Like any drug, the type 2 diabetes medication empagliflozin (Jardiance) can cause side effects for some people. Most are mild, and some may go away once your body gets used to the drug. But some can be bothersome, and others serious.
When you know what to look out for, you can take steps to manage any side effects you may have. And you’ll know when it’s time to talk to your doctor.
How to Manage Common Side Effects of Empagliflozin (Jardiance)
The two most common side effects of empagliflozin are urinary tract infections and yeast infections.
Why is that? Empagliflozin works by helping your body get rid of excess blood sugar through your pee. High sugar levels in your pee create an environment in your genital area that encourages bacteria and yeast to grow.
Urinary tract infections (UTIs). These bacterial infections cause pain or burning when you pee, make you pee more often, and have pee that looks cloudy or dark. Female anatomy increases your risk of UTIs.
If you have these symptoms, see your doctor. They can treat you with antibiotics. To make yourself more comfortable during treatment:
- Drink lots of water to help flush out the bacteria.
- Use a warm heating pad on your belly to ease discomfort.
- Stay away from drinks like sodas, coffee, and alcohol that could irritate your bladder.
To prevent UTIs:
- Drink plenty of liquids, since peeing a lot helps flush bacteria out of your urinary tract.
- After using the toilet, wipe from front to back to keep bacteria out of your vagina and urethra.
- Pee after you have sex to help clear out bacteria.
- Avoid birth control methods that can help bacteria grow, like diaphragms, unlubricated condoms, and condoms with spermicide.
Yeast infections. Those with female anatomy are more likely to get these, too. Their symptoms include itching, burning, and a discharge.
You can treat them with antifungal medications you buy over the counter. They come as creams, lotions, tablets, and suppositories, and you use them for 3-7 days. If that’s not effective, your doctor can prescribe a stronger medication.
During treatment:
- Don’t have sex, since you can give a yeast infection to your partner.
- Wear loose-fitting underwear and clothing made from fabrics that breathe, like cotton.
- Try sleeping without underwear.
- Don’t douche or use tampons. (Pads are OK.)
To help avoid future yeast infections:
- Keep your genital area clean and dry.
- Wear cotton underwear (or underwear with a cotton crotch) and change it daily.
- Change out of wet swimsuits or sweaty workout clothes quickly.
- Stay away from hot tubs.
- Avoid douches and scented period products.
- Don’t wash your groin with harsh soap.
If you often get yeast infections that affect your penis, you might consider getting circumcised. Yeast infections are less likely in those who’ve been circumcised.
How to Manage Other Mild Side Effects of Empagliflozin (Jardiance)
Empagliflozin may cause some other minor side effects. They include:
Peeing more often. Taking your daily pill in the morning can keep you from having to get up to pee at night. Don’t try to manage this by drinking less fluid, since that could lead to dehydration.
Increased thirst. Because you’re peeing more often, you need to drink more. Listen to your body and drink water throughout the day. But if your thirst becomes intense and comes with other symptoms like fatigue, nausea, and belly pain, seek medical care right away. You may be having a serious side effect called ketoacidosis.
Nausea. Like many prescription meds, empagliflozin can make you feel nauseated. Try taking your daily dose with food, or at least a few crackers. If the nausea doesn’t go away in a few weeks, ask your doctor about taking your pill later in the day. They might also recommend an anti-nausea medication.
Joint pain. In clinical studies, a few people who took empagliflozin reported joint pain. If this happens to you and it doesn’t go away, talk to your doctor. They may change your medication or your dosage. Or they might recommend ice packs, heating pads, or over-the-counter pain relievers.
Upper respiratory infections. It’s not clear how empagliflozin might lead to upper respiratory infections, such as colds. But they were more likely to affect people taking the 25-milligram dosage than those on 10-milligram pills. Typical symptoms include a cough, runny nose, and sore throat. They often get better in a week or 2 without treatment. To ease symptoms, try rest, extra fluids, and over-the-counter pain relief meds.
Even if you don’t think it’s serious, tell your doctor about any side effect that lasts a long time or interferes with your daily life.
What to Do if You Have Serious Side Effects With Empagliflozin (Jardiance)
It’s rare, but empagliflozin could cause some side effects that are serious and even potentially life-threatening. They include:
Dehydration. Because it makes you pee more, empagliflozin causes you to lose body fluid and salt. If you get dehydrated, you might feel weak, dizzy, or lightheaded, particularly when you stand up. Your risk for this side effect goes up if you:
- Are 65 or over
- Have kidney problems
- Take certain blood pressure medicines
- Follow a low-salt diet
If you’re mildly dehydrated, you’ll usually get better after you drink more water. (Avoid fruit juice and soda.) But serious dehydration requires medical treatment. You may need an IV with a hydration solution.
To avoid dehydration, drink enough fluids every day, especially if it’s hot or you’re exercising. Ask your doctor how much you should be drinking. Tell them if you’re drinking or eating less than usual, such as when you’re sick or vomiting.
Serious UTIs.Sometimes, a urinary tract infection can be bad enough to send you to the hospital. Call your doctor if you have:
- Burning when you pee
- A need to pee very often or right away
- Pain in your lower belly
- Blood in your urine
You might also have a fever, back pain, and nausea.
Your doctor can treat you with antibiotics. For a very serious UTI, you might get antibiotics through an IV.
Low blood sugar (hypoglycemia). This is more likely when you take empagliflozin along with another diabetes medication. Symptoms include:
- Headache
- Confusion
- Crankiness
- Dizziness
- Tiredness
- Hunger
- Shakiness
- Weakness
- Sweating
- Fast heartbeat
To avoid low blood sugar, monitor your blood sugar regularly and take your diabetes medications as your doctor tells you to.
If your sugar gets too low, use glucose tablets, fruit juice, or hard candy to quickly increase it. If needed, someone can give you the emergency medication glucagon. Make sure your loved ones know the symptoms of low blood sugar and what to do if they notice them. Wear jewelry or carry a card that identifies you as someone with diabetes.
Very low blood sugar can lead to problems like unconsciousness or seizures, for which you’ll need emergency care.
Ketoacidosis. This is a serious condition that requires hospital treatment. You could get it if your blood sugar stays too low for too long. When this happens, your liver breaks down fat for fuel. This process creates acids called ketones that can reach dangerous levels in your body.
The symptoms of ketoacidosis include
- Tiredness
- Nausea or vomiting
- Belly pain
- Trouble breathing
If you have these symptoms, call your doctor right away or go to the emergency room. If you can, check for ketones in your urine using a strip or monitor. Do this even if your blood sugar is less than 250 mg/dL.
To prevent ketoacidosis, keep your diabetes under control and test your blood sugar regularly.
Fournier’s gangrene (necrotizing fasciitis). This is a rare bacterial infection that destroys tissue in the area between and around your genitals and anus, called the perineum. It’s more likely to happen to those with male genitals. Symptoms include:
- Pain, swelling, or redness around the perineum
- Weakness
- Fever
- Tiredness
Get emergency medical help if you have these symptoms. This infection can send you to the hospital and require several surgeries. It can even be fatal.
It’s not clear if there’s any way to prevent Fournier’s gangrene, but you could catch it early if you regularly check your genital area for redness, swelling, and tenderness. Keeping the area clean and using a clean razor when you shave the area could help, too.
Allergic reaction. Allergic reactions to empagliflozin are usually mild. But you might be having a serious allergic reaction if you have:
- Hives (red bumps that are sometimes itchy)
- Swelling in your face, lips, throat or other areas of skin
- Trouble breathing or swallowing
If you have any of these symptoms, call your doctor right away or go to the emergency room.
