Can you take Jardiance (Empagliflozin) if you have a parasitic worm infection?

Taking Jardiance with Parasitic Worm Infections

There are no specific contraindications for taking Jardiance (empagliflozin) if you have a parasitic worm infection, but treatment of the worm infection should be prioritized before focusing on diabetes management.

Understanding the Interaction

When dealing with concurrent conditions like diabetes and parasitic infections, it's important to consider:

1. No direct contraindication: The available evidence doesn't indicate a specific interaction between Jardiance and antiparasitic medications commonly used to treat worm infections.

2. Treatment priorities: Parasitic infections, especially those involving the central nervous system like neurocysticercosis, require prompt treatment as they can lead to serious complications 1.

Management Approach

Step 1: Identify and Treat the Parasitic Infection

• Diagnosis through concentrated stool microscopy (at least 3 samples) is recommended for intestinal parasites 2
• Treatment depends on the specific parasite:
  • For most intestinal helminths: Albendazole 400 mg daily for 3 days 2
  • For tapeworm infections: Praziquantel 10 mg/kg as a single dose 2
  • For pinworm: Mebendazole or ivermectin 2

Step 2: Monitor for Treatment Effects

• If albendazole is used for >14 days, monitor for:
  • Hepatotoxicity (elevated liver enzymes seen in up to 16% of cases) 1
  • Leukopenia (occurs in up to 10% of patients) 1

Step 3: Continue Diabetes Management

• Jardiance can be continued during parasitic treatment if liver function remains normal
• Benefits of Jardiance include:
  • Reduced cardiovascular mortality (38% relative risk reduction) 3
  • Reduced hospitalization for heart failure (35% relative risk reduction) 3
  • Reduced all-cause mortality (32% relative risk reduction) 3

Important Considerations

• Liver function: Both albendazole (for worm infections) and Jardiance can affect the liver. Monitor liver function tests if both medications are used concurrently.

• Hydration: Jardiance increases urination, which could potentially worsen dehydration if the parasitic infection causes diarrhea or vomiting.

• Nutritional status: Parasitic infections can affect nutritional absorption, potentially affecting blood glucose levels and diabetes management.

Follow-up Recommendations

• Clinical follow-up in 2-4 weeks is recommended for most intestinal helminths 2
• Monitor blood glucose more frequently during parasitic infection treatment
• Reassess diabetes management once the parasitic infection is resolved

Pitfalls to Avoid

• Don't ignore the parasitic infection: Treating the worm infection should be prioritized as it can lead to serious complications if left untreated.
• Don't stop Jardiance abruptly: Unless there are specific contraindications (like severe liver dysfunction), continue diabetes management.
• Avoid dehydration: Ensure adequate fluid intake, especially when taking Jardiance during treatment for parasitic infections.