results. If you miss a dose of Jardiance, take it as soon as you remember. If it is almost time for your next dose, skip the initial dose and continue as normal. Never double up doses.
You should also never stop treatment or adjust the dose without first speaking with your healthcare provider.
Overdose: What Happens If I Take Too Much Jardiance?
There is limited research on the risk of Jardiance overdose or at what dose Jardiance can become toxic.
A 2020 case report detailed an incident in which a healthy woman overdosed on SGLT-2 inhibitors. Although there was moderate kidney impairment, the only notable side effect was frequent urination. After 36 hours, kidney function returned to normal, and there was no evidence of severe hypoglycemia.
This should not suggest that the risk of Jardiance overdose is low—particularly in older adults, children, people with kidney disease or heart failure, or those taking certain medications.
Always keep medications out of the reach of children to avoid accidental overdose.
What Happens If I Overdose on Jardiance?
If you think you or someone else may have overdosed on Jardiance, call a healthcare provider or the Poison Control Center (1-800-222-1222).
If someone collapses or isn't breathing after taking Jardiance, call 911 immediately.
Precautions
Drug Content Provided and Reviewed by IBM Micromedex
It is very important that your doctor check your progress at regular visits, especially during the first few weeks that you take this medicine. Blood and urine tests may be needed to check for unwanted effects.
Tell your doctor if you are pregnant or planning to become pregnant. It is not safe to take this medicine during the second and third trimester of pregnancy. It could harm an unborn baby.
Dizziness, lightheadedness, or fainting may occur with this medicine. This is more common if you have kidney disease, low blood pressure, or if you are taking a diuretic (water pill). Taking plenty of fluids each day may help. Drink plenty of water during exercise or in hot weather. Check with your doctor if you have severe nausea, vomiting, or diarrhea that does not stop. This may cause you to lose too much water.
Ketoacidosis (high ketones and acid in the blood) may occur while you are using this medicine. This can be life-threatening and requires immediate medical attention. Your doctor may give you insulin, fluid, and carbohydrate replacement to treat this condition. Tell your doctor right away if you have nausea, vomiting, trouble breathing, increased thirst or urination.
This medicine may cause hypoglycemia (low blood sugar). This is more common when this medicine is taken together with other diabetes medicines (eg, insulin, glipizide, or glyburide). The symptoms of low blood sugar must be treated before they cause you to pass out. People feel different symptoms with low blood sugar. It is important that you learn which symptoms you usually have so you can treat it quickly. Some symptoms of low blood sugar include: behavior changes that are similar to being drunk, blurred vision, cold sweats, confusion, cool, pale skin, difficulty with thinking, drowsiness, excessive hunger, a fast heartbeat, headaches that continue, nausea, shakiness, slurred speech, or unusual tiredness or weakness. Talk to your doctor about how to treat low blood sugar.
This medicine may cause vaginal yeast infections in women and yeast infections of the penis in men. This is more common in patients who have a history of genital yeast infections or in men who are not circumcised. Women may have a vaginal discharge, itching, or odor. Men may have redness, itching, swelling, or pain around the penis, or a discharge with a strong odor from the penis. Check with your doctor right away if you have any of these symptoms.
This medicine may increase your risk of having urinary tract infections (eg, pyelonephritis, urosepsis). Check with your doctor right away if you have bladder pain, bloody or cloudy urine, difficult, burning, or painful urination, or lower back or side pain.
This medicine may cause a rare but serious bacterial infection, called necrotizing fasciitis of the perineum or Fournier's gangrene, which can cause damage to the tissue under the skin in the area between and around the anus and genitals (perineum). Fournier's gangrene may lead to hospitalization, multiple surgeries, or death. Check with your doctor right away if you have fever, unusual tiredness or weakness, or pain, tenderness, redness, or swelling of the area between and around your anus and genitals.
This medicine may cause serious allergic reactions, including angioedema, which can be life-threatening and require immediate medical attention. Check with your doctor right away if you have large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs.
Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests (eg, urine glucose tests may not be accurate). Also, you may need to stop using this medicine at least 3 days before having a surgery or medical tests.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
What Are Reasons I Shouldn't Take Jardiance?
There may be reasons why Jardiance is not the right medication for you.
You should not take this medication if:
- You have a known hypersensitivity to empagliflozin or any other ingredient in Jardiance
- You have severe kidney disease (eGFR below 30) or are on dialysis
- You are in your second or third trimester of pregnancy
- You are breastfeeding
If you intend to have a baby or are in your child-bearing years, speak with your healthcare provider about the benefits and risks of Jardiance. If you get pregnant while taking Jardiance, contact your provider immediately. Due to the lack of safety research, Jardiance is not recommended while breastfeeding.
What Other Medications Interact With Jardiance?
Jardiance has relatively few drug interactions. Studies have shown the SGLT-2 inhibitors neither affect nor are affected by other glucose-lowering drugs (including metformin and sulfonylureas) or cardiovascular drugs (including diuretics, calcium channel blockers, and statins) commonly used in people with type 2 diabetes.
This should not suggest there are no risks. Certain drugs are known to decrease the excretion of Jardiance in urine, which can reduce how well the kidneys work. Although there is little evidence of this occurring in people with healthy kidneys, the risk may be increased in those with underlying kidney dysfunction.
These drugs include:
- Lopid (gemfibrozil): A fibrate drug used to lower cholesterol
- Probalan (probenecid): A uric acid reducer used to treat gout
- Rifampicin: An antibiotic used to treat tuberculosis
To avoid interactions, always advise your healthcare provider about any drugs you take, whether prescription, over-the-counter, herbal, nutritional, or recreational.
What Medications Are Similar?
In addition to Jardiance, three other SGLT-2 inhibitors are approved by the FDA for the treatment of type 2 diabetes:
- Farxiga (dapagliflozin)
- Invokana (canagliflozin)
- Steglatro (ertugliflozin)
None of the approved SGLT-2 inhibitors are "better" than the others. The only differentiating factor may be that Steglatro costs less than the other drugs.
Several combination drugs pair an SGLT-2 inhibitor with either metformin or a sulfonylurea. These include:
- Glyxambi (empagliflozin and linagliptin)
- Invokamet (canagliflozin and metformin)
- Synjardy (empagliflozin and metformin)
- Trijardy XR (empagliflozin, linagliptin, and metformin)
- Xigduo XR (dapagliflozin and metformin)
How Can I Stay Healthy While Taking Jardiance?
Medications alone cannot treat type 2 diabetes. Although Jardiance is highly effective, it is meant to be used alongside diet and exercise as part of a holistic treatment plan.
Diets rich in whole grains, fruits, vegetables, legumes, and nuts can improve glycemic control in people with type 2 diabetes. You should reduce intake of refined grains, red/processed meats, and sugar-sweetened foods or drinks. Moderate alcohol consumption is also advised.
According to the American Diabetes Society, people with type 2 diabetes should undertake no less than 150 minutes of moderate to vigorous aerobic exercise per week. In addition to aerobic activities, you should aim to devote two to three days per week to moderate to vigorous resistance training.
Adherence to your treatment plan (including routine glucose monitoring) is key to maintaining optimal glycemic control. Missing doses or failing to follow your diet and exercise plan can take back the gains afforded by drugs like Jardiance. Consistency is key.
If you have trouble following your treatment plan, speak with your healthcare provider. By working together, you'll be better able to find the solution best suited for you as an individual.
Medical Disclaimer
Verywell Health's drug information is meant for education purposes only and not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare professional. Consult your doctor before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.
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