Jardiance (Empagliflozin) and Risk of Balanitis in Males

Yes, Jardiance (empagliflozin) is associated with an increased risk of balanitis in males, particularly in uncircumcised men. 1

Mechanism and Risk

SGLT2 inhibitors like Jardiance cause glycosuria (increased urinary glucose excretion), creating favorable conditions for fungal growth in the genital area 2, 3
Male patients taking Jardiance may develop yeast infections of the penis (balanitis or balanoposthitis), with uncircumcised males and those with history of chronic/recurrent infections at highest risk 1
The FDA label for Jardiance specifically lists balanitis as a recognized side effect that patients should be informed about 1

Balanitis typically presents as erythematous areas on the glans penis accompanied by pruritus (itching) or irritation 2
Other symptoms include redness, swelling of the penis, rash, foul-smelling discharge, and pain in the skin around the penis 1
In uncircumcised men, the moist, warm space underneath the foreskin promotes yeast growth, especially with poor hygiene 4

Most cases of balanitis associated with Jardiance are mild to moderate and respond well to standard antifungal treatment 3
First-line treatment includes topical antifungal agents such as miconazole 2% cream applied twice daily for 7 days or tioconazole 6.5% ointment as a single application 6
For severe or resistant cases, oral fluconazole 150 mg as a single dose may be considered 6
Patients should be advised that over-the-counter antifungal medications can be used, but to seek medical attention if symptoms persist 1

Complicated infections requiring discontinuation of the medication can occur, particularly in patients with underlying anatomical abnormalities of the urogenital tract 5
Rare cases of candidemia (Candida in the bloodstream) have been reported in patients with anatomical urogenital abnormalities taking empagliflozin 5
Despite the risk of genital mycotic infections, SGLT2 inhibitors provide significant cardiovascular benefits that make them valuable treatment options for many patients with type 2 diabetes 5

Patients should be informed about the risk of balanitis before starting Jardiance 1
Good genital hygiene is important for prevention 4
Maintaining good glycemic control can help reduce the risk of infection and recurrence 4
Follow-up is recommended if symptoms persist or recur within 2 months 6

The risk of balanitis should be weighed against the cardiovascular and renal benefits of SGLT2 inhibitors 2
Most genital infections associated with SGLT2 inhibitors are clinically manageable and rarely lead to discontinuation of treatment 3
Assessment of urogenital anatomical abnormalities should be considered prior to prescribing SGLT2 inhibitors to identify patients who may be at risk of complicated infections 5