Jardiance (empagliflozin) is a sodium-glucose cotransporter 2 (SGLT2) inhibitor. It is commonly prescribed to manage type 2 diabetes by lowering blood sugar, and it also offers benefits for people with heart failure or chronic kidney disease. Due to its unique mechanism, Jardiance is associated with an increased, though generally manageable, risk of developing a urinary tract infection (UTI). Understanding this connection helps patients recognize symptoms and take preventive steps.
The Biological Mechanism Behind Increased UTI Risk
Jardiance’s effect on the body is directly linked to the function of the SGLT2 protein, which is located in the kidney tubules. Normally, this protein is responsible for reabsorbing the majority of glucose filtered out of the blood back into the bloodstream. When a person takes empagliflozin, the drug blocks the action of the SGLT2 protein.
Blocking SGLT2 prevents the kidneys from reclaiming glucose, resulting in glycosuria—the excretion of excess sugar into the urine. This mechanism effectively lowers blood glucose levels but fundamentally changes the environment inside the urinary tract. The bladder and urethra now contain urine with a higher concentration of glucose than usual.
Bacteria, especially Escherichia coli which is a common cause of UTIs, thrive in sugar-rich environments. The presence of this extra glucose provides a ready nutrient source that encourages bacterial proliferation within the urinary system. This increased bacterial growth significantly raises the likelihood of developing an infection in the bladder or urethra.
The increased incidence of UTIs is a recognized side effect of SGLT2 inhibitors, though infections are often mild and treatable with standard antibiotics. This mechanism also increases the risk of genital yeast infections, as the sugar-rich urine affects the genital area. The potential for serious infections exists, even if the risk of simple UTIs is not dramatically higher than with other diabetes medications.
Recognizing Symptoms of a Urinary Tract Infection
Recognizing early UTI signs is important for prompt treatment and complication prevention. The most common symptoms involve changes in urination patterns and comfort. These include a burning sensation or pain during urination, medically known as dysuria.
Patients may also notice a persistent, strong urge to urinate, even immediately after emptying the bladder, along with increased frequency. The urine itself might appear cloudy, dark, or contain traces of blood, and it may have an unusually foul or strong odor. Pain in the lower abdomen or pelvic area is another localized symptom indicating a potential bladder infection.
Patients must monitor for signs of a more severe infection that may have spread to the kidneys, a condition called pyelonephritis. These systemic symptoms require immediate medical attention as they indicate a serious health threat. Key warning signs include a high fever, chills, and pain in the back or flank, which is the area on the side between the ribs and the hip.
Nausea and vomiting indicate that the infection may be complicated or advancing beyond the lower urinary tract. A very rare but dangerous soft-tissue infection in the perineum, known as Fournier’s gangrene, has also been reported with SGLT2 inhibitors. This presents with pain, tenderness, swelling, or redness in the genital or anal area, often accompanied by fever and fatigue. Any suspicion of these severe symptoms warrants an urgent call to a healthcare provider or a trip to the emergency room.
Strategies for Minimizing UTI Risk While Taking Jardiance
Minimizing UTI risk centers on promoting a flushing action within the urinary tract. Maintaining hydration is paramount, as drinking plenty of water dilutes the glucose concentration in the urine and increases urination frequency, which helps wash away bacteria. Patients should discuss an appropriate daily fluid intake goal with their healthcare provider, especially since Jardiance causes increased urination.
Diligent personal hygiene practices are recommended, particularly for women who have a higher baseline risk for UTIs due to anatomical differences. Proper wiping technique, specifically wiping from front to back after using the toilet, helps prevent the transfer of bacteria from the rectal area to the urethra. Regular cleansing of the genital area can also help reduce the microbial load.
Managing underlying type 2 diabetes effectively remains a significant factor. High blood sugar levels independently weaken the immune system and increase infection susceptibility. Keeping blood glucose within the target range limits the amount of glucose excreted into the urine, reducing the nutrient source for bacteria.
If UTI symptoms arise, prompt communication with a healthcare professional is crucial for early diagnosis and treatment. Patients should never stop taking Jardiance abruptly without medical guidance, as this could compromise the medication’s cardiovascular and renal protective benefits. If an antibiotic is prescribed, complete the entire course of medication as directed, even if symptoms improve quickly, to ensure the infection is fully eradicated.