Jardiance (empagliflozin) Tablets
Jardiance tablets contain the active ingredient empagliflozin, which is a medicine used to help control blood sugar levels in people with type 2 diabetes. Read on for advice on its use and possible side effects.
Pharmacist - M.B.A. (Public Health) D.I.C.
Jardiance (empagliflozin) Tablets
What is Jardiance used for? Type 2 diabetes (…
What is Jardiance used for?
- Type 2 diabetes (non-insulin dependent diabetes) in adults aged 18 years and over.
- Jardiance tablets can be used on their own to improve blood sugar control in people whose blood sugar is not controlled by changes to their diet and exercise alone, and who can't take an antidiabetic medicine called metformin.
- Jardiance tablets can also be used for people with type 2 diabetes whose blood sugar is not sufficiently controlled by other antidiabetic medicines. It can be added to treatment with medicines such as metformin, a sulphonylurea such as gliclazide or glibenclamide, or to treatment with insulin.
How does Jardiance work?
- Jardiance tablets contain the active ingredient empagliflozin, which is a type of medicine called an SGLT2 inhibitor.
- In type 2 diabetes the cells in the body become resistant to the action of insulin. Insulin is the main hormone responsible for controlling the level of sugar (glucose) in the blood. It makes cells in the body remove sugar from the blood. When the cells are resistant to insulin this makes blood sugar levels rise too high.
- Empagliflozin works in the kidneys, where it allows the body to excrete excess glucose from the blood into the urine.
- Normally, when the kidneys filter and clean the blood, glucose is filtered out of the blood at the same time. The glucose is then reabsorbed back into the blood by a mechanism called the sodium-glucose co-transporter 2 (SGLT2). The kidneys normally reabsorb glucose back into the blood even when the levels of glucose in the blood are too high, as in diabetes.
- Empagliflozin works by inhibiting the SGLT2 transporter. This allows excess glucose to be filtered out of the blood and excreted in the urine. This will reduce blood sugar levels.
Empagliflozin has two other effects that may be of benefit for people with diabetes. Firstly, it may cause weight loss due to the loss of sugar from the body. Secondly, it causes a small increase in the amount of water being filtered out of the blood into the urine (diuresis). This may help to reduce blood pressure.
How do I take Jardiance?
- Jardiance should be taken once a day. The usual dose is 10mg once daily. Your doctor may decide to increase your dose to 25mg once daily if your blood sugar is not controlled well enough.
- The tablets should be swallowed whole with a drink of water. They can be taken either with or without food.
- You can take the tablet at any time during the day, but try to take it at the same time each day. This will help you remember to take it.
- If you forget to take a tablet and it is more than 12 hours until your next dose is due, take the missed dose. Then take the next one at your usual time. If it is less than 12 hours until your next dose is due, then do not take the missed tablet. Just take your next tablet at your usual time. Do not take a double dose to make up for a missed dose.
What should I know before taking Jardiance?
It is important that you continue to follow the diet and exercise advice given to you by your doctor or nurse while you are taking Jardiance. Empagliflozin only helps to control your blood sugar levels and should not be used as a substitute for eating healthily and taking regular exercise.
- Hypoglycaemia (low blood glucose) has been very commonly reported when Jardiance is used with sulphonylurea medicines, eg glibenclamide, or with insulin. Symptoms of hypoglycaemia usually occur suddenly and may include cold sweats, cool pale skin, tremor, anxious feeling, unusual tiredness or weakness, confusion, difficulty in concentration, excessive hunger, temporary vision changes, headache, nausea and palpitations. You should talk to your doctor or diabetes specialist about this and make sure you know what to do if you experience these symptoms. Your doctor may need to adjust your doses.
- Your ability to concentrate or react may be reduced if you have low blood sugar, and this can cause problems driving or operating machinery. You should take precautions to avoid low blood sugar when driving - discuss this with your doctor. Jardiance may also cause dizziness or fatigue. If affected you should take care driving or operating machinery.
- People who are taking antidiabetic tablets should only drink alcohol in moderation and accompanied by food. This is because alcohol can make the warning signs of low blood sugar less clear, and can cause delayed low blood sugar, even several hours after drinking.
- Your doctor may want you to check your blood sugar level from time to time while you are taking Jardiance. Make sure you discuss how to do this and how often with your GP, pharmacist or diabetes specialist. You should be aware that your urine will test positive for glucose while you are taking this medicine; this is due to the way the medicine works.
- This medicine can sometimes cause your body too lose too much fluid (dehydration). People who are more susceptible to this include elderly people, those with kidney problems and those taking diuretic medicines. You should tell your doctor if you experience possible symptoms of dehydration, which may include feeling dizzy or lightheaded, particularly when getting up from sitting or lying down, feeling very thirsty or weak, or passing little or no urine. You should also tell your doctor if you develop vomiting or diarrhoea, or are unable to eat or drink while you are taking Jardiance because these problems can increase the risk of dehydration. Your doctor may want you to stop taking this medicine temporarily until you recover to help avoid dehydration.
- Your kidney function should be monitored regularly while you are taking Jardiance. Your doctor will usually want to check your kidney function once or twice a year, or more frequently if you are elderly, have any existing kidney problems or start taking any medicines that could affect your kidney function.
- If you frequently get cystitis or urinary tract infections while taking this medicine you should consult your doctor. Tell your doctor if you get signs of a severe UTI, such as a fever, shivering, pain in your back or side or blood in your urine. Most UTIs can be treated while you are still taking Jardiance, but if the infection affects your kidneys your doctor may want you to stop taking this medicine temporarily.
- A potentially serious side effect called diabetic ketoacidosis has been reported rarely in people taking SGLT2 inhibitor medicines such as this one. Signs and symptoms of this condition include rapid weight loss, nausea or vomiting, stomach pain, excessive thirst, fast and deep breathing, confusion, unusual sleepiness or tiredness, a sweet smell to the breath, a sweet or metallic taste in the mouth, or a different odour to urine or sweat. It is important to get medical advice from your doctor immediately if you experience these symptoms while taking Jardiance.
Jardiance should be used with caution by
- Elderly people. This medicine is not recommended for people over 85 years of age.
- People with kidney problems.
- People taking medicines for high blood pressure who have a history of low blood pressure or feeling dizzy.
- People with heart disease or heart failure.
- People with a high percentage of red blood cells in the blood (high haematocrit).
- People with a history of frequent urinary tract infections.
- People with a history of frequent genital infections such as thrush.
Who should not take Jardiance?
- People with type 1 diabetes.
- People with diabetic ketoacidosis.
- People with moderate to severely decreased kidney function.
- People with severely decreased liver function.
- Women who are pregnant or breastfeeding. See below.
- People who are allergic to any ingredient of the medicine, for example people with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption (Jardiance tablets contain lactose).
- Jardiance is not recommended for people taking loop diuretics such as furosemide.
- Jardiance is not recommended for people with low fluid volume or salt levels in the body, eg due to diuretic therapy, diarrhoea or vomiting.
- Jardiance is not recommended for children and adolescents under 18 years of age, because its safety and effectiveness have not been studied in this age group.
Can I take Jardiance while pregnant or breastfeeding?
- The safety of empagliflozin for use during pregnancy has not been established and Jardiance should not be used during pregnancy. Diabetes mellitus is usually controlled using insulin during pregnancy, because this provides a more stable control of blood sugar. If you get pregnant while taking Jardiance, or are planning a pregnancy, you should seek medical advice from your doctor.
- It is not known if empagliflozin passes into breast milk. The manufacturer states that Jardiance should not be used by breastfeeding mothers.
What are the possible side effects of Jardiance?
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with empagliflozin. Just because a side effect is stated here, it does not mean that all people using Jardiance will experience that or any side effect.
- Low blood sugar levels levels (when used with a sulphonylurea such as glibenclamide, or with insulin).
- Vaginal thrush.
- Inflammation of the penis and/or foreskin (candida balanitis) due to thrush infection.
- Increased production of urine (polyuria).
- Urinary tract infections.
- Itchy skin.
- Difficulty or pain passing urine (dysuria).
- Dehydration. Consult a doctor straight away if you experience symptoms of this, such as excessive thirst, a very dry or sticky mouth, dizziness, sleepiness, a fast heartbeat, or passing little or no urine. See what should I know above.
- If you want any more information about the possible side effects of Jardiance you should talk to your doctor or pharmacist, or read the leaflet that comes with the medicine.
Can I take other medicines with Jardiance?
It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with Jardiance. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe.
Empagliflozin may enhance the effect of diuretic medicines such as furosemide or bendroflumethiazide, which help to remove water from the body. Your doctor may change your dose of Jardiance or the diuretic medicine to make sure that you do not lose too much fluid. Empagliflozin is not recommended for people who are taking loop diuretics such as furosemide or bumetanide.
Medicines that increase blood sugar levels as a side effect may make Jardiance less effective at controlling blood sugar. Medicines that can increase blood sugar levels include the following:
- antipsychotic medicines, such as chlorpromazine, olanzapine, risperidone
- beta-2-agonists, such as salbutamol, salmeterol
- corticosteroids, such as prednisolone
- oestrogens and progestogens, such as those found in oral contraceptives or HRT
- thiazide diuretics, such as bendroflumethiazide.