Side effects of Jardiance (Empagliflozin) – SGLT2 Inhibitor

Side effects of Jardiance (empagliflozin) are mostly mild in nature and generally reversible when the treatment is discontinued.

Most side effects occur as a result of the drug’s mechanism of action. Jardiance is a drug that belongs to the class of diabetes medicines called SGLT2 Inhibitors.

These drugs inhibit the reabsorption of glucose from the kidneys back to the blood.

Since it allows glucose to be excreted via the urine, the most common side effect of Jardiance is an infection of the urinary tract.

More than 5% of patients experience side effects such as urinary tract infections or fungal infections of their penis or vagina.

What are the Side Effects of Jardiance?

Jardiance can cause side effects that may be milder if the medication is continued for a longer time. Jardiance usually clears within a few days.

The half-life of Jardiance is 12 hours. This means that most of the drug is eliminated within 24 hours. However, it can take several days to clear the entire body.

Minor side effects like increased urination should disappear within a couple of days. It may take several days or even weeks for infections, liver abnormalities, or kidney injuries to be resolved.

Low blood pressure (Hypotension):

Jardiance can reduce the fluid levels in your blood vessels by changing the way they work. Reduced body fluid can lead to decreased blood flow and hypotension or low blood pressure in some people.

Jardiance is more likely to cause hypotension in the following high-risk patients:

• People with renal disease
• People 65 and over
• People with low blood pressure already
• People who are taking diuretic medication such as furosemide and hydrochlorothiazide

Hypotension can cause dizziness and lightheadedness, particularly when standing up. Jardiance can cause hypotension.

Severe hypotension (low blood pressure) can manifest as any of the following symptoms:

• Clammy skin
• Feeling dizzy or falling while standing up
• Lightheadedness

It is better to adjust the blood pressure-lowering medicines, especially diuretics, ACE Inhibitors, ARBs, and vasodilators before prescribing Jardiance.

Dehydration:

Jardiance may cause dehydration as a result of osmotic diuresis.

Symptoms of dehydration can be:

• Feeling dizzy or lightheaded
• Producing less urine than normal
• Thirst

It is advisable to take plenty of fluids, preferably water. It is also important to review your list of medications and discontinue or reduce the dose of medicines that can result in dehydration and fluid loss.

Allergic reactions:

• If you have had an allergy to Jardiance and any of its components, avoid using it. Talk to your doctor about other options.

Kidney damage:

Jardiance may reduce the fluids in your body. This can cause your kidneys to work less efficiently. Jardiance is not recommended for people with kidney disease or dialysis.

Before you begin Jardiance, your doctor will perform a blood test to check the health of your kidneys.

Jardiance may not be recommended for you if you have moderate-to-severe kidney damage. Jardiance will require regular blood tests to determine if it is affecting your kidneys.

Kidney problems such as sudden kidney injury can occur with Jardiance use in diabetic patients.

You may experience the following symptoms:

• Swelling in the legs and ankles
• confusion
• fatigue or a lack of energy
• Producing less urine and urinating less frequently than normal

Diabetic ketoacidosis is (DKA):

Jardiance users have reportedly developed diabetic ketoacidosis despite normal blood glucose levels (euglycemic ketoacidosis).

This is a life-threatening condition and requires immediate medical attention in a hospital. DKA is a condition where there is a buildup of acid in the blood due to high blood sugar or low blood sugar.

It occurs when ketones build up in the bloodstream due to the body burning fats for energy. Ketoacidosis can be life-threatening and causes severe symptoms like intense thirst, frequent urination, and nausea.

It also causes abdominal pain, weakness, and fatigue. Jardiance should be administered with a regular check of both glucose and ketone levels to avoid ketoacidosis.

Consult your doctor, if you experience any symptoms of DKA such as:

• Nausea or vomiting
• Stomach pain (belly pain)
• Feeling generally unwell and tired.
• Breathing difficulty

Ketoacidosis risk can be increased by certain factors. These include problems with your pancreas, alcohol abuse, and not eating enough.

Talk to your doctor if you have any of the risk factors. Jardiance may be monitored more closely by your doctor.

Recurrent urinary tract infection (UTI):

Jardiance can lead to one of its most common side effects, which is UTI. You can also get treatment at a hospital for severe UTIs.

Jardiance should not be used if you are already susceptible to frequent UTIs. Your doctor may ask for more frequent monitoring during treatment. They may also recommend a safer medication.

Patients with diabetes are generally more susceptible to fungal and bacterial infections. Because bacteria and fungi use glucose as energy, this is why patients with diabetes are more susceptible.

Their food supply is increased by high blood sugar. A high blood sugar level can also affect the immune system’s ability to fight off infection.

Jardiance lowers blood glucose levels by filtering glucose from the bloodstream to the urine. This reduces blood sugar, which is a good thing.

However, it makes urine sugary. This sugary environment is conducive to yeast, bacteria, and mold growth in the urinary tract, genitals, and bladder.

Jardiance can lead to kidney, urinary tract, and genital infections. Jardiance bacteria can cause serious infections in rare cases.

Urosepsis is a condition that causes a severe infection of the urinary tract. Pyelonephritis is a severe kidney infection.

Low blood sugar:

Jardiance does not cause hypoglycemia when taken alone. It does not lower blood glucose even if the patient does not have diabetes. However, it can cause hypoglycemia if it is taken with insulin or sulfonylureas like glyburide.

Symptoms of hypoglycemia may manifest as:

• dry mouth
• Fatigue
• Feeling dizzy or lightheaded
• headache
• Hunger
• Concentration difficulties

Recurring genital yeast infections and Vaginal Itching:

Jardiance can lead to genital yeast infections. Vaginal yeast infections were a common side effect of Jardiance according to studies.

Itching in the vagina and around the area is another common sign of vaginal yeast infections. Other symptoms include redness, discoloration, and swelling.

According to studies, genital yeast infections were one of the most common side effects for people who took Jardiance.

It was more common in females than in males. When the body’s “good” bacteria (called microflora), is out of balance, yeast infections can occur.

Talk to your doctor if you have had yeast infections in the past or are currently suffering from a persistent yeast infection. Jardiance can make your condition worse and could be dangerous.

These tips can help avoid yeast infections when you take Jardiance.

• If you have a yeast infection, it is best to avoid sexual activity with your partner. Yeast infections can spread back and forth.
• Use breathable cotton underwear and make sure to change it every day. Don’t wear your wet swimsuit longer than necessary. Non-breathable, tight fabrics can trap moisture. The yeast fungus likes to grow in dark, moist areas.
• After using the bathroom, wipe your body from the front to the back. This will prevent bacteria from spreading to the genitals and urinary tract.
• Foods that support good bacteria are best. This helps to keep yeast from growing. Yogurt which is rich in natural probiotics is one example of such food.

Fournier’s Gangrene:

Fournier’s Gangrene is a condition where a bacterial infection explodes and begins attacking and killing the tissues around the genitals, anus, and skin. It can be life-threatening if it is not treated immediately.

• Fever
• Sickness
• Moderate to severe swelling or pain around the anus and genitals
• Foul smell in the area
• When you rub the area, you will hear crackling, crunching, or popping sounds

Fournier’s Gangrene symptoms can appear as soon as you start Jardiance. Rare cases of this infection have been seen in men and women since Jardiance has been available on the market. These infections can lead to hospitalizations, surgeries, or even death.

These suggestions can lower your chance of necrotizing fasciitis.

• Drink plenty of water and maintain healthy blood sugar levels:
  • Your risk of skin infections increases when your blood sugar is high. High blood sugar levels can lead to dry skin. Dry skin is more likely to crack and heals slower. Increase water intake to at least eight 8-ounce of glasses once a day to maintain adequate hydration.
• Maintain good hygiene:
  • To prevent bacteria from spreading to your bladder, wipe down the toilet seat from the front and back. Wear loose-fitting cotton underneath and change it every day.
• Do not wait to seek treatment:
  • Contact your doctor immediately if you suspect you may have an infection in your genital or urinary tract. The earlier you treat it, the less likely it is for the infection to spread or become more severe.

High cholesterol:

If you have high cholesterol, before you start Jardiance, speak with your doctor. In studies, people who took Jardiance saw an increase in their low-density cholesterol (LDL) levels.

High cholesterol can increase your risk of heart attack and stroke. Jardiance may cause your doctor to be more vigilant about your cholesterol.

Your doctor may prescribe you a cholesterol medication (or increase the dose if you are already taking one).

Fractures risk with Jardiance?

There has been an increase in the risk of fractures with SGLT2 inhibitors Drugs. It is commonly associated with the use of Canagliflozin (Invokana).

However, patients on other SGLT2 Inhibitors including Jardiance (empagliflozin) should also take precautions if their baseline fracture risk is high.

In the Empa-Reg Trial, bone fractures occurred in 31 out of 765 patients (4.1%) who were using 25 mg empagliflozin and 33 out of 780 patients (4.2%) who were on Glimepiride.

Hence, the author concluded that empagliflozin was not associated with an increased risk of bone fractures [Ref].

Can Jardiance affect the eyes?

Jardiance should not cause any eye problems. Side effects of Jardiance on the eyes were not reported in studies.

Blurred vision and other eye problems may occur if your blood sugar levels are high. Blurred vision is also possible when you start insulin (a treatment for diabetes).

Diabetes patients should visit their eye doctor annually or as necessary if they have vision problems. Call your doctor immediately if you notice any vision problems.

Is Jardiance a cause of anxiety?

Jardiance does not cause anxiety. Jardiance was not reported to cause this side effect in students. However, anxiety is common among those who have long-term conditions such as type 2 diabetes or heart disease.

Jardiance has no effect on the nervous system. Jardiance may cause dangerously low blood sugar levels if taken in combination with diabetes medication.

Low blood sugar, also known as hypoglycemia or adrenaline, causes the body’s release of epinephrine.

This “adrenaline rush”, which causes anxiety, panic attacks, rapid heartbeats, palpitations and jitteriness, sweating excessively, tremors, and tremors, is responsible for many of the symptoms of low sugar.

Jardiance can cause anxiety and other symptoms such as low blood sugar. You should seek immediate medical attention.

If low blood sugar is common, your healthcare provider might recommend an emergency glucagon kit.

There are many methods to deal with anxiety. These include deep breathing exercises. Talk to your doctor if you find these coping methods insufficient. Your doctor can help you choose the best treatment option to treat your anxiety.

Jardiance and Weight Loss:

Jardiance can be used to control blood sugar and decrease body fat. Jardiance has been shown to significantly reduce abdominal fat (visceral excess tissue).

The risk of heart attack, stroke, and other cardiovascular events is increased by abdominal body fat. A reduction in belly fat can help reduce your risk of developing heart disease or other cardiovascular diseases.

While weight loss is a desirable side effect for most diabetes patients, very lean patients can not afford to lose even a little weight. The weight loss effect of Jardiance in these patients can be undesirable.

Jardiance and alcohol use:

Excessive alcohol consumption while on Jardiance is not advised. Many alcoholic beverages also contain added sugars that can increase blood sugar levels. Jardiance and other SGLT2 inhibitors can cause side effects that may be more severe when taken with alcohol. These side effects include::

• Urinating more frequently than usual
• Dehydration (low fluid level in the body).
• Diabetic ketoacidosis is a buildup of acid in the blood due to high blood sugar levels and low Insul levels.

To Summarize:

Side effects of Jardiance include:

• Increased frequency and volume of urine (despite normal blood glucose)
• Fluid and volume loss resulting in dehydration and low blood pressure
• Acute kidney injury as a result of volume depletion especially in individuals who are at risk of developing kidney disease
• Recurrent genital and urinary tract infections that may be at times life-threatening (Fournier’s gangrene)
• Euglycemic diabetic ketoacidosis
• High cholesterol levels can occur.