Disclaimer: This article is for informational purposes only and does not constitute medical advice. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition.
Overview
Jardiance is a brand name for empagliflozin, a once-daily tablet made by Boehringer Ingelheim. It belongs to a group of medicines called SGLT2 inhibitors. Health Canada has authorized it for adults with type 2 diabetes, heart failure or chronic kidney disease.
Jardiance is not authorized for weight loss or for anyone under 18, and it must not be used in type 1 diabetes.
Jardiance needs a prescription. BC residents can speak with a BC-licensed doctor by phone through Avee Health to ask whether it is appropriate for them. The doctor decides based on your health history. A prescription is not guaranteed.
In Canada, Jardiance is authorized for adults:
- With type 2 diabetes, to improve blood sugar control along with diet and exercise. It can be used alone when metformin is not suitable, or together with other diabetes medicines such as metformin, a sulfonylurea, pioglitazone, linagliptin or insulin.
- With type 2 diabetes and established cardiovascular disease, to lower the risk of cardiovascular death
- With heart failure, added to standard treatment
- With chronic kidney disease, to lower the risk of a sustained decline in kidney function, end-stage kidney disease, and death from cardiovascular or kidney causes
Jardiance is not for type 1 diabetes or for treating diabetic ketoacidosis.
Empagliflozin
SGLT2 inhibitor
diabetes
Prescription required
Available
How Jardiance Works
Empagliflozin blocks SGLT2, a protein in the kidneys that takes sugar back into the blood. When it is blocked, the kidneys pass more sugar out in the urine, which lowers blood sugar. This also makes you pass more urine and can lower blood pressure.
Dosage Instructions of Jardiance
Your doctor sets your dose. The usual doses in the Canadian product monograph are:
- Type 2 diabetes (blood sugar control): 10 mg once daily. The dose can be raised to 25 mg once daily if more control is needed.
- Lowering the risk of cardiovascular death, heart failure and chronic kidney disease: 10 mg once daily
Kidney function: the dose stays at 10 mg if eGFR is below 30. Starting Jardiance is not recommended for people on dialysis.
Take the tablet once a day, at any time, with or without food. Swallow it whole. Do not cut or split it.
Missed dose: take it as soon as you remember. Do not take a double dose on the same day.
Surgery and illness: Jardiance is stopped at least 3 days before major surgery or a procedure that involves a long fast, when possible. It is also paused if you are in hospital for a serious infection or another serious illness. Your doctor will tell you when to restart it, usually once you are well and eating and drinking normally again.
Storage Instructions
Store at room temperature, 15°C to 30°C. Keep out of reach of children. Return unused or expired medicines to your pharmacist for disposal.
Side Effects of Jardiance
In clinical trials in people with type 2 diabetes, these effects were reported on the 10 mg and 25 mg doses, compared with placebo:
- Genital yeast infections: 4.1% on 10 mg and 3.7% on 25 mg, compared with 0.9% on placebo. They were more common in women (5% to 6%) than in men (2% to 3%).
- Urinary tract infections: 9.3% on 10 mg and 7.6% on 25 mg, compared with 7.6%
- Passing urine more often: 1.5% to 1.9%, compared with 0.5%
- Itching of the vulva and vagina: 1.9% to 2.5%, compared with 0.6%
- Thirst: 1.2% to 1.5%, compared with none
- Low blood sugar: about 8%, compared with 6%. The risk is higher with insulin or a sulfonylurea.
Get medical help right away if you have:
- Nausea, vomiting, stomach pain, loss of appetite, extreme thirst, trouble breathing, confusion or unusual tiredness or sleepiness. These can be signs of ketoacidosis, even if your blood sugar is not very high.
- Pain, tenderness, redness or swelling around the genitals or the area between the genitals and the anus, with fever or feeling unwell (possible Fournier's gangrene, a serious infection)
- Signs of a serious urinary or kidney infection, such as fever, chills or back pain with urinary symptoms
- Dizziness, fainting or signs of dehydration, such as a very dry mouth or passing very little urine
- Signs of a serious allergic reaction, such as rash, hives or swelling of the face or throat
Important Safety Information About Jardiance
Ketoacidosis: the Canadian monograph carries a boxed warning. Ketoacidosis is a serious, life-threatening build-up of acids in the blood that needs urgent hospital care. Fatal cases have been reported. It can happen with blood sugar below 13.9 mmol/L, so a near-normal reading does not rule it out. Stop Jardiance and get help right away if you have the symptoms listed above.
The risk of ketoacidosis is higher with a very low-carbohydrate diet, reduced food intake, dehydration, heavy alcohol use, a lowered insulin dose, serious illness or surgery. Ketoacidosis can last 3 days or more after Jardiance is stopped. Jardiance should not be used by people who have had ketoacidosis before or who have type 1 diabetes.
Allergy: do not use Jardiance if you are allergic to empagliflozin or any ingredient in it.
Pregnancy and breastfeeding: do not use Jardiance during pregnancy or while breastfeeding. Stop it and call your doctor if you become pregnant.
Genital infections: yeast infections of the genitals are more common with Jardiance. Fournier's gangrene, a rare but life-threatening infection of the skin around the genitals, has been reported.
Urinary tract infections: serious infections, including kidney infections and urosepsis, have been reported.
Dehydration and low blood pressure: Jardiance increases urine output. Take care if you are older, have low blood pressure, are ill with vomiting or diarrhea, or take blood pressure medicines or diuretics (water pills).
Kidneys: your kidney function should be checked before you start and regularly afterward.
Liver and age: Jardiance is not recommended with severe liver problems. Older adults, especially those 75 and over, have a higher risk of urinary tract infections and dehydration.
Amputations: in a trial in people with chronic kidney disease, lower limb amputations (most often of a toe) occurred in 0.8% of people on Jardiance and 0.6% on placebo.
Drug Interactions
Tell your doctor and pharmacist about everything you take, including non-prescription products. Points from the Canadian monograph:
- Diuretics (water pills), especially loop diuretics: use with caution because of a higher risk of dehydration and low blood pressure.
- Insulin and sulfonylureas: the risk of low blood sugar is higher. Your doctor may lower the dose of these medicines.
- Lithium: Jardiance may lower lithium levels, so blood levels should be checked more often.
- Urine sugar tests: your urine will test positive for sugar while you take Jardiance. This is expected.
Studies found no clinically relevant interaction with metformin, pioglitazone, sitagliptin, linagliptin, warfarin, digoxin, ramipril, simvastatin or oral contraceptives.
Brands & DIN Number of Jardiance
Brand Names
Jardiance
Key Takeaways
- 1Jardiance is empagliflozin, a once-daily SGLT2 inhibitor tablet authorized in Canada for adults with type 2 diabetes, heart failure and chronic kidney disease.
- 2The usual dose is 10 mg once daily. For blood sugar control it can be raised to 25 mg.
- 3Genital yeast infections and urinary tract infections are the main side effects to know about.
- 4Ketoacidosis is a serious risk and can happen even when blood sugar is not very high. Get urgent care for nausea, vomiting, stomach pain, trouble breathing or unusual tiredness.
- 5Jardiance is paused during serious illness and stopped at least 3 days before major surgery when possible. Do not use it during pregnancy or while breastfeeding.
- 6BC PharmaCare's Plan NP covers the full cost of Jardiance for BC residents enrolled in MSP.
- 7Jardiance needs a prescription. BC residents can ask a BC-licensed doctor by phone whether it is right for them.
Frequently Asked Questions
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Avee Editorial
Avee Editorial Team