Diarrhea is not a recognized side effect of Jardiance (empagliflozin). It does not appear on the FDA’s list of adverse reactions for the medication, and in pooled clinical trials, it was not reported at higher rates among people taking Jardiance than among those taking a placebo. That said, some people do experience digestive changes when starting a new medication, and there are specific reasons why diarrhea matters if it happens while you’re on Jardiance.
What the Clinical Data Actually Shows
The FDA requires drug manufacturers to report any side effect that occurs in at least 2% of clinical trial participants and at a higher rate than placebo. Diarrhea did not meet that threshold for Jardiance at any dose. The side effects that did make the list include genital yeast infections, urinary tract infections, increased urination, and joint pain.
This is a meaningful distinction from other common diabetes medications. Metformin, for example, is well known for causing digestive problems. In user-reported data, roughly 26% of metformin users experience diarrhea. Jardiance doesn’t carry this pattern. If you switched to Jardiance from metformin and your diarrhea improved, that’s consistent with what the data would predict. If you’re experiencing new diarrhea after starting Jardiance, the cause is more likely something else: a dietary change, another medication, or an unrelated illness.
Why Jardiance Spares the Gut
Jardiance belongs to a class of drugs called SGLT2 inhibitors, which work by blocking a protein in the kidneys that normally reabsorbs sugar back into the bloodstream. The sugar gets flushed out through urine instead. This mechanism is highly specific to the kidneys and doesn’t directly involve the digestive tract.
There is a related protein called SGLT1 that works in the small intestine, helping absorb sugars from food. Blocking SGLT1 can cause severe diarrhea and dehydration because unabsorbed sugars draw water into the gut. This is why Jardiance was designed to be highly selective for SGLT2 over SGLT1. It targets the kidney protein while largely leaving the intestinal one alone, which is exactly why gastrointestinal side effects are uncommon.
Why Diarrhea Still Matters on Jardiance
Even though Jardiance doesn’t cause diarrhea, the medication’s prescribing information specifically warns about it for a different reason: fluid loss. Jardiance already increases urination as part of how it works. If you develop diarrhea from any cause while taking it, you lose fluid through two pathways at once. This raises the risk of dehydration, which can lead to dizziness, lightheadedness, and drops in blood pressure.
More seriously, dehydration is one of the factors that can trigger a rare but dangerous condition called diabetic ketoacidosis (DKA) in people taking SGLT2 inhibitors. DKA can sometimes occur even when blood sugar levels appear normal, making it harder to recognize. UK drug safety regulators have specifically identified “conditions leading to severe dehydration” as a risk factor for DKA in patients on these medications. Persistent vomiting, reduced food intake, and illness all fall into this category alongside diarrhea.
The Jardiance medication guide reflects this concern. It instructs patients to contact their healthcare provider if they experience any condition that causes fluid loss, including diarrhea, vomiting, or prolonged sun exposure, particularly if they’re also eating or drinking less than usual.
What to Watch For
If you develop diarrhea while taking Jardiance, pay close attention to signs of dehydration: excessive thirst, dry mouth, dark urine, producing very little urine, dizziness, or feeling unusually weak. These warrant a call to your doctor promptly, especially because Jardiance is already reducing your fluid levels through increased urination.
General guidelines for diarrhea in adults also apply. Diarrhea lasting more than two days without improvement, blood or black color in stools, or severe abdominal pain are all reasons to seek medical attention regardless of what medications you take. For anyone on Jardiance, the threshold for concern about dehydration should be lower than usual. Staying well hydrated during any illness that causes fluid loss is especially important while on this medication.
Other Jardiance Side Effects to Expect
The side effects people actually experience with Jardiance reflect its mechanism of action. Increased urination is the most predictable one, since the drug works by sending excess sugar out through urine. That sugar-rich urine also creates a favorable environment for yeast, which is why genital yeast infections are among the most commonly reported side effects, particularly in women. Urinary tract infections occur at modestly higher rates as well.
Some people notice increased thirst, which makes sense given the extra fluid loss. Lightheadedness or dizziness, especially when standing up quickly, can occur due to mild drops in blood pressure. These effects tend to be most noticeable in the first few weeks and often settle as the body adjusts. If you’re experiencing gastrointestinal symptoms like diarrhea or stomach cramps, it’s worth looking at other medications in your regimen or recent dietary changes as more likely explanations.