From the Guidelines
Jardiance (empagliflozin) and metformin are used to treat type 2 diabetes, with metformin being the first-line treatment and Jardiance often added when monotherapy is insufficient. The choice of these medications is based on their efficacy, safety profile, and patient factors such as comorbidities and potential adverse effects 1. Metformin works by reducing glucose production in the liver and improving insulin sensitivity, while Jardiance prevents glucose reabsorption in the kidneys, leading to excess glucose excretion in urine 1. Both medications have benefits beyond glucose control, including weight loss and cardiovascular protection, particularly with Jardiance in patients with established heart disease 1. However, they also have potential side effects, such as gastrointestinal issues with metformin and genital yeast infections with Jardiance, and require monitoring of kidney function 1. The most recent guidelines recommend metformin as the initial pharmacologic agent for type 2 diabetes, with the addition of other agents like SGLT2 inhibitors (e.g., Jardiance) based on individual patient factors and response to treatment 1. Key considerations in the management of type 2 diabetes include achieving and maintaining individualized glycemic goals, managing weight, and reducing cardiovascular risk factors 1. Given the potential benefits and risks, the combination of metformin and Jardiance can be an effective treatment strategy for type 2 diabetes, particularly in patients who require additional glucose-lowering therapy beyond metformin alone 1.
From the FDA Drug Label
JARDIANCE is a sodium-glucose co-transporter 2 (SGLT2) inhibitor indicated: as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus, to reduce the risk of cardiovascular death in adult patients with type 2 diabetes mellitus and established cardiovascular disease.
Jiardiance (empagliflozin) and metformin are used for improving glycemic control in adults with type 2 diabetes mellitus. Key points include:
- Type 2 diabetes mellitus: Jiardiance is indicated as an adjunct to diet and exercise to improve glycemic control.
- Cardiovascular death: Jiardiance is also indicated to reduce the risk of cardiovascular death in adult patients with type 2 diabetes mellitus and established cardiovascular disease.
- Limitations of use: Jiardiance is not for the treatment of type 1 diabetes mellitus or diabetic ketoacidosis 2.
From the Research
Jiardiance and Metformin Usage
- Jiardiance (empagliflozin) and metformin are used in combination for the treatment of type 2 diabetes mellitus (T2DM) 3, 4, 5, 6.
- The combination of empagliflozin and metformin has been shown to be effective and well tolerated in patients with T2DM, offering improved glycemic control, reduced body weight, and blood pressure, with a manageable risk profile 3, 6.
- Empagliflozin, as an adjunct to standard care, has demonstrated cardioprotective and renoprotective properties, largely independent of glycemic control, in patients with T2D and established cardiovascular disease (CVD) 4, 7.
Benefits of Combination Therapy
- The combination of empagliflozin and metformin offers the potential to improve glycemic control in T2DM, with a minimal risk of hypoglycemia, while reducing body weight and arterial blood pressure 5, 6.
- This combination may be suitable for patients with T2DM who are inadequately controlled by metformin, particularly for those who would benefit from modest reductions in blood pressure and body weight or who have risk factors for CV disease or declining renal function 3, 5.
Safety and Efficacy
- The safety and efficacy of empagliflozin plus metformin have been evaluated in several studies, with results showing that the combination is generally well tolerated, with a low risk of hypoglycemia, and effective in improving glycemic control 5, 6.
- However, caution may be required in fragile elderly patients and in patients with severe impaired renal function, and further post-marketing surveillance is recommended to demonstrate long-term safety 5, 7.