From the Guidelines
Alternatives to Jardiance (empagliflozin) include other SGLT2 inhibitors such as Invokana (canagliflozin) and Farxiga (dapagliflozin), which have demonstrated cardiovascular benefits similar to empagliflozin 1. These medications work by helping the kidneys remove excess sugar through urine. Other classes of diabetes medications that can be considered as alternatives include GLP-1 receptor agonists like Ozempic (semaglutide) or Trulicity (dulaglutide), DPP-4 inhibitors such as Januvia (sitagliptin), metformin (often used as first-line therapy), sulfonylureas like glipizide, or thiazolidinediones such as pioglitazone. The best alternative depends on individual factors including kidney function, heart health, risk of hypoglycemia, weight management goals, and cost considerations. Some key considerations for dose adjustments in patients with chronic kidney disease are outlined in recent guidelines 1, which recommend careful consideration of eGFR when initiating or adjusting doses of SGLT2 inhibitors and other diabetes medications. Typical starting doses vary by medication - for example, Farxiga typically starts at 10mg once daily and Invokana at 100mg once daily, as recommended by expert consensus 1. These alternatives should only be used under medical supervision, as your doctor needs to consider your specific health profile, potential drug interactions, and insurance coverage when recommending a substitute for Jardiance. Key factors to consider when choosing an alternative to Jardiance include:
- Kidney function: SGLT2 inhibitors may need to be dose-adjusted or avoided in patients with severe kidney impairment 1
- Heart health: Certain SGLT2 inhibitors, such as canagliflozin and dapagliflozin, have demonstrated benefits for heart failure and cardiovascular risk reduction 1
- Risk of hypoglycemia: GLP-1 receptor agonists and DPP-4 inhibitors may have a lower risk of hypoglycemia compared to sulfonylureas and insulin 1
- Weight management goals: SGLT2 inhibitors and GLP-1 receptor agonists may have benefits for weight loss 1
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Alternatives to Jardiance
There are several alternatives to Jardiance (empagliflozin) for the treatment of type 2 diabetes, including:
- Canagliflozin (Invokana) 2, 3, 4
- Dapagliflozin (Farxiga) 2, 3, 4
- Metformin 2, 5
- Glimepiride 5
- Pioglitazone 2
- Sitagliptin (Januvia) 2
- Gliclazide 2
Comparison of Alternatives
These alternatives have been compared to empagliflozin in various studies, with results showing:
- Canagliflozin and dapagliflozin have similar efficacy to empagliflozin in improving glycaemic control, promoting weight loss, and lowering blood pressure 2, 3
- Metformin is the first-line treatment for type 2 diabetes, but some patients may not tolerate it or have renal impairment, making empagliflozin or other alternatives a viable option 2, 5
- Glimepiride, pioglitazone, and sitagliptin have been compared to empagliflozin in terms of cost-effectiveness, with results showing that empagliflozin may be a more cost-effective option in certain cases 2, 4
Considerations for Choosing an Alternative
When choosing an alternative to Jardiance, considerations should include:
- Efficacy in improving glycaemic control and reducing cardiovascular risk
- Safety profile, including risk of hypoglycaemia, urinary and genital tract infections, and other adverse events
- Cost-effectiveness, including comparison to other treatment options
- Patient-specific factors, such as renal impairment, weight, and comorbidities 6, 2, 5, 3, 4