Jardiance®
Empagliflozin
Version 2025-04 · Last reviewed April 1, 2025 · Methodology
List Price
$600+
With Insurance
$30–80 (with manufacturer coupon)
Supplement Questions
How It Works
Empagliflozin blocks a kidney transporter that normally recaptures glucose from filtered urine. By preventing this reabsorption, the drug causes the body to excrete glucose — essentially peeing out excess blood sugar regardless of insulin.
Why the side effects happen
Glucose in the urine changes the urinary environment — promoting yeast growth (vaginal and penile yeast infections are the most common side effect). The osmotic effect of glucose in urine causes increased urination and fluid loss, lowering blood pressure and reducing fluid overload in heart failure. The heart failure and kidney benefits appear to be independent of glucose-lowering — possibly related to reduced cardiac preload, ketone body production, and reduced inflammation.
When Will I Feel It?
Glucose excretion begins within hours of the first dose. Blood glucose improvements visible within 1–2 weeks. Heart and kidney protection benefits accumulate over years.
Glycosuria (glucose in urine) begins immediately. Blood glucose starts falling.
Blood glucose, blood pressure, and weight all begin declining. Yeast infection risk highest in the first weeks.
HbA1c fully reflects the drug effect. Blood pressure and weight stabilizing at new lower levels.
Cardiovascular death and heart failure hospitalization reduced (EMPA-REG OUTCOME: 38% reduction in CV death). Kidney disease progression slowed.
Adherence Note
The cardiovascular and kidney benefits of empagliflozin are separate from blood glucose control — even patients without diabetes with heart failure benefit. Do not stop Jardiance because your A1c looks good; the heart and kidney benefits require ongoing use.
Medical Disclaimer
The information on this page is compiled from publicly available clinical trial data, FDA prescribing information, and peer-reviewed literature. It is provided for educational purposes only and does not constitute medical advice, diagnosis, or treatment recommendations. Individual responses to medications vary. Always consult a qualified healthcare provider before starting, stopping, or changing any medication.
Common Side Effects
While taking this medication, you may experience the following common side effects. We've included tips on how to manage them.
Genital yeast infections
9%Maintain hygiene; OTC antifungals usually effective; may recur with continued use
Urinary tract infections
9%Increase hydration; report fever, back pain, or bloody urine to doctor
Increased urination / dehydration
12%Increase water intake; especially important in hot weather or during exercise
Low blood pressure / dizziness
5%Rise slowly from sitting; monitor if on other blood pressure medications
Elevated LDL cholesterol
4%Annual lipid panel; discuss with prescriber if LDL worsens
Serious Adverse Effects
- • Diabetic ketoacidosis (DKA) — can occur at NORMAL blood sugar. Hold before surgery, fasting, or major illness.
- • Lower limb amputations — class-wide warning; daily foot inspection is essential
- • Fournier's gangrene — rare but life-threatening genital infection; seek emergency care for any genital pain, swelling, or fever
- • Acute kidney injury — especially when combined with NSAIDs, diuretics, or dehydration
Drug Interactions
Major Interactions (Avoid)
Moderate Interactions (Caution)
Food Interactions
When to Contact Your Doctor
This medication requires ongoing medical supervision. The following situations warrant a prompt conversation with your prescribing physician — do not wait for your next scheduled appointment.
Contact soon if you notice
- Diabetic ketoacidosis (DKA) — can occur at NORMAL blood sugar. Hold before surgery, fasting, or major illness.
- Lower limb amputations — class-wide warning; daily foot inspection is essential
- Fournier's gangrene — rare but life-threatening genital infection; seek emergency care for any genital pain, swelling, or fever
- Acute kidney injury — especially when combined with NSAIDs, diuretics, or dehydration
- Blood sugar rising above your target range
Also discuss if you want to
- Review whether this medication is still appropriate for you
- Consider dosage adjustments based on response
- Explore lifestyle or non-drug alternatives
- Understand stopping or tapering options
- Plan monitoring labs and follow-up
In the US, call 911 or go to the nearest emergency room for severe symptoms. Poison Control: 1-800-222-1222.
Special Populations
Safety classifications for specific groups — discuss with your provider before use.
Causes fetal kidney development issues in second/third trimesters. Discontinue immediately if pregnant.
Excreted in breast milk in animal studies; not recommended during breastfeeding.
Type 2 diabetes risk rises sharply after menopause as insulin resistance increases with estrogen loss. SGLT2 inhibitors like Jardiance are frequently started during this period. Note: the risk of UTIs from SGLT2 inhibitors is already higher in women — this should factor into the decision, especially in the postmenopausal period.
Not studied in children under 10. Approved for T2D in children 10+ in 2023.
Higher dehydration, UTI, and fall risk. Monitor volume status. Not for eGFR <20.
For glycemic control: not recommended eGFR <30. For heart failure: may use down to eGFR 20. Hold before contrast dye.
FDA Adverse Event Reports
Patient-filed reports from the FDA FAERS database · refreshed daily
Community Reports
User-reported experiences — anonymous & anecdotal
Medical Disclaimer
The information on this page is compiled from publicly available clinical trial data, FDA prescribing information, and peer-reviewed literature. It is provided for educational purposes only and does not constitute medical advice, diagnosis, or treatment recommendations. Individual responses to medications vary. Always consult a qualified healthcare provider before starting, stopping, or changing any medication.
Metabolic & Lifestyle Alternatives
Addressing Insulin Resistance: The Root Cause SGLT2 Inhibitors Bypass
Jardiance forces the kidneys to excrete excess glucose as a workaround — it does not address why glucose is elevated in the first place. The root cause is carbohydrate-driven hyperinsulinemia. Carbohydrate restriction removes the glucose load entirely, achieving HbA1c reductions matching or exceeding Jardiance without the UTI, DKA, or genital infection risks. Fat is not the problem — processed carbohydrates and excess glucose are.
Important context: Evidence quality varies across these approaches. Some are well-studied with randomized controlled trial data; others are based on observational or smaller studies. These interventions are not guaranteed to replace medication for all patients. Discuss with your doctor whether any of these are appropriate for your clinical situation.
Ketogenic Diet (<20g net carbs/day)
Removes the dietary glucose load at its source — no excess glucose means no excess insulin means no insulin resistance progression
HbA1c reduction 1.0–2.0% in meta-analyses; Virta 2-year RCT: 53.5% T2D remission, 94% reduced or eliminated medications. Also lowers triglycerides and shifts LDL to large buoyant particles.
Resistance Training (3×/week)
Heavy compound movements build insulin-sensitive muscle — the body's largest glucose sink
Increases GLUT4 transporter density; glucose disposal increased 48%; improvements persist 48–72 hours per session. Reduces visceral fat independently of weight loss.
Time-Restricted Eating (16:8)
Compresses the insulin-elevated window; allows insulin levels to fall fully each day
Improves fasting insulin, HbA1c, and visceral fat independently of caloric restriction. Combines powerfully with low-carb to extend the metabolic rest period.
Berberine (500mg 3×/day)
Plant alkaloid that activates AMPK — the same pathway as metformin
Multiple RCTs: HbA1c reduction equivalent to metformin (–0.9%); also lowers LDL and triglycerides. Available OTC. Often used as a bridge while transitioning off medications.
Weight loss 5–10% body weight
Even modest weight loss reduces visceral adipose tissue and improves beta-cell function
Each 1% weight loss reduces HbA1c by ~0.1–0.2%; 10% loss can normalize blood sugar in many patients. Best achieved through carbohydrate restriction rather than caloric restriction alone.
Key Studies
Global Prescribing & Pricing
Jardiance adoption is strong globally — but the US prices it at 10–15× European levels for identical pills
United States
$600+/mo
Rapidly growing — expanded to heart failure and CKD beyond T2D
No lifestyle prerequisite; being prescribed increasingly for weight loss and metabolic syndrome off-label
Often covered with restrictions; prior auth common
United Kingdom
~$45–60/mo
NICE approved for T2D + established CV disease and heart failure
Requires documented T2D or heart failure diagnosis; lifestyle counseling documented alongside
Covered by NHS with indication criteria
Germany
~$50–80/mo
Adopted for CV indications per ESC guidelines
IQWiG benefit assessment required; lifestyle program concurrent with prescribing
Covered by GKV with criteria
Japan
~$35–55/mo
Growing in T2D and heart failure
Strict dietary counseling required concurrently; SGLT2 inhibitors have strict glucose monitoring requirements
Covered by JHIS with criteria
Australia
~$35–50 (PBS)/mo
PBS restricted to T2D + CV disease criteria
PBS requires cardiologist or endocrinologist initiation for heart failure indication
PBS covered with criteria
The identical 10mg Jardiance pill costs $600+/month in the US, ~$45 in the UK, and ~$35 in Australia. The drug is the same; the pricing difference is entirely a function of government negotiating power. Australia's PBS and the UK's NHS negotiate directly — the US does not.
Clinical Trials & Funding
Understanding who funds research helps contextualize results. Industry-funded trials are not automatically invalid — they undergo the same FDA review — but declared conflicts and sponsor effects are worth knowing. All linked trials can be verified on ClinicalTrials.gov.
Funding Sources
All major Jardiance outcomes trials were funded and conducted by Boehringer Ingelheim and Eli Lilly. EMPA-REG was a landmark trial that showed cardiovascular mortality reduction — but the mechanism was debated. The dramatic benefit emerged early in the trial, before glycemic effects could explain it, raising questions about trial design and patient selection.
Declared Conflicts of Interest
EMPA-REG study investigators had extensive financial ties to Boehringer Ingelheim. The rapid adoption of SGLT2 inhibitors for heart failure (a new indication not originally studied) was driven by manufacturer-funded trials and KOL physicians with company relationships.
Key Efficacy Results
14% reduction in CV mortality in T2D with established CV disease; 25% reduction in heart failure hospitalization; significant HbA1c reduction 0.5–0.8%
Referenced Studies
Each study carries a Cochrane RoB-2 risk-of-bias badge — tap the badge for details.
Evidence & Transparency
Cochrane RoB-2 (Risk of Bias)
Badges reflect an editorial assessment using Cochrane's RoB-2 tool domains: randomization, intervention deviation, missing data, outcome measurement, and selective reporting. These are not certified Cochrane reviews. Learn more ↗
CMS Open Payments
Manufacturer payment disclosures are reported via the CMS Sunshine Act. Disclosure is legally required and does not imply bias or misconduct. Language uses "may," "suggests," or "appears" — never definitive clinical claims. CMS Open Payments ↗
Live Clinical Trials
Live from ClinicalTrials.gov · refreshed every 4 hours
Currently enrolling, active, and recently completed studies involving Empagliflozin. Data is pulled directly from the U.S. National Library of Medicine.
Recent Research
Live from PubMed · peer-reviewed literature · refreshed every 4 hours
Most recently indexed clinical trials and systematic reviews mentioning Empagliflozin in PubMed.
Source Documentation
Structured citations for referenced clinical trials
Each referenced trial is listed with its registry ID, funding source, and bias assessment. Use the copy button to generate a formatted citation.
| Trial | Registry ID | Cite |
|---|---|---|
| EMPA-REG OUTCOME | NCT01131676 | |
| EMPEROR-Reduced (Heart Failure) | NCT03057977 | |
| EMPA-REG Outcomes (NEJM) | PMID:26378978 |
Bias ratings use Cochrane RoB-2 methodology. Editorial assessment — not a certified Cochrane review.
Our MethodologyMedical Disclaimer
The information on this page is compiled from publicly available clinical trial data, FDA prescribing information, and peer-reviewed literature. It is provided for educational purposes only and does not constitute medical advice, diagnosis, or treatment recommendations. Individual responses to medications vary. Always consult a qualified healthcare provider before starting, stopping, or changing any medication.
Stopping This Medication Safely
Jardiance does not cause physical dependence and can generally be stopped without tapering. Blood sugar will rise when stopped — this is expected and should be managed with your doctor.
What Published Research Shows About Stopping This Medication
This summarizes what published research documents — it is not personal medical advice. Any changes to your medication require discussion with your prescribing physician.
- ·Research shows no taper is needed for empagliflozin itself
- ·Research highlights that other diabetes medications, especially insulin, may need adjustment before stopping — blood glucose management requires coordination
- ·Research recommends monitoring blood glucose more frequently for 2–4 weeks after stopping
- ·Dietary approaches to maintaining glycemic control after stopping are well-documented in diabetes research
Warning Symptoms — Contact Your Doctor If You Experience:
- Blood sugar rising above your target range
- Signs of DKA: nausea, vomiting, abdominal pain, difficulty breathing (even with normal blood sugar)
- Rapid weight gain or swelling (heart failure relapse)
Never change or stop a medication without consulting your prescribing physician.
Questions for Your Doctor
Questions to Ask
- 1.Do I also have heart failure or kidney disease, which changes whether this is the right choice?
- 2.Is my DKA risk higher because I sometimes fast or follow a low-carb diet?
- 3.Should I stop this medication before any surgery or hospitalization?
- 4.What should I do if I get sick and can't eat or drink normally?
- 5.Are there dietary or lifestyle changes that could reduce or replace this medication?
Lab Tests to Request
- HbA1c every 3 months initially
- eGFR and electrolytes
- Urine microalbumin
- Annual foot exam
- Blood pressure monitoring
Medical Disclaimer
The information on this page is compiled from publicly available clinical trial data, FDA prescribing information, and peer-reviewed literature. It is provided for educational purposes only and does not constitute medical advice, diagnosis, or treatment recommendations. Individual responses to medications vary. Always consult a qualified healthcare provider before starting, stopping, or changing any medication.
Frequently Asked Questions About Jardiance®
- What is Jardiance® used for?
- Jardiance® (Empagliflozin) is a SGLT2 Inhibitor manufactured by Boehringer Ingelheim / Eli Lilly. FDA-approved indications include: Type 2 diabetes (glycemic control); Heart failure with reduced ejection fraction; Chronic kidney disease; Cardiovascular risk reduction in T2D.
- What are the common side effects of Jardiance®?
- Common side effects of Jardiance® include: Genital yeast infections (9%); Urinary tract infections (9%); Increased urination / dehydration (12%); Low blood pressure / dizziness (5%); Elevated LDL cholesterol (4%).
- How much does Jardiance® cost?
- Jardiance® list price is approximately $600+. With insurance it typically costs $30–80 (with manufacturer coupon); without insurance approximately $550–650.
- Who funded the clinical trials for Jardiance®?
- All major Jardiance outcomes trials were funded and conducted by Boehringer Ingelheim and Eli Lilly. EMPA-REG was a landmark trial that showed cardiovascular mortality reduction — but the mechanism was debated. The dramatic benefit emerged early in the trial, before glycemic effects could explain it, raising questions about trial design and patient selection.
- How strong is the clinical evidence for Jardiance®?
- Key studies: EMPA-REG OUTCOME (2015), EMPEROR-Reduced (2020), EMPEROR-Preserved (2021). 14% reduction in CV mortality in T2D with established CV disease; 25% reduction in heart failure hospitalization; significant HbA1c reduction 0.5–0.8% Potential conflicts of interest: EMPA-REG study investigators had extensive financial ties to Boehringer Ingelheim. The rapid adoption of SGLT2 inhibitors for heart failure (a new indication not originally studied) was driven by manu.
- Are there non-drug alternatives to Jardiance®?
- Jardiance forces the kidneys to excrete excess glucose as a workaround — it does not address why glucose is elevated in the first place. The root cause is carbohydrate-driven hyperinsulinemia. Carbohydrate restriction removes the glucose load entirely, achieving HbA1c reductions matching or exceedin See the Alternatives tab for full details.
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