Jardiance (empagliflozin) is FDA-approved to treat four conditions: type 2 diabetes, heart failure, chronic kidney disease, and cardiovascular risk reduction in people with type 2 diabetes and established heart disease. Originally developed as a diabetes medication, its uses have expanded significantly as clinical trials revealed broad benefits for the heart and kidneys.
FDA-Approved Uses for Jardiance
Jardiance carries four distinct indications on its FDA label, each supported by large-scale clinical trials:
- Type 2 diabetes: As an add-on to diet and exercise to improve blood sugar control in adults and children aged 10 and older.
- Heart failure: To reduce the risk of cardiovascular death and hospitalization in adults with heart failure, regardless of ejection fraction.
- Chronic kidney disease: To slow kidney function decline and reduce the risk of cardiovascular death in adults with CKD at risk of progression.
- Cardiovascular protection: To reduce the risk of cardiovascular death in adults who have both type 2 diabetes and established cardiovascular disease.
This range of uses makes Jardiance unusual. Many people taking it today were not prescribed it primarily for blood sugar control. If your doctor recommended Jardiance for heart failure or kidney disease, that is now a well-established, on-label use.
How Jardiance Works
Jardiance belongs to a class of drugs called SGLT2 inhibitors. In a healthy kidney, a transporter protein called SGLT2 sits in the early part of the kidney’s filtration tubes and reclaims about 97% of the glucose that gets filtered from your blood. Jardiance blocks that transporter, so more glucose passes into your urine instead of being reabsorbed back into your bloodstream.
But glucose isn’t the only thing affected. When SGLT2 is blocked, the kidney also excretes more sodium and water. This reduces fluid volume in your body and lowers blood pressure, which partly explains why the drug helps the heart and kidneys. The kidney’s filtration tubes reabsorb roughly 27% less fluid when an SGLT2 inhibitor is on board. That reduction in workload appears to protect kidney tissue from long-term damage, and the drop in fluid volume eases the burden on a struggling heart.
Blood Sugar Control in Type 2 Diabetes
Jardiance’s original purpose is lowering blood sugar. In clinical trials, patients taking Jardiance saw their HbA1c (a measure of average blood sugar over roughly three months) drop meaningfully compared to placebo. In a pediatric trial of children and adolescents with type 2 diabetes, pooled empagliflozin groups showed an HbA1c reduction of 0.84 percentage points more than placebo after 26 weeks. For context, a drop of 0.5 to 1.0 percentage points is generally considered clinically significant.
Jardiance is not used for type 1 diabetes. It works by blocking glucose reabsorption in the kidneys, so it complements but does not replace insulin or other diabetes medications. Most people take it alongside other treatments rather than on its own.
Heart Failure Protection
The heart failure indication covers both major types: heart failure with reduced ejection fraction (where the heart pumps weakly) and heart failure with preserved ejection fraction (where the heart pumps with normal force but is stiff and doesn’t fill properly). This broad coverage is notable because few medications work well for both forms.
The EMPEROR-Reduced trial tested Jardiance in patients whose hearts pumped weakly. Those taking the drug had a 25% lower risk of cardiovascular death or hospitalization for heart failure compared to placebo. Hospitalizations alone dropped by 31%. The benefit appeared within weeks of starting treatment, not months. A companion trial, EMPEROR-Preserved, extended these findings to patients with the stiffer-heart form of heart failure, leading to the broad FDA approval that now covers heart failure regardless of ejection fraction.
Cardiovascular Death Reduction in Diabetes
Before the heart failure approvals came a landmark finding. The EMPA-REG OUTCOME trial enrolled patients who had both type 2 diabetes and established cardiovascular disease, such as a prior heart attack or stroke. Adding Jardiance to their standard care reduced the risk of dying from cardiovascular causes by 38% compared to placebo. That result, published in 2015, was the first time any diabetes drug had demonstrated such a clear cardiovascular survival benefit, and it reshaped how doctors think about treating diabetes in people with heart disease.
Slowing Chronic Kidney Disease
The EMPA-KIDNEY trial enrolled over 6,600 adults with chronic kidney disease, including many who did not have diabetes. After a median follow-up of two years, patients on Jardiance had a 28% lower risk of kidney disease progression or cardiovascular death compared to those on placebo. The rates were 13.1% in the Jardiance group versus 16.9% with placebo. Importantly, these benefits held across a wide range of kidney function levels and applied equally to people with and without diabetes.
This means Jardiance is now a treatment for kidney disease itself, not just a diabetes drug that happens to help the kidneys. If you have CKD and your doctor prescribes Jardiance even though your blood sugar is normal, the kidney protection is the reason.
Dosing Basics
Jardiance comes in two tablet strengths: 10 mg and 25 mg, taken once daily by mouth. For type 2 diabetes, the starting dose is typically 10 mg, with the option to increase to 25 mg for additional blood sugar lowering. For heart failure and chronic kidney disease, the 10 mg dose is standard. You can take it in the morning with or without food.
Because the drug works through the kidneys, kidney function matters for eligibility. Doctors check your estimated glomerular filtration rate (eGFR), a blood test that measures how well your kidneys filter. The specific eGFR thresholds for starting or continuing Jardiance depend on the condition being treated, and your doctor will monitor this over time.
Common Side Effects
The most frequently reported side effects reflect how the drug works. Because Jardiance pushes extra glucose into your urine, it creates an environment where yeast can thrive. Genital yeast infections are more common in both men and women taking Jardiance than in those on placebo. Urinary tract infections also occur at slightly higher rates.
The increased urination can lead to dehydration, especially in older adults or those already taking diuretics. Symptoms like dizziness, lightheadedness, or feeling faint when standing up can signal that your fluid intake needs to increase. A rare but serious side effect is diabetic ketoacidosis, a condition where acid builds up in the blood. This can occasionally occur even when blood sugar levels appear near-normal, which makes it harder to recognize. Symptoms include nausea, vomiting, abdominal pain, unusual fatigue, and difficulty breathing.
Most people tolerate Jardiance well. The side effects that do occur tend to be mild and manageable, which is one reason the drug has become so widely prescribed across its four approved uses.