What is the relationship between Empagliflozin (Jardiance) and the development of nephrolithiasis (kidney stones)?

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Last updated: April 1, 2025View editorial policy

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From the Guidelines

Jardiance (empagliflozin) is not directly associated with an increased risk of kidney stones, and its use may be beneficial in reducing the risk of kidney stones in some patients due to its mechanism of increasing sugar excretion through the urine. According to the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) consensus report 1, SGLT2 inhibitors like Jardiance have been shown to have a high efficacy in lowering glucose in the setting of normal renal function. The report also highlights the importance of monitoring renal function when using SGLT2 inhibitors, as their efficacy is dependent on renal function.

Some key points to consider when taking Jardiance include:

  • Drinking adequate fluids throughout the day to prevent dehydration, which could increase kidney stone risk
  • Discussing any history of kidney stones with your doctor before starting Jardiance
  • Being aware of the potential kidney-protective effects of Jardiance, particularly for people with diabetes and chronic kidney disease
  • Monitoring for symptoms of kidney stones, such as severe pain in the side or back, blood in urine, frequent urination, or pain when urinating, and contacting your healthcare provider immediately if these symptoms occur.

It's also important to note that Jardiance has been associated with an increased risk of acute kidney injury, dehydration, and orthostatic hypotension, and caution should be taken when using it in combination with diuretics and/or ACE inhibitors and angiotensin receptor blockers 1. However, the standard dosing of Jardiance is typically 10 mg once daily, taken in the morning, with or without food, and some patients may be prescribed 25 mg daily. Overall, the benefits of Jardiance in reducing the risk of kidney stones and its kidney-protective effects make it a viable treatment option for patients with diabetes, including those with a history of kidney stones.

From the Research

Jardiance and Kidney Stones

  • There is no direct evidence in the provided studies that links Jardiance (empagliflozin) to an increased risk of kidney stones 2, 3, 4, 5, 6.
  • The studies primarily focus on the efficacy and safety of empagliflozin in patients with type 2 diabetes, its effects on cardiovascular outcomes, and its use in patients with chronic kidney disease.
  • Empagliflozin has been shown to have a favorable effect on various outcomes, including reductions in body weight and blood pressure, and a low risk of hypoglycemia 3, 4.
  • In patients with type 2 diabetes and chronic kidney disease, empagliflozin has been found to have a similar safety profile to placebo, with no new safety concerns raised 5.
  • The effects of empagliflozin on clinical outcomes, including cardiovascular death, hospitalization for heart failure, and all-cause mortality, have been investigated in patients with type 2 diabetes, established cardiovascular disease, and chronic kidney disease, with empagliflozin showing improved outcomes in these patients 6.
  • However, none of the studies specifically address the risk of kidney stones associated with empagliflozin use.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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