Jardiance is the brand name for empagliflozin, a prescription medication that lowers blood sugar by causing your kidneys to flush excess glucose out through your urine. It belongs to a drug class called SGLT2 inhibitors. While originally approved for type 2 diabetes, Jardiance has since gained FDA approval for heart failure and chronic kidney disease, making it one of the more versatile cardiovascular and metabolic medications available today.
How Jardiance Works
Your kidneys normally filter glucose from your blood and reabsorb most of it back into your bloodstream. Jardiance blocks the protein responsible for that reabsorption (called SGLT2), so more glucose passes into your urine instead. The result is lower blood sugar levels without directly affecting insulin production. Because you’re essentially urinating out extra sugar and the water that follows it, the drug also has a mild diuretic effect, which partly explains its benefits for heart failure and blood pressure.
FDA-Approved Uses
Jardiance has four approved indications, which is unusually broad for a single medication:
- Type 2 diabetes: As an add-on to diet and exercise to improve blood sugar control in adults and children aged 10 and older.
- Cardiovascular protection in diabetes: To reduce the risk of cardiovascular death in adults with type 2 diabetes who already have established heart disease.
- Heart failure: To reduce the risk of cardiovascular death and hospitalization in adults with heart failure, regardless of whether they also have diabetes.
- Chronic kidney disease: To slow kidney decline and reduce hospitalizations in adults with CKD at risk of progression.
Jardiance is not approved for type 1 diabetes and is not recommended for blood sugar control when kidney function is severely reduced (eGFR below 30).
Evidence Behind the Heart Benefits
The cardiovascular benefits of Jardiance are among the strongest selling points of the drug. In the landmark EMPA-REG OUTCOME trial, which studied people with type 2 diabetes and existing heart disease, empagliflozin reduced cardiovascular death by 38%, all-cause death by 32%, and hospitalization for heart failure by 35% compared to placebo.
A separate trial called EMPEROR-Preserved broke new ground by showing that Jardiance reduced the combined risk of cardiovascular death or heart failure hospitalization by 21% in people with a type of heart failure that had historically been very difficult to treat. That made it the first therapy to show a statistically significant improvement in outcomes for heart failure with preserved ejection fraction, a condition where the heart pumps normally but stiffens and doesn’t fill properly.
These results are a major reason why the American Diabetes Association’s 2024 guidelines recommend SGLT2 inhibitors as a preferred treatment for people with type 2 diabetes who also have heart failure, cardiovascular disease, or chronic kidney disease.
Common Side Effects
The most frequently reported side effects are urinary tract infections and yeast infections in women. Both are a direct consequence of the drug’s mechanism: extra sugar in the urine creates a friendlier environment for bacteria and yeast. Good hygiene and staying well hydrated help reduce this risk.
Because Jardiance increases urination, dehydration is a practical concern. You may feel dizzy, lightheaded, or faint when standing up, especially early on. The risk goes up if you’re over 65, take blood pressure medications or diuretics, follow a low-salt diet, or have reduced kidney function. Drinking plenty of water throughout the day is important, particularly when you first start the medication or during hot weather, illness, or any situation where you’re losing fluids.
Serious Risks to Know About
Jardiance carries several rare but serious warnings. Ketoacidosis, a dangerous buildup of acids in the blood, can occur even when blood sugar levels appear normal (below 250 mg/dL). This is sometimes called euglycemic ketoacidosis because it doesn’t come with the sky-high blood sugar readings that typically signal the condition. Symptoms include nausea, vomiting, stomach pain, tiredness, and difficulty breathing.
A very rare but severe bacterial infection called necrotizing fasciitis can develop in the genital and perineal area. This is a medical emergency that may require surgery. Any unusual pain, tenderness, redness, or swelling in that region warrants immediate medical attention.
Low blood sugar is generally not a major risk when Jardiance is taken alone, since the drug doesn’t stimulate insulin production. However, the risk increases significantly if you also take insulin or other medications that actively lower blood sugar. In children aged 10 and older, the risk of low blood sugar is higher even without additional diabetes medications.
SGLT2 inhibitors as a class have been associated with a small increased risk of lower-limb amputations, particularly in people with a history of amputation, poor circulation in the legs, or diabetic foot ulcers.
Kidney Function Requirements
Because Jardiance works through the kidneys, your kidney function needs to be checked before starting the drug. The key measurement is eGFR, a number that estimates how well your kidneys filter waste. For blood sugar control, Jardiance should not be started if eGFR is below 45 and is contraindicated below 30. If kidney function drops persistently below 45 while you’re already taking it, the medication is typically discontinued for that purpose.
The thresholds differ somewhat for heart failure and kidney disease indications, where Jardiance has shown benefits even in people with lower kidney function. Your prescriber will determine whether the drug is appropriate based on your specific situation and the reason for prescribing it.
Practical Tips While Taking Jardiance
Jardiance comes as a tablet taken once daily by mouth. Staying hydrated is the single most important lifestyle adjustment. Increased urination is expected, especially in the first few weeks, and you should contact your prescriber if you become ill, stop eating or drinking normally, or lose fluids through vomiting or diarrhea.
Because excess sugar in the urine can promote infections, keeping the genital area clean and dry helps reduce the chance of yeast infections and urinary tract infections. If you notice burning during urination, unusual discharge, or persistent itching, let your healthcare provider know promptly rather than waiting for it to resolve on its own.