Jardiance (empagliflozin) is a powerful medication from the class of drugs known as SGLT2 inhibitors. It helps manage blood glucose by prompting the kidneys to excrete excess sugar through urine. It is also prescribed for its heart and kidney protective benefits. While generally safe, its mechanism of action means that certain drug combinations and lifestyle habits can increase the risk of serious side effects, such as dehydration, ketoacidosis, and hypoglycemia. For optimal treatment and safety, it is essential to be aware of what to avoid while taking Jardiance.
Medications and Supplements to Approach with Caution
Certain medications and supplements can interact with Jardiance, primarily by affecting blood sugar levels or fluid balance. Always inform your doctor or pharmacist about all other medications, over-the-counter drugs, and supplements you are taking.
- Diuretics (Water Pills): Taking Jardiance with diuretics, such as furosemide (Lasix) or hydrochlorothiazide, significantly increases the risk of dehydration and low blood pressure. Both types of medication increase urination, and combining them can lead to excessive fluid loss, causing dizziness or lightheadedness. Your doctor may need to adjust your diuretic dose or monitor you more closely.
- Insulin and Insulin Secretagogues: When used with insulin or medications that stimulate insulin production (like sulfonylureas such as glipizide), Jardiance increases the risk of hypoglycemia (dangerously low blood sugar). Your healthcare provider may need to lower the dose of your insulin or sulfonylurea to prevent this.
- Lithium: Jardiance may reduce the effectiveness of lithium, a medication used for bipolar disorder. The kidneys clear lithium from the body, and Jardiance can alter this process. Your doctor might need to increase your lithium dosage and monitor your blood levels more frequently.
- Herbal Supplements: Supplements known to lower blood sugar, like garlic extract, ginseng, green tea extract, and chromium, can increase the risk of hypoglycemia when combined with Jardiance. While adding small amounts of these herbs to your cooking is generally fine, high-dose supplements should be avoided unless approved by your doctor.
Dietary and Lifestyle Restrictions
No foods are strictly forbidden, but some dietary choices can interfere with Jardiance's benefits or increase the risk of adverse effects. Maintaining a healthy diet and being mindful of certain habits are key to a successful treatment plan.
High-Sugar and Ultra-Processed Foods
- High-Sugar Foods: Foods and drinks high in added sugar (e.g., sodas, pastries, sugary cereals) counteract Jardiance's blood sugar-lowering effects. The medication works by removing excess glucose, but flooding the system with sugar forces it to work overtime, potentially increasing the risk of genital yeast infections.
- Ultra-Processed Carbohydrates: Refined carbohydrates like white bread, white pasta, and crackers can cause rapid blood sugar spikes, undermining the medication's purpose. Choosing whole-grain alternatives can help maintain more stable glucose levels.
Alcohol and Caffeine
- Alcohol: Excessive alcohol is strongly discouraged while taking Jardiance due to a three-fold risk. Both Jardiance and alcohol increase urination, elevating the risk of dehydration. Heavy drinking can also increase the risk of diabetic ketoacidosis (DKA), a serious side effect of SGLT2 inhibitors. Lastly, alcohol can unpredictably raise or lower blood sugar, complicating diabetes management.
- Excessive Caffeine: As a mild diuretic, caffeine can amplify Jardiance's effect of increased urination, potentially contributing to dehydration. While moderate coffee or tea consumption is generally safe, be sure to stay well-hydrated with water.
Ketogenic and Low-Carb Diets
- Ketogenic Diets: Very low-carbohydrate diets force the body to produce ketones for energy. This, combined with Jardiance, can significantly increase the risk of euglycemic DKA—ketoacidosis that occurs even when blood sugar levels are normal. This is a medical emergency that requires prompt treatment.
Prolonged Fasting
- Fasting: Similar to very low-carb diets, prolonged periods of fasting can increase the risk of ketoacidosis. Patients taking Jardiance, especially those with diabetes, should avoid skipping meals. Consult your doctor before fasting for any reason, including surgery, as they may advise temporarily stopping the medication.
Comparison of Jardiance-Friendly vs. Restricted Diets
| Aspect | Jardiance-Friendly Diet | Restricted / Cautionary Diet |
|---|---|---|
| Carbohydrates | High-fiber, whole grains (oats, quinoa) | Very low-carb or ketogenic diets |
| Sugars | Natural, whole fruits in moderation | Added sugars, refined carbs (soda, pastries) |
| Protein | Lean proteins (chicken, fish, beans) | Fried or ultra-processed proteins |
| Fats | Healthy fats (avocado, nuts, olive oil) | High-fat, greasy fast foods |
| Hydration | Prioritize water and non-sugary fluids | Excessive caffeine and alcohol |
When to Seek Medical Attention
While avoiding interactions is crucial, it is also important to recognize the signs of serious side effects and seek immediate medical help if they occur.
- Signs of Ketoacidosis: Look for nausea, vomiting, stomach pain, fatigue, and trouble breathing. This can occur even with normal blood sugar levels and requires immediate hospitalization.
- Signs of Dehydration: Be vigilant for dizziness, lightheadedness, weakness, dry mouth, or dark-colored urine. This risk is higher in the elderly, those with kidney problems, or those on diuretic medications.
- Signs of Hypoglycemia: Pay attention to symptoms like shaking, sweating, headache, weakness, and a rapid heartbeat. If you take insulin or a sulfonylurea with Jardiance, monitor your blood sugar frequently.
Conclusion
Taking Jardiance is a significant step toward managing complex health conditions like Type 2 diabetes, heart failure, and chronic kidney disease. However, maximizing its benefits and ensuring safety require vigilance regarding specific interactions and lifestyle habits. By being aware of what to avoid while taking Jardiance—including certain medications, high-sugar foods, excessive alcohol, and extreme low-carb diets—patients can significantly reduce their risk of complications. Always maintain open communication with your healthcare provider to discuss dietary changes, new medications, or any unusual symptoms you experience. Following these guidelines empowers you to manage your health safely and effectively.
For more information on the safety profile of Jardiance, you can consult the official FDA prescribing information.
