Jardiance, with the active ingredient empagliflozin, is a prescription medication used to manage type 2 diabetes, heart failure, and chronic kidney disease. As a sodium-glucose cotransporter-2 (SGLT2) inhibitor, it lowers blood sugar by causing the kidneys to excrete more glucose in the urine. While highly effective, its mechanism of action can lead to significant interactions with other drugs, supplements, and lifestyle choices. Understanding these risks is crucial for anyone taking Jardiance.
Key Medications That Interact With Jardiance
Diuretics (Water Pills)
Combining Jardiance with diuretics can increase the risk of dehydration and low blood pressure due to both medications increasing urination. This can cause dizziness, lightheadedness, and fainting, particularly in older adults or those with kidney issues. Severe dehydration can worsen kidney function. Healthcare providers may adjust dosages and recommend increased hydration. Common diuretics include furosemide, hydrochlorothiazide, and spironolactone.
Insulin and Insulin Secretagogues
Taking Jardiance with insulin or insulin secretagogues (like sulfonylureas and glinides) can significantly increase the risk of hypoglycemia (low blood sugar). While Jardiance alone has a low hypoglycemia risk, combining it with other glucose-lowering drugs raises this risk. Dosage adjustments for insulin or sulfonylureas are often necessary, and patients should monitor for hypoglycemia symptoms such as sweating, shakiness, and confusion.
Lithium
Jardiance can impact the kidneys' ability to clear lithium, a medication for bipolar disorder. This can result in lower lithium levels in the blood, making the medication less effective. Closer monitoring of serum lithium levels and potential dosage adjustments are required when taking Jardiance with lithium.
Other Potential Interactions
Caution is also needed with other SGLT2 inhibitors and certain herbal supplements and antidepressants that can affect blood sugar levels. Some blood pressure medications, like ACE inhibitors and ARBs, can increase the risk of low blood pressure when combined with Jardiance, especially with diuretic use.
Lifestyle and Diet Interactions
Alcohol Consumption
Drinking alcohol while on Jardiance can worsen side effects and health risks. Alcohol's diuretic effect can increase dehydration risk, and it can also lower blood sugar, increasing hypoglycemia risk, particularly with other diabetes medications. Furthermore, heavy alcohol use with Jardiance may increase the risk of diabetic ketoacidosis.
Ketogenic Diet
A ketogenic diet can also increase the risk of ketoacidosis when combined with Jardiance. Patients on this diet should discuss the risks with their doctor.
Comparison of Key Jardiance Interactions
| Interacting Agent | Interaction Mechanism | Associated Risk |
|---|---|---|
| Diuretics (Water Pills) | Both increase urination, leading to fluid loss. | Dehydration, low blood pressure, fainting, and potential kidney issues. |
| Insulin & Sulfonylureas | Both lower blood sugar levels, with a cumulative effect. | Hypoglycemia (dangerously low blood sugar). |
| Lithium | Jardiance affects kidney clearance, reducing lithium concentration. | Decreased therapeutic effect of lithium; frequent monitoring required. |
| Alcohol | Dehydration effect and impact on blood sugar. | Heightened risk of dehydration, low blood pressure, hypoglycemia, and ketoacidosis. |
| Certain Supplements | Some supplements can independently affect blood sugar levels. | Unpredictable blood sugar changes and potential hypoglycemia (e.g., with chromium, green tea). |
| Ketogenic Diet | Increases ketone production in the body. | Increased risk of diabetic ketoacidosis. |
Conclusion
Being aware of potential interactions is crucial when taking Jardiance. Combining it with diuretics, insulin, or lithium requires careful management by a healthcare professional due to risks of dehydration, hypoglycemia, and altered lithium levels. Lifestyle choices like alcohol consumption and diet also play a significant role. Always discuss all medications, supplements, and lifestyle factors with your doctor to ensure safe and effective treatment.
Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice. Always consult with a healthcare provider before starting or stopping any medication.
Frequently Asked Questions
What are the main drug interactions with Jardiance? The main drug interactions are with diuretics (water pills), insulin and insulin secretagogues (like sulfonylureas), and lithium. These can increase the risk of dehydration, low blood sugar, and reduced lithium effectiveness, respectively.
Can you take Jardiance with metformin? Yes, Jardiance and metformin are often prescribed together and are generally considered safe. The combination can be effective for managing blood sugar, though it may slightly increase the risk of hypoglycemia compared to Jardiance alone.
What are the symptoms of dehydration when taking Jardiance with a diuretic? Symptoms of dehydration can include dizziness, feeling lightheaded, weakness, and excessive thirst. If you experience these, especially when standing up, inform your doctor immediately.
Is it safe to drink alcohol while taking Jardiance? It is generally advised to limit or avoid alcohol while taking Jardiance. Alcohol can increase the risk of dehydration, low blood pressure, hypoglycemia, and raises the risk of ketoacidosis.
What happens if you take Jardiance with insulin? Taking Jardiance with insulin can increase the risk of hypoglycemia (low blood sugar). A doctor will typically adjust the insulin dose to mitigate this risk, and you will need to monitor your blood sugar more closely.
Can Jardiance be taken with pain medications like aspirin? Low-dose aspirin is generally considered safe to take with Jardiance. However, if you are taking high-dose aspirin for pain relief, consult your doctor, especially if you have kidney or heart issues.
Why is lithium monitoring important with Jardiance? Jardiance can decrease the amount of lithium in your blood, which could make it less effective. Frequent monitoring allows your doctor to check your lithium levels and adjust your dosage as needed.
