- What is Jardiance?
- What is metformin?
- Jardiance vs metformin effectiveness for diabetes
- What are the benefits of Jardiance vs metformin?
- What are the side effects of each medication?
- What is the price difference between Jardiance and metformin?
- Ease of use for Jardiance vs metformin
- Can you take metformin and Jardiance together?
- Can Jardiance be taken without metformin?
- Natural alternatives to Jardiance and metformin
- Conclusion
- Source
Managing type 2 diabetes can involve trial-and-error in treatment plans.
Several different medications are available to treat type 2 diabetes if you require medication to effectively manage your diabetes.
More medications available can bring some confusion about which might be best for you.
Let’s compare metformin, an older medication, vs Jardiance, one of the newer types of diabetes medications.
What is Jardiance?
Jardiance is one of the brand names for the drug empagliflozin, a type of SGLT2 inhibitor. SGLT2 inhibitor drugs help treat type 2 diabetes by reducing the amount of glucose excreted in your urine. The main way Jardiance achieves this is by reducing the amount of glucose reabsorbed in your kidneys.
Because it doesn’t stimulate insulin release, Jardiance doesn’t come with a risk of low blood sugar. In a controlled clinical trial, only 0.4% of participants developed low blood sugar, which wasn’t severe.
The Food and Drug Administration approved Jardiance to treat type 2 diabetes in 2014. They approved it for use to reduce cardiovascular death in people with type 2 diabetes in 2016 and again in 2021 to treat patients with heart failure.
Jardiance is most commonly prescribed in 10-milligram dosages taken in the morning. A 25-milligram dosage is also available.
What is metformin?
Metformin is one of the most commonly prescribed oral medications to treat type 2 diabetes.
The FDA approved Metformin for the treatment of type 2 diabetes in 1995, making it one of the older medications still used to treat type 2 diabetes today.
Metformin is the generic name most commonly prescribed. The brand name for metformin is Glucophage. Metformin doesn’t cause low blood sugar (hypoglycemia), which is one of its major benefits.
Metformin is in a drug class called biguanides. Biguanides help reduce the amount of sugar your liver makes while improving insulin sensitivity, which helps reduce high blood sugar. There are two types of metformin – regular and extended-release (XR) tablets.
The common dosage for metformin ranges from 500 milligrams to a maximum of 2,550 milligrams per day. It’s recommended to split the dose of regular metformin (not extended-release) among meals, typically two to three times per day.
Metformin works by helping improve your insulin sensitivity and reducing how much sugar your liver releases into your bloodstream. This medication works to counteract insulin resistance, which is the root cause of type 2 diabetes.
Jardiance vs metformin effectiveness for diabetes
According to studies, metformin effectively lowers fasting blood sugar and hemoglobin A1c levels. The reduction in blood sugar levels appears to be dose-dependent, meaning the more metformin you take, the better your blood sugar levels might be (1).
Metformin can lower blood sugar levels in both obese and non-obese patients with type 2 diabetes.
One study found that hemoglobin A1c levels dropped by slightly over 1% in both obese and non-obese patients after 12 months of taking metformin (2). A1c levels might drop by as much as 1.5% when used at the maximum dose.
According to a meta-analysis of randomized control trials, Jardiance at 25 milligrams daily had similar effects on blood sugar compared to metformin (3).
Average reductions in A1c for Jardiance were around 0.65%. Another study cited a range in A1c reduction between 0.59-0.82% from taking Jardiance (4).
A bonus is that Jardiance may help you lose weight, which appears to have beneficial effects on blood pressure levels. According to a review of studies, the average reduction in body weight while taking Jardiance was considered significant, ranging from 1.7-1.9 kilograms when compared to a placebo (5).
Bottom line: Metformin seems to lower A1c more significantly than Jardiance. However, Jardiance might have an advantage in promoting weight loss and measures of heart health.
What are the benefits of Jardiance vs metformin?
Benefits of metformin
- More affordable – metformin will likely cost you less than $10 to fill, whereas Jardiance can cost over $500 without prescription drug coverage.
- It doesn’t cause urinary tract infections
- Effective at lowering blood sugar with minimal serious side effects
- Can be used while breastfeeding; Jardiance isn’t recommended while nursing
- Can be used during pregnancy (category B); Jardiance is a category C pregnancy risk medication and isn’t recommended during the second and third trimesters
Benefits of Jardiance
- Standard once-daily dosing
- Might have more cardioprotective benefits (improved blood pressure, lower risk of congestive heart failure, etc.) (6)
- Can improve blood sugar control when added to an existing medication regimen
- Can promote more significant weight loss compared to metformin
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What are the side effects of each medication?
All medications come with potential risks and side effects. Medications impact everyone differently.
You might have severe side effects with one medication and virtually no side effects with another.
Side effects typically decrease in severity as your body gets used to the medication. If you still have significant side effects after around four weeks of taking a new medication, speak with your healthcare provider.
Metformin side effects
The most common metformin side effects are gastrointestinal-related. If you start taking metformin, you may experience some of these side effects:
- Heartburn
- Stomach pain
- Nausea or vomiting
- Bloating
- Gas
- Diarrhea
- Constipation
- Weight loss
- Headache
- Metallic taste in your mouth
While rare, taking too much metformin can result in a life-threatening condition called lactic acidosis.
Jardiance side effects
The side effects of Jardiance include:
- Dehydration – which may cause dizziness, lightheadedness, and weakness
- Yeast infections
- Low blood sugar (hypoglycemia), especially if Jardiance is taken with a sulfonylurea or insulin
- Nausea
- Upper respiratory tract infections
- High cholesterol
- Joint pain
- Increased Urination
- Thirst due to dehydration
- Low blood pressure (hypotension)
Increased risk of urinary tract infections (UTI)
Jardiance changes the way your kidneys process the sugar in your blood. Taking Jardiance causes increased glucose in your urine since the kidneys aren’t absorbing as much. This increased glucose feeds bacteria that can cause UTIs.
Women are more prone to urinary tract infections because their urethras are shorter than men’s, allowing bacteria to travel up the bladder. Left untreated, a urinary tract infection can cause kidney problems and infections.
Rare side effects of Jardiance
Diabetic ketoacidosis (DKA)
Diabetic ketoacidosis is a condition when you don’t have enough insulin available to lower your blood sugar levels.
DKA isn’t common in people with type 2 (it affects those with type 1 diabetes), but some people taking Jardiance have reported DKA.
Symptoms of DKA include nausea, vomiting, abdominal pain, tiredness, and trouble breathing. It’s also a good idea to check your urine for ketones if you suspect you might have DKA.
Pyelonephritis
If you develop a urinary tract infection from taking Jardiance, it may turn into pyelonephritis, which is a kidney infection. Pyelonephritis can lead to decreased kidney function and kidney injury.
Jardiance isn’t recommended if you have a GFR of less than 45, which indicates decreased kidney function. If you have chronic kidney disease, you should speak with your provider about which medications might be safe for you to take for your diabetes.
Necrotizing fasciitis
In rare cases, some people taking Jardiance developed necrotizing fasciitis from a bacterial infection. Necrotizing fasciitis damages the skin of the perineum, the thin layer of skin near the genitals.
What is the price difference between Jardiance and metformin?
Metformin is generally very affordable, even without healthcare or prescription insurance coverage.
According to GoodRx, at the time of this article, 60 tablets of 500-milligram tablets cost around $6-$8 out-of-pocket, while 30 tablets of 10-milligram Jardiance tablets cost around $550.
Ease of use for Jardiance vs metformin
Jardiance is taken once daily with dosages ranging from 10-25 milligrams daily. You can take metformin once daily if it’s the extended-release version. Otherwise, it’s usually taken 2-3 times daily with meals.
Jardiance might be a better choice for people who have difficulty remembering to take medications more than once daily.
Otherwise, Jardiance and metformin are similar in their ease of use because they are both in tablet form.
Can you take metformin and Jardiance together?
Jardiance and metformin can be taken together. The drug Synjardy is a Jardiance-metformin combo.
Dosages of Synjardy include 5 milligrams Jardiance/1000 milligrams metformin, 12.5 milligrams Jardiance/1000 milligrams metformin, and 25 milligrams Jardiance/1000 milligrams metformin.
You can take Jardiance alongside metformin if you’re taking the medications separately as well. Combining metformin and Jardiance might improve your blood sugar control even more than just one of the medications on its own.
Neither Jardiance nor metformin are likely to cause low blood sugar. Taking them together (without a sulfonylurea or insulin) shouldn’t cause low blood sugar, while medications like sulfonylureas and insulin are known to cause low blood sugar at times.
Can Jardiance be taken without metformin?
You can take Jardiance on its own without metformin. Jardiance can be combined with many other types of diabetes medications. Your healthcare provider can offer guidance as to which medications might be the best fit for your treatment plan.
Natural alternatives to Jardiance and metformin
If you prefer not to take prescription diabetes medications, there are natural alternatives you can try. You should consult with your healthcare provider if you want to take a natural alternative instead of a prescription medication.
Bear in mind that you should monitor your blood sugar while taking natural alternatives to determine if they are effective for you.
If you’re a good candidate to try natural alternatives to Jardiance and metformin, consider the following:
Berberine
Berberine is a compound we can find in plants. It is often used as a natural metformin alternative for type 2 diabetes.
Berberine has been found to improve insulin sensitivity while also helping to reduce blood triglyceride levels and reduce waist circumference, which are signs of insulin resistance. It might also help you lose weight, which can further improve blood sugar control (7).
Berberine also reduced blood pressure in participants in that same study, which is important to note since people with diabetes are at higher risk of cardiovascular disease (8).
A pilot study compared berberine vs metformin directly for their efficacy in treating type 2 diabetes (9).
The researchers found that berberine produced identical results as metformin in terms of improving blood glucose metabolism. A1c, fasting blood sugar, post-prandial blood sugar, and insulin levels.
Berberine administered at 500 milligrams three times daily was more effective at improving blood lipids, including cholesterol and triglycerides, compared to metformin.
You can purchase berberine in capsule form over-the-counter.
Curcumin
Type 2 diabetes is thought to be an inflammatory condition. Chronic inflammation can increase your risk of other health problems like cardiovascular disease and certain cancers.
Curcumin is the active compound in turmeric that gives it its rich golden yellow color. Curcumin has demonstrated powerful antioxidant properties. This, therefore, makes it a popular supplement among people trying to improve their overall health and reduce inflammation.
Studies on curcumin in animal models using diabetic rats suggest that it has potential benefits for improving blood sugar, reducing insulin resistance, and improving blood lipids (10).
However, researchers stress that studies need to be done on human subjects to gauge its potential efficacy in people before it can be strongly recommended for improving blood sugar levels in humans.
Conclusion
Jardiance and metformin work in different ways to help treat type 2 diabetes. Metformin has many advantages over Jardiance, including affordability, safety during pregnancy and lactation, and its ability to improve blood sugar levels.
Jardiance might work better when combined with metformin so you can utilize each medication’s potential benefits. Jardiance can also be taken with other medications used to treat diabetes.
Along with your healthcare provider, you can create a customized treatment plan to help you effectively manage your diabetes.
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