Key Points

• The beneficial effect of Jardiance on your blood sugar levels may begin quickly, within the first 1 to 2 weeks. However, Jardiance is an oral drug typically used over the long-term in type 2 diabetes and can offer benefits for heart health, kidney function and weight loss.
• Jardiance treatment can take up to 24 weeks for the full therapeutic results based on clinical study results in adults.
• Your results may be different from other people, so check with your doctor about your progress in maintaining control of your type 2 diabetes if you have a concern.

Jardiance (empagliflozin) is used in addition to diet and exercise to control blood glucose (sugar) in adults and children 10 years of age and older with type 2 diabetes.

It is used also to lower the risk of:

• cardiovascular (heart-related) death (such as heart attack or stroke) in adults with heart disease and type 2 diabetes.
• cardiovascular death and hospitalization for heart failure (when the heart is weak and cannot pump enough blood to the body) in adults with heart failure.
• kidney function decline, kidney failure, cardiovascular death and hospitalizations in adults with chronic kidney disease (CKD) at risk of progression.

This medicine is given as an oral tablet taken once daily in the morning with or without food. Take your medicine exactly as your doctor prescribes it.

Jardiance may be added to other medicines used to treat type 2 diabetes such as metformin, sulfonylureas, pioglitazone, and insulin. However, the risk for low blood sugar (hypoglycemia) may increase. Metformin is the only other oral type 2 diabetes treatment approved for children.

Only the 10 mg dose of Jardiance is approved to lower the risk of further worsening of kidney disease, end-stage kidney disease (ESKD), death due to cardiovascular disease, and hospitalization in adults with chronic kidney disease (CKD).

Your doctor may occasionally change your dose. Be sure to tell your doctor if you take other diabetes medicines.

How long does it take for Jardiance to lower blood sugar?

In 24-week long studies in adults with Jardiance (empagliflozin), the 10 mg or 25 mg daily dose provided statistically significant reductions in A1C, fasting plasma glucose (FPG), and body weight when compared to an inactive placebo.

Results showed that 35% of patients taking the 10 mg dose lowered their A1C to less than 7%, with 44% of patients in the 25 mg group and 12% in the inactive placebo group seeing similar results .

Fasting blood glucose was also lowered in both the 10 mg and 25 mg groups. At the beginning of the study, patients had an average fasting blood sugar of 153 mg/dL. Those taking Jardiance 10 mg and 25 mg saw their fasting blood sugar drop 19 and 25 points (mg/dL), respectively, while the placebo group dropped 12 points.

Top 7 benefits of Jardiance

Besides being an effective choice to lower your blood sugar, Jardiance has many other benefits for patients living with type 2 diabetes.

1. Does Jardiance protect my heart?

Patients with type 2 diabetes are at a greater risk for heart disease, even if their blood sugar (A1C) is under control. Jardiance has been proven to have a protective effect on the heart in adults in large cardiovascular outcome trials.

• In a 3-year clinical study with over 7,000 patients, Jardiance was shown to reduce major cardiovascular events such as stroke or heart attack, as well as reduce death due to a cardiovascular event in patients with a diagnosis of heart disease.
• These patients were already taking common heart medications used in patients with type 2 diabetes like statins, beta blockers and ACE inhibitors.

2. Is Jardiance recommended in guidelines?

Metformin is usually the preferred first-line agent used when a patient needs to start an oral medication for type 2 diabetes. However, when added therapy is needed, certain SGLT-2 inhibitors, including Jardiance, are recommended.

• In the American Diabetes Association (ADA) guidelines, Jardiance is one of the drugs recommended as a first-line agent in patients with established atherosclerotic heart disease, such as coronary heart disease, cerebrovascular disease, or peripheral artery disease. This uses includes weight management and physical activity.
• The ADA also recommends empagliflozin (Jardiance) use to reduce the risk of cardiovascular death in adults with type 2 diabetes and established CV disease, when added to metformin.
• Certain SGLT-2 inhibitors, including Jardiance, are also recommended for use in heart failure patients with adequate kidney function as well as for patients where weight gain is a concern.
• Jardiance has also been shown to have beneficial effects on progression of diabetic kidney disease in patients with established disease. Patients with advanced renal (kidney) disease may not be able to use this drug. Your doctor can tell you if you need a dose adjustment or cannot use this medicine.

3. Does Jardiance lead to weight loss?

Jardiance is not approved for weight loss, but it can help patients with type 2 diabetes lose weight. In 24-week studies, weight loss was found to be statistically significant in adults with type 2 diabetes.

In patients taking the 10 and 25 mg dose, a weight loss of 2.8% and 3.2% of their baseline weight (weight at the start of the study) was seen, compared to a 0.4% weight loss in the placebo group.

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4. Can Jardiance lower my blood pressure?

Jardiance is not specifically approved by the FDA to lower blood pressure, but this effect was seen in clinical trials. Blood pressure was lowered whether Jardiance was used alone or with metformin.

• At Week 24 in studies, the systolic blood pressure (the top number) was statistically significantly reduced compared to placebo by -2.6 mmHg in adults taking the 10 mg dose of Jardiance.
• In patients taking the 25 mg dose of Jardiance, systolic blood pressure was reduced by -3.4 mmHg.

5. Does Jardiance cause hypoglycemia (low blood sugar) as a side effect?

When used alone, SGLT-2 inhibitors like Jardiance carry a low risk of hypoglycemia (low blood sugar levels). However, your doctor may need to adjust your dose of Jardiance if you take it with other drugs that can cause low blood sugar, like insulin or a sulfonylureas such as glipizide or glimepiride.

In studies in children 10 years and older, the risk of hypoglycemia (blood glucose <54 mg/dL) was higher with Jardiance (19.2%) compared to placebo (7.5%), whether or not they used insulin.

6. Can Jardiance be used with other diabetes medications?

Jardiance (empagliflozin) has been studied and can be added to other medicines for type 2 diabetes such as:

• metformin
• sulfonylureas such as glimepiride
• pioglitazone
• linagliptin
• insulin
• other heart medications like statins, beta blockers, ACE inhibitors, and diuretics.

​Adding these medications to Jardiance may increase your risk for low blood sugar (hypoglycemia) and dose adjustments of the medication may be needed.

Empagliflozin is also found in combination medicines such as Synjardy, Synjardy XR, Glyxambi and Trijardy XR.

If your A1C target is not achieved after roughly 3 months with initial use of metformin, other medicines can be combined with metformin, including sulfonylureas, thiazolidinediones, DPP-4 inhibitors, SGLT2 inhibitors, GLP-1 RA, or basal insulin. You and your doctor will make the best choice based on factors such as safety, drug interactions, side effects and cost or availability.

In a large comparative study, researchers found that each new class of noninsulin agents added to initial therapy with metformin generally lowers the A1C number by about 0.7–1.0%.

7. Is Jardiance well-tolerated by patients?

Yes, in clinical studies, few adults patient stopped treatment due to the most common side effects: genital yeast infections and urinary tract infections.

• Discontinuation from the studies due to genital infection occurred in 0.2% of patients (2 out of 1000) treated with Jardiance 10 mg or 25 mg compared to 0% patients taking an inactive placebo.
• Discontinuation due to urinary tract infections (UTIs) occurred in 0.2% and 0.1% of patients receiving the 10 mg and 25 mg doses of Jardiance, respectively. About 0.1% of patients taking an inactive placebo stopped treatment because of UTIs (same as the group taking the 25 mg dose of Jardiance).

Important side effects with Jardiance

Jardiance is usually well-tolerated in patients with type 2 diabetes. However, as with all drugs, there are important side effects that you should review and discuss with your doctor.

Serious side effects reported with Jardiance include:

• ketoacidosis (increased ketones in your blood or urine)
• sudden kidney injury
• urinary tract infections
• dehydration (the loss of body water and salt)
• low blood sugar (hypoglycemia)
• necrotizing fasciitis (a rare but serious tissue infection under the skin that can happen around the anus and genitals)
• allergic reactions
• increased cholesterol

The most common side effects (5% or greater) that may occur with Jardiance are:

• urinary tract infections
• female genital yeast infections (but may also occur in 2-3% of males)

Bottom Line

• In studies, most patients saw an effect with Jardiance in about 24 weeks, but effects on your blood sugar may occur more quickly.
• Results will differ between patients and you should ask your doctor’s advice on how quickly you may meet your treatment goals for type 2 diabetes.
• Jardiance can be added to many other types of type 2 diabetes medications, including metformin, if needed.

Overall, Jardiance is a well-tolerated, once-daily oral treatment option for type 2 diabetes that can provide benefits for your blood sugar, heart, kidneys, weight goals, and risks for low blood sugar. However, side effects can occur, so be sure to discuss all possible side effects with your doctor.

This is not all the information you need to know about Jardiance for safe and effective use and does not replace your doctor's advice. Review the full Jardiance information here, and speak to your health care provider before you start treatment.

References

• Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes 2021. American Diabetes Association. Diabetes Care 2021;44(Supplement_1):S111–S124 Accessed July 7, 2022 at https://doi.org/10.2337/dc21-S009
• Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med. 2015;373(22):2117‐2128. doi:10.1056/NEJMoa1504720. Accessed July 7, 2022.
• Jardiance [package insert]. Boehringer Ingelheim Pharmaceuticals, Inc.; Ridgefield, CT Accessed June 22, 2023 at https://content.boehringer-ingelheim.com/DAM/7d9c411c-ec33-4f82-886f-af1e011f35bb/jardiance-us-pi.pdf
• Jardiance [Medication Guide]. Boehringer Ingelheim Pharmaceuticals, Inc.; Ridgefield, CT Accessed June 22, 2023.

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