Jardiance Side Effects: What Patients Should Know

Jardiance (empagliflozin) belongs to the SGLT2 inhibitor class — a group of diabetes drugs that also protect the heart and kidneys in ways no one expected when they were first developed. It is one of the more widely prescribed medicines of its kind in the U.S., and its benefits extend well beyond blood sugar control. But Jardiance side effects stem directly from how the drug works — by flushing glucose out through your urine — and that mechanism creates a set of predictable risks that every patient should understand. This article is general education; Jardiance is prescription-only, and the decision to start it, the dose, and how it is monitored are your prescriber’s to make. Never start, stop, or change it on your own.

How Jardiance Works

Jardiance blocks the sodium-glucose co-transporter 2 (SGLT2) protein in the kidneys, which normally reabsorbs most of the glucose filtered from your blood. By blocking SGLT2, Jardiance causes your body to excrete a substantial amount of glucose through the urine each day. This lowers blood sugar, reduces caloric intake (contributing to modest weight loss), and promotes mild fluid loss that helps lower blood pressure.

The FDA has approved Jardiance for type 2 diabetes, heart failure (across the range of ejection fraction), chronic kidney disease, and reducing cardiovascular death risk in adults with type 2 diabetes and established cardiovascular disease. The landmark EMPA-REG OUTCOME trial, published in the New England Journal of Medicine, showed a meaningful reduction in cardiovascular death — a result that reshaped how clinicians think about diabetes treatment, and later kidney-outcome trials extended those benefits to people with chronic kidney disease. (Trial specifics evolve as new data emerge, so verify the current evidence with your clinician.)

Common Jardiance Side Effects

The most frequently reported Jardiance side effects are tied directly to its glucose-flushing mechanism:

• Genital yeast infections — the sugar-rich urine promotes fungal growth; more common in women (vulvovaginal candidiasis) but also seen in men (balanitis)
• Urinary tract infections (UTIs) — excess glucose in the urine creates a favorable environment for bacteria; symptoms include burning, urgency, and frequency
• Increased urination — including at night, particularly during the first weeks
• Increased thirst — linked to the mild fluid-loss (diuretic) effect
• Upper respiratory symptoms and, in some people, joint aches

Genital infections are the side effect most characteristic of SGLT2 inhibitors. Both yeast infections and bacterial infections of the genital area can occur. Good hygiene, staying well-hydrated, and promptly treating any infection reduce complications. Most infections respond to standard antifungal or antibiotic therapy — but tell your prescriber if they keep coming back.

Hypoglycemia — Usually Low Risk, But It Depends on Your Other Medicines

Used on its own, Jardiance carries a low risk of hypoglycemia (low blood sugar) because its mechanism is glucose-dependent — as blood sugar normalizes, less glucose is excreted. However, combining Jardiance with insulin or a sulfonylurea (such as glipizide or glimepiride) meaningfully increases hypoglycemia risk. Your prescriber may adjust the dose of those other medicines when adding Jardiance — another reason changes should never be made on your own.

Serious Side Effects of Jardiance

Diabetic Ketoacidosis (DKA) — Including at Near-Normal Blood Sugar

Diabetic ketoacidosis is a rare but dangerous complication of SGLT2 inhibitors, and the crucial point is that it can occur even when blood sugar is only mildly elevated or near normal — a pattern called euglycemic DKA. Because glucose readings can look acceptable, this form is easy to miss. The FDA has warned about this risk. Symptoms to take seriously include nausea, vomiting, abdominal pain, unusual fatigue, and difficulty breathing. Situations that raise the risk include serious illness, surgery, prolonged fasting or very low-carbohydrate intake, dehydration, heavy alcohol use, and abrupt reductions in insulin. If you have these symptoms, do not wait for a high glucose number — seek urgent medical care and tell the team you take an SGLT2 inhibitor. Your prescriber will advise on “sick-day” rules — when to hold the medicine and how to check for ketones — and you should follow their individualized instructions rather than a generic plan.

Fournier’s Gangrene (Necrotizing Fasciitis of the Perineum)

This rare but devastating infection of the genital and perineal area has been linked to SGLT2 inhibitors, and the FDA has warned about it for the entire class. Although cases are very uncommon, the condition is a surgical emergency and can be life-threatening if not treated quickly. Warning signs include severe pain, tenderness, redness, or swelling in the genital or perineal area, often with fever and a general feeling of being unwell. Treat these symptoms as an emergency and get immediate care.

Dehydration, Low Blood Pressure, and Acute Kidney Injury

Jardiance’s mild diuretic effect can cause low blood pressure, dizziness (especially on standing), and dehydration — particularly in older adults, people also taking blood pressure medicines such as losartan or metoprolol, diuretics, or NSAIDs, and anyone who cannot keep up their fluid intake. Significant dehydration can, in turn, contribute to acute kidney injury, even though the drug is protective for the kidneys over the long term. The Mayo Clinic emphasizes maintaining adequate fluid intake, especially during hot weather, vomiting, diarrhea, or illness.

Foot Care

People with diabetes should practice routine foot care and report new foot sores, ulcers, redness, or swelling to their clinician. While a lower-limb amputation signal has been most associated with a different SGLT2 inhibitor, careful foot care remains sensible for anyone with diabetes.

When to seek emergency care: Call 911 or go to the nearest emergency room if you experience symptoms of DKA (persistent nausea, vomiting, abdominal pain, difficulty breathing) — even if your glucose is not high — signs of Fournier’s gangrene (severe genital/perineal pain, swelling, or redness with fever), severe dehydration with confusion, a serious allergic reaction (rash, hives, swelling of the face or throat, trouble breathing), or an inability to keep fluids down.

Drug Interactions

Jardiance has relatively few drug-drug interactions compared with many diabetes medicines, but several combinations deserve attention:

• Insulin and sulfonylureas — increased hypoglycemia risk; your prescriber may adjust those doses
• Diuretics — loop diuretics (such as furosemide) and thiazides can compound fluid loss and raise the risk of dehydration and kidney injury
• Other blood-pressure medicines — additive lowering of blood pressure and dizziness
• Positive urine glucose tests — Jardiance puts glucose in the urine, which can cause false-positive urine glucose readings; use blood glucose testing instead

Give your prescriber and pharmacist a complete list of everything you take, including over-the-counter products and supplements. For broader context, see our medical conditions guide. Patients taking Mounjaro or other GLP-1 medications alongside Jardiance should discuss the combined effects with their prescriber.

Long-Term Benefits That Balance the Risks

Context matters when weighing Jardiance side effects. Large trials and the American Diabetes Association Standards of Care support important long-term benefits for the right patients:

• Reduced risk of cardiovascular death in people with diabetes and established cardiovascular disease
• Fewer hospitalizations for heart failure
• Slower progression of chronic kidney disease
• Modest, sustained weight loss
• A small reduction in blood pressure

Because of these cardiovascular and kidney benefits, SGLT2 inhibitors are now recommended for many people with type 2 diabetes who also have heart disease, heart failure, or chronic kidney disease — sometimes regardless of blood sugar level. Whether Jardiance is right for you is an individualized decision your clinician makes with you.

Before Surgery and During Illness (Prescriber-Directed)

Because the stress of surgery, fasting, and illness raises the risk of DKA, prescribing information advises pausing SGLT2 inhibitors before scheduled surgery, and clinicians give individualized “sick-day” instructions for when you are acutely unwell. The exact timing of any hold — and when to restart — is a decision your surgical team and prescriber make based on your situation; do not stop or restart on your own. Always tell every member of your care team that you take an SGLT2 inhibitor.

When to Call Your Doctor

Reach out to your prescriber if you experience:

• Recurrent UTIs or genital infections
• Signs of dehydration — extreme thirst, very dry mouth, infrequent urination, dark urine
• Nausea, vomiting, or abdominal pain that does not resolve (a possible DKA warning)
• Unexplained fatigue or difficulty breathing
• Pain, tenderness, redness, or swelling in the genital or perineal area
• Dizziness or lightheadedness when standing
• New foot sores or wounds that are not healing

Frequently Asked Questions

Does Jardiance cause weight loss?

Often, yes — Jardiance typically produces modest weight loss, mainly from calories lost through glucose excretion and some fluid loss. It is not as dramatic as GLP-1 medications, but it is a welcome benefit for many patients, especially since some other diabetes drugs cause weight gain. It is prescribed to treat diabetes, heart failure, or kidney disease — not as a weight-loss drug.

Can I take Jardiance if I have kidney disease?

Often, yes — SGLT2 inhibitors are actually used to protect the kidneys, and Jardiance can be appropriate across a range of kidney function, though its blood-sugar-lowering effect fades as kidney function declines. Your prescriber decides whether it is suitable and monitors your kidney function before and during treatment. This is not a decision to make on your own.

Should I stop Jardiance before surgery?

Usually there is a recommended pause before scheduled surgery to reduce the risk of euglycemic DKA, but the exact timing is set by your prescriber and surgical team, not by you. Tell them you take an SGLT2 inhibitor, and ask when to stop and when to restart.

Does Jardiance interact with metformin?

Jardiance and metformin work through different mechanisms and are commonly prescribed together with no significant drug-drug interaction; a combination product containing both exists. Together they can provide complementary blood-sugar control. As always, take exactly what your prescriber directs.

What is euglycemic DKA and why does it matter?

It is diabetic ketoacidosis that develops while blood sugar is only mildly elevated or near normal. Because the glucose number looks reassuring, it can be missed. That is why symptoms like persistent nausea, vomiting, abdominal pain, or trouble breathing should prompt urgent care even if your glucose reading seems fine.

Bottom Line on Jardiance Side Effects

The most common Jardiance side effects — genital infections, UTIs, and increased urination — are direct consequences of the drug’s glucose-flushing mechanism and are usually manageable. The serious risks, DKA (including euglycemic DKA) and Fournier’s gangrene, are rare but demand awareness and prompt action. For many patients, Jardiance’s proven heart and kidney protection outweighs its side-effect risks. Stay hydrated, practice good hygiene, know the warning signs, keep your lab-monitoring appointments, and never start, stop, or change the medicine on your own — those decisions belong to your prescriber.

Sources

• FDA / DailyMed — empagliflozin (Jardiance) prescribing information: indications and warnings (ketoacidosis, Fournier’s gangrene, volume depletion, genitourinary infections) and peri-procedural guidance
• MedlinePlus (U.S. National Library of Medicine) — empagliflozin: uses, side effects, and serious warnings (ketoacidosis, Fournier’s gangrene, dehydration, genital and urinary infections, foot care)
• American Diabetes Association (ADA) — Standards of Care in Diabetes: SGLT2 inhibitors for cardiovascular and kidney protection
• Mayo Clinic — empagliflozin drug information (hydration and monitoring)
• Landmark SGLT2 inhibitor trials referenced in labeling and guidelines (e.g., EMPA-REG OUTCOME and kidney-outcome trials) — verify current specifics