Can Metformin and Jardiance (Empagliflozin) be given together?

From the Guidelines

Yes, Metformin and Jardiance (empagliflozin) can be safely taken together and are often prescribed as a combination therapy for type 2 diabetes. This combination is beneficial because the medications work through different mechanisms to lower blood glucose. Metformin primarily reduces glucose production in the liver and improves insulin sensitivity, while Jardiance works by helping the kidneys remove excess glucose through urine. When used together, they can provide more comprehensive blood glucose control than either medication alone.

The standard dosing for Metformin typically ranges from 500-2000 mg daily (often divided into two doses), while Jardiance is usually prescribed as a once-daily 10 mg or 25 mg tablet. Patients should take these medications as prescribed, with Metformin usually taken with meals to reduce gastrointestinal side effects. It's essential to stay well-hydrated while taking Jardiance since it increases urination. Patients should also be aware that this combination may increase the risk of hypoglycemia (low blood sugar), especially if they're also taking other diabetes medications like insulin or sulfonylureas, so regular blood glucose monitoring is essential 1.

Some key considerations when prescribing this combination include:

• Monitoring kidney function, as both medications can affect renal function, although the benefits of SGLT2 inhibitors like Jardiance in reducing kidney disease progression are well-documented 1.
• Being aware of the potential for increased risk of genital mycotic infections and diabetic ketoacidosis with SGLT2 inhibitors, and educating patients on these risks 1.
• Adjusting doses of other medications, such as insulin or sulfonylureas, as needed to minimize the risk of hypoglycemia when adding Jardiance to the treatment regimen 1.

Overall, the combination of Metformin and Jardiance can be a valuable treatment strategy for managing type 2 diabetes, offering benefits in terms of glycemic control, cardiovascular risk reduction, and kidney protection, as supported by recent clinical guidelines and studies 1.

From the FDA Drug Label

A total of 637 patients with type 2 diabetes participated in a double-blind, placebo-controlled study to evaluate the efficacy and safety of JARDIANCE in combination with metformin Patients with type 2 diabetes inadequately controlled on at least 1500 mg of metformin per day entered an open-label 2 week placebo run-in. At the end of the run-in period, patients who remained inadequately controlled and had an HbA1c between 7 and 10% were randomized to placebo, JARDIANCE 10 mg, or JARDIANCE 25 mg At Week 24, treatment with JARDIANCE 10 mg or 25 mg daily provided statistically significant reductions in HbA1c (p-value <0. 0001), FPG, and body weight compared with placebo

Yes, Metformin and Jardiance (Empagliflozin) can be given together, as evidenced by the clinical studies that evaluated the efficacy and safety of JARDIANCE in combination with metformin 2. The combination therapy provided statistically significant reductions in HbA1c, FPG, and body weight compared with placebo.

• Key findings:
  • Statistically significant reductions in HbA1c (p-value <0.0001)
  • Statistically significant reductions in FPG
  • Statistically significant reductions in body weight
• Study design: Double-blind, placebo-controlled study
• Patient population: Patients with type 2 diabetes inadequately controlled on at least 1500 mg of metformin per day

From the Research

Combination Therapy with Metformin and Jardiance

• Metformin is a commonly used medication for the treatment of type 2 diabetes, and Jardiance (Empagliflozin) is a sodium-glucose cotransporter 2 (SGLT2) inhibitor that has been shown to have beneficial effects on cardiovascular outcomes in patients with type 2 diabetes 3.
• There is no direct evidence from the provided studies that specifically addresses the safety and efficacy of combining Metformin and Jardiance.
• However, it is known that Metformin can be used in combination with other glucose-lowering agents, including SGLT2 inhibitors like Jardiance, to achieve better glycemic control 4, 5.
• The use of Jardiance in combination with other medications, including Metformin, has been shown to have a moderate glucose-lowering effect and may also have beneficial effects on cardiovascular outcomes, particularly in patients with a history of cardiovascular disease 3.
• It is essential to consider the potential risks and benefits of combination therapy, including the increased risk of adverse effects such as genital infections, kidney failure, and diabetic ketoacidosis associated with SGLT2 inhibitors like Jardiance 3.
• Additionally, Metformin may have a favorable safety profile when used in combination with other medications, but it is crucial to monitor patients for potential adverse effects, such as lactic acidosis, particularly in those with kidney dysfunction 4, 6.

Key Considerations

• When considering combination therapy with Metformin and Jardiance, it is crucial to carefully evaluate the potential benefits and risks for each patient.
• Patients should be monitored closely for signs of adverse effects, and the dosage of each medication should be adjusted as needed to minimize the risk of hypoglycemia and other complications.
• Further studies are needed to fully understand the safety and efficacy of combining Metformin and Jardiance in patients with type 2 diabetes.