Jardiance is a prescription medication approved for four purposes: improving blood sugar control in type 2 diabetes, reducing the risk of cardiovascular death in people with type 2 diabetes and heart disease, treating heart failure in adults, and slowing the progression of chronic kidney disease. It belongs to a class of drugs called SGLT2 inhibitors, which work through the kidneys rather than through insulin.
How Jardiance Works
Your kidneys filter about 180 grams of glucose from your blood every day. Normally, a protein called SGLT2 recaptures about 90% of that glucose and sends it back into your bloodstream. Jardiance blocks this protein, so instead of being reabsorbed, excess glucose passes out of your body through urine. The result is lower blood sugar levels without directly affecting insulin production.
This mechanism also causes your body to excrete extra sodium and water, which reduces fluid volume in your blood vessels. That’s why Jardiance has benefits beyond blood sugar control: less fluid means less strain on your heart and kidneys, which explains its effectiveness in heart failure and kidney disease even in people who don’t have diabetes.
Type 2 Diabetes
Jardiance is approved as an add-on to diet and exercise for adults and children aged 10 and older with type 2 diabetes. It is not used for type 1 diabetes. In people with type 2 diabetes who also have established heart disease, the EMPA-REG OUTCOME trial found that Jardiance reduced the risk of cardiovascular death by 38%, all-cause death by 32%, and hospitalization for heart failure by 35% compared to placebo. These reductions were on top of whatever other diabetes and heart medications patients were already taking.
That cardiovascular protection is a significant reason Jardiance is prescribed over some older diabetes medications. It doesn’t just lower blood sugar; it changes long-term outcomes for people at high cardiovascular risk.
Heart Failure
Jardiance is approved to reduce the risk of cardiovascular death and hospitalization in adults with heart failure, regardless of whether they also have diabetes. This is worth emphasizing: you do not need to have diabetes to be prescribed Jardiance for heart failure.
Clinical trials tested Jardiance across both major types of heart failure. In patients whose hearts pump weakly (reduced ejection fraction) and in those whose hearts pump normally but are stiff and don’t fill properly (preserved ejection fraction), Jardiance lowered the combined risk of cardiovascular death or heart failure hospitalization by about 21%. Heart failure hospitalizations specifically dropped by 29%. These benefits held whether patients had diabetes or not, with nearly identical risk reductions in both groups.
For heart failure patients, the practical effect is fewer hospital stays and a slower decline in heart and kidney function over time. Patients in the trials also showed a significantly slower rate of kidney function decline compared to those on placebo.
Chronic Kidney Disease
The newest approved use for Jardiance is slowing the progression of chronic kidney disease in adults at risk of their condition worsening. The medication reduces the risk of sustained kidney function decline, end-stage kidney disease, cardiovascular death, and hospitalization. Again, this indication applies whether or not the patient has diabetes.
The protective effect on the kidneys likely comes from Jardiance reducing the pressure inside the kidney’s filtering units, giving them less workload over time. In pooled data from major trials, patients on Jardiance had roughly a 20% lower rate of serious kidney outcomes compared to placebo.
Dosage and How to Take It
Jardiance comes in two tablet strengths: 10 mg and 25 mg. The starting dose is typically 10 mg once daily, taken in the morning with or without food. If you tolerate the medication well and need additional effect, your prescriber may increase the dose to 25 mg once daily.
Common Side Effects
The most frequently reported side effects are urinary tract infections and yeast infections. Both are a direct consequence of how the drug works: more glucose in your urine creates a friendlier environment for bacteria and yeast. Urinary tract infections can cause burning during urination, urgency, pelvic pain, or blood in the urine. Vaginal yeast infections may cause itching, unusual discharge, or odor. Men can develop yeast infections on the penis, with redness, swelling, discharge, or rash, particularly in uncircumcised men.
Increased urination and mild dehydration are also common since the medication pulls extra water into the urine. Drinking enough fluids throughout the day helps offset this.
Serious but Rare Risks
Jardiance carries a warning for diabetic ketoacidosis, a dangerous buildup of acids in the blood. Unusually, this can occur even when blood sugar levels appear normal or only slightly elevated, which can delay diagnosis. Symptoms include nausea, vomiting, abdominal pain, fatigue, and difficulty breathing.
An extremely rare risk is Fournier’s gangrene, a severe infection of the genital or perineal area. UK safety data documented 6 cases across more than 548,000 patient-years of treatment with SGLT2 inhibitors, making it exceptionally uncommon. Severe pain, swelling, redness, or fever in the genital area warrants immediate medical attention.
Serious genital or urinary tract infections requiring hospitalization have also been reported, though they remain infrequent. Any infection symptoms that worsen rapidly or come with fever should be evaluated promptly.