Jardiance (empagliflozin) is a prescription medication used to treat Type 2 diabetes and heart failure, and to reduce the risk of cardiovascular death in adults with Type 2 diabetes and established cardiovascular disease. As a sodium-glucose cotransporter-2 (SGLT2) inhibitor, it works by helping the kidneys excrete excess glucose from the body through the urine. While effective, like many medications, it can cause side effects. Dizziness is one such potential side effect, though it is not one of the most frequently reported. It is most often linked to the drug's effect on fluid levels and blood pressure.
The Primary Causes of Dizziness with Jardiance
Dehydration and Low Blood Pressure
Jardiance increases urination to expel glucose from the body, a process known as osmotic diuresis. This can lead to a loss of body water and salt, resulting in dehydration, also called volume depletion. For some individuals, this reduction in blood volume can cause a drop in blood pressure (hypotension). When blood pressure drops, the brain and other organs may not receive enough blood flow, leading to lightheadedness or dizziness.
One specific type of low blood pressure related to Jardiance is orthostatic hypotension, which causes dizziness or faintness when a person stands up quickly from a sitting or lying position. Risk factors for dehydration and low blood pressure on Jardiance include:
- Taking other medications that lower blood pressure, such as diuretics ('water pills')
- Being over the age of 65
- Having kidney problems
- Being on a low-salt diet
Hypoglycemia (Low Blood Sugar)
Although Jardiance primarily works by removing glucose, it can also increase the risk of low blood sugar, especially when taken with other diabetes medications like insulin or sulfonylureas. Symptoms of hypoglycemia often include dizziness, headache, weakness, confusion, and a fast heartbeat. In adults taking Jardiance alone, the risk of hypoglycemia is lower. However, in combination with insulin or sulfonylureas, a dose adjustment of the other medication may be necessary to lower the risk. Pediatric patients taking Jardiance are at a higher risk of hypoglycemia, regardless of whether they are on other blood-sugar-lowering medications.
Preventing and Managing Dizziness
Stay Well-Hydrated
Drinking plenty of fluids is one of the most effective strategies to prevent dehydration and the resulting dizziness. Aim for eight to ten glasses of water daily, and increase intake during exercise or hot weather. For heart failure patients, a doctor will provide specific guidance on safe fluid intake.
Move Cautiously
To manage orthostatic hypotension, avoid sudden movements. Instead, get up slowly from sitting or lying down, allowing your body to adjust to the change in posture.
Monitor Blood Sugar
If you are on other diabetes medications, consistent blood sugar monitoring is important to catch and treat low blood sugar promptly. Always carry a fast-acting sugar source, such as glucose tablets or hard candy, to treat hypoglycemia quickly.
Avoid Compounding Factors
Certain substances can worsen dehydration. Limit or avoid excessive alcohol and caffeine consumption, as both can increase urination.
When to Contact a Healthcare Provider
If dizziness becomes severe, persistent, or is accompanied by other concerning symptoms, contact your healthcare provider. This may signal an underlying issue or necessitate a dose adjustment or medication change.
Comparing Causes of Dizziness with Jardiance
| Feature | Dehydration/Low Blood Pressure | Hypoglycemia (Low Blood Sugar) |
|---|---|---|
| Mechanism | Increased urination leads to volume depletion, causing blood pressure to drop. | Can occur when Jardiance is used with other blood-sugar-lowering drugs. |
| Symptom Profile | Lightheadedness, feeling faint, weakness, especially when standing up. | Headache, sweating, shaking, irritability, hunger, confusion. |
| Risk Factors | Elderly age, kidney disease, diuretic use, low-sodium diet. | Co-administration with insulin or sulfonylureas. |
| Management | Increase fluid intake and move slowly when changing positions. | Check blood sugar and consume a source of quick sugar. |
What to Do If You Experience Dizziness
- Sit or lie down: Change your position to a safer one to prevent a fall.
- Drink fluids: If you suspect dehydration, slowly drink a glass of water.
- Check blood sugar: If you have diabetes and are on other blood-sugar-lowering medications, check your blood glucose levels.
- Notify your doctor: Contact your healthcare provider if the dizziness is severe, does not resolve, or is accompanied by other serious symptoms.
Conclusion
Dizziness is a possible, though not uncommon, side effect of Jardiance, stemming primarily from dehydration due to the medication's diuretic action. It can also be a symptom of hypoglycemia, particularly in patients on combination therapy. By staying properly hydrated, exercising caution when standing up, and monitoring blood sugar levels, many patients can manage or prevent this side effect. Anyone experiencing persistent or severe dizziness should consult their healthcare provider to discuss potential dose adjustments or alternative treatment options. Do not stop taking Jardiance without speaking to your doctor first. For more detailed information on Jardiance side effects, consult a reliable medical resource like the Mayo Clinic.
