Can Jardiance Cause Itching?
Yes, Jardiance (empagliflozin) can cause itching, primarily as a symptom of genital mycotic infections (vaginal or penile yeast infections), which are among the most common adverse reactions to this medication. 1
Primary Mechanism of Itching with Jardiance
The itching associated with Jardiance occurs predominantly through two pathways:
- Genital mycotic infections are explicitly listed in the FDA label as common adverse reactions, with vaginal itching being a specific symptom of vaginal yeast infections in women 1
- Penile yeast infections (balanitis or balanoposthitis) in men can cause itching, redness, or swelling of the penis, particularly in uncircumcised males 1
Clinical Presentation
When itching occurs with Jardiance, look for these specific patterns:
- In women: Vaginal itching accompanied by white or yellowish vaginal discharge (may be lumpy or cottage cheese-like) and vaginal odor 1
- In men: Itching of the penis with rash, redness, swelling, foul-smelling discharge, or pain in the skin around the penis 1
- Timing: These mycotic infections typically develop after starting the medication, as SGLT2 inhibitors increase glucose in the urine, creating a favorable environment for yeast growth 2
Management Approach
For mild genital itching from suspected yeast infection, initiate over-the-counter antifungal treatment immediately while continuing Jardiance, as the FDA label specifically advises discussing treatment options with patients. 1
- Apply topical antifungal agents (such as clotrimazole or miconazole) to affected genital areas as first-line treatment 1
- Consider oral fluconazole 150 mg as a single dose for more severe or recurrent vaginal yeast infections 1
- Maintain adequate genital hygiene and keep the area dry to prevent recurrence 1
When to Consider Drug Discontinuation
- Hypersensitivity reactions: If itching is accompanied by urticaria or angioedema, discontinue Jardiance immediately, as serious hypersensitivity reactions have been reported 1
- Recurrent infections: Chronic and recurrent genital mycotic infections may require reassessment of continued Jardiance use, particularly in patients with predisposing factors 1
- Generalized pruritus without rash: If itching is widespread and not localized to genital areas, conduct a comprehensive evaluation for drug-induced pruritus, including liver function tests and renal function, as drug-induced itching can occur without visible skin lesions 3, 4
Differential Considerations
If itching persists or presents atypically:
- Rule out urinary tract infection, which is also common with Jardiance and may cause perineal discomfort that could be mistaken for itching 1
- Assess for cholestatic liver disease if generalized itching develops, as drug-induced cholestasis can cause pruritus 3
- Consider trial cessation if the risk-benefit analysis supports it and itching significantly impacts quality of life 3
Patient Counseling Points
- Inform patients that genital yeast infections with associated itching are expected common side effects of Jardiance 1
- Advise patients to report symptoms early so treatment can be initiated promptly without necessarily discontinuing the medication 1
- Emphasize that most cases respond well to antifungal treatment and do not require stopping Jardiance 1
- Instruct patients to seek immediate medical attention if they develop signs of serious hypersensitivity (facial swelling, difficulty breathing, widespread rash) 1