Jardiance (empagliflozin) is an oral diabetes prescription that can help manage high blood sugar in people with type 2 diabetes. Just like any medication, Jardiance has its pros and cons. Knowing how this drug works and what to expect if a doctor prescribes it (whether in-person or through an online doctor appointment) can help patients stay informed about their treatment plan. 

What Is Jardiance?

Jardiance is the brand name for empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor used to help keep blood sugar within normal limits for individuals with type 2 diabetes mellitus. The drug works by making the kidneys retain less blood sugar (glucose), thus letting the body release some glucose via the urine. 

Doctors may also prescribe Jardiance to help reduce the risk of some cardiovascular events such as heart attack or stroke, in people who have both type 2 diabetes mellitus and heart disease. 

One of the proven benefits of Jardiance is its ability to lower hemoglobin A1c (HbA1c) levels. HbA1c is one of the markers that doctors use to diagnose and monitor the progression of diabetes. [1] One measurement reflects a person’s average blood sugar over the preceding three months, with measurements over 6.5% meaning diabetes. 

Jardiance can potentially reduce a patient’s hemoglobin A1C by up to 1%,[2] which is a significant amount. For example, the difference between a hemoglobin A1C level of 6.0% and 6.5% (which is less than 1%[3]) is the difference between having prediabetes and actual diabetes.

Jardiance dosing

Jardiance comes in oral tablet form, in both 10mg and 25mg dosages. Typically, patients new to the drug will be started at the lower dose and adjusted as necessary.

Jardiance is designed as a once-daily pill that should be taken in the morning.[4] It is important for patients on the drug to take it at the same time every day to keep their blood sugar stable. Jardiance can generally be taken with or without food, without increasing the risk of potential side effects.

It’s important to remember that type 2 diabetes mellitus is a chronic condition, so treating it will involve lifelong management. However, in some situations, type 2 adult onset diabetes may be reversible if the blood sugar can be lowered and kept in a normal range for a long enough period. 

Potential side effects of Jardiance

There are a few potential side effects of Jardiance for patients to consider.[5] Most side effects will improve as the body adjusts to the medication, but any symptoms that either worsen or do not get better should be reported to the prescribing provider right away. 

The more common possible side effects of Jardiance include:

• Urinary tract infection (UTI).

• Yeast infection.

Less frequent possible side effects include:

• Abdominal pain.

• Allergic reactions (hives, itching, skin rash, swelling of the face, lips, or tongue).

• Breathing problems.

• Dizziness.

• Fungal infection.

• Increased cholesterol.

• Increased urination.

• Joint pain.

• Lightheadedness.

• Muscle weakness.

• Nausea (which may progress to vomiting).

• Skin changes (color, infections, or ulcerations).

• Unusual tiredness.

• Upper respiratory tract infection.

In addition, because Jardiance stimulates the kidneys to get rid of glucose through the urine, there may be additional effects on the kidneys patients should be aware of. Although it is rare, there have been some reports of people on Jardiance experiencing kidney problems. Some doctors may order blood testing to check kidney function before starting a patient on Jardiance.

Kidney disease is also one of the known side effects of diabetes, and other studies have shown that Jardiance may slow the progression to end-stage kidney disease.[5] 

Hypoglycemia, hyperglycemia, and diabetic ketoacidosis

While all people with both adult onset diabetes and insulin dependent diabetes should be aware of the symptoms of hypoglycemia and hyperglycemia, those on Jardiance should ensure they are well-versed in identifying and addressing imbalances in blood sugar in either direction.

In certain situations, such as when the body is first adjusting to the new diabetes prescription, Jardiance may drop the blood sugar too low and trigger a hypoglycemic episode. Awareness of the signs and symptoms can help identify hypoglycemia in its early stages before it becomes a medical emergency. 

Symptoms of hypoglycemia (low blood sugar) include:

• Blurred vision.

• Dizziness.

• Fast heart rate.

• Hunger.

• Sudden sweating.

• Tingling hands or feet.

• Tremoring.

Hyperglycemia (high blood sugar) is less common with appropriate blood sugar control, but symptoms to watch for include:

• Confusion.

• Drowsiness.

• Fruity breath.

• Rapid breathing.

• Skin flushing.

• Thirst.

One final complication to monitor for patients on Jardiance is diabetic ketoacidosis (DKA).[6] Although DKA is more common in type 1 diabetics, Jardiance may increase the risk of developing this complication. 

Symptoms of DKA (ketoacidosis) include:

• Ketones in the urine test.

• Fruity breath.

• Nausea and vomiting.

• Abdominal pain.

• Trouble breathing.

• Extreme fatigue. 

DKA is an emergency, and patients who suspect they may be experiencing DKA should seek immediate medical attention. 

Potential drug interactions with Jardiance 

Jardiance is often combined with other oral diabetes medications, frequently metformin. Although many doctors consider metformin to be a first-line treatment for type 2 diabetes, Jardiance can be taken in combination if metformin is not enough to manage high blood sugar on its own. 

However, it’s worth noting that when these medications are taken together, they can be too good at lowering blood sugar and can drop the blood sugar to hypoglycemic levels. 

Another potential interaction for Jardiance patients to be aware of is with medications for blood pressure known as beta-blockers (metoprolol, propranolol, timolol, etc.). While beta-blockers are efficient at keeping blood pressure in a normal range, they may hide the cardiac symptoms (i.e. a fast heart rate) associated with hypoglycemia. Patients on both medications should be aware of this, and should ensure they are familiar with the other symptoms of low blood sugar.

Finally, people who are taking Jardiance in combination with diuretic medications (like Lasix) should use caution. Because both types of drugs can increase urinary output, patients may be at increased risk of dehydration. 

Jardiance cost

Jardiance may be effective at helping to manage blood sugar, but it is also much more expensive than many other oral diabetes medications. For some, the cost of Jardiance may even be cost-prohibitive. The company that makes Jardiance has savings cards available for those who qualify, and certain pharmacies and reputable websites also offer coupons. 

Can Jardiance be used for type 1 diabetes?

Even though Jardiance can be beneficial for reducing blood sugar in people with adult onset diabetes, it is not safe for those with  type 1 diabetes (or insulin-dependent diabetes). 

Although DKA is a potential risk for type 2 diabetics taking Jardiance, the risk is much worse for those with type 1. As Jardiance works efficiently to lower blood sugar on its own, the lowering effect can be too much when combined with insulin. Since type 1 diabetics have to rely on insulin to manage their blood sugar, Jardiance is generally unnecessary and potentially harmful. 

Get easy, affordable care for diabetes online

While Jardiance can be beneficial for managing blood sugar in individuals with type 2 diabetes mellitus, it is a prescription medication that needs to be ordered by a doctor. 

HealthTap offers online doctor appointments that can help with easier, more affordable management of chronic conditions like diabetes, high blood pressure, allergies, arthritis, and more. Talk to your doctor or sign up for HealthTap today to get started.