11 Scary Jardiance Side Effects You Should Know (And More)

1. Lower Limb Amputations

Drugs similar (like other SGLT2 inhibitors) to Jardiance (empagliflozin) have been linked to patient experiences where lower limb amputations took place from taking the drug. But here’s what you should know. There are no lawsuits or experiences that are directly linked with Jardiance and lower limb amputations.

While Jardiance itself has not been conclusively linked to an increased risk of lower limb amputations, other drugs in the SGLT2 inhibitor class, like canagliflozin (Invokana), have faced significant legal action due to this risk.

The FDA issued a “black box warning” for Invokana in 2017 about the increased risk of leg and foot amputations, which has led to lawsuits from patients who suffered amputations

However, Jardiance itself has not experienced these similar cases. Although, since the drug is considered to be an SGLT2 inhibitor, Jardiance includes these side effects as part of the medications prescription label.

2. Ketoacidosis

Reported in less than 1% of patients who take Jardiance, Ketoacidosis is one the “scarier” side effects that patients should know.

Since Jardiance (empagliflozin) is in the SGLT2 inhibitor class of type 2 diabetes treatment options, and while it is effective in lowering blood sugar levels, one of its potential side effects is the development of a condition called ketoacidosis. Specifically, euglycemic diabetic ketoacidosis (EDKA). This form of ketoacidosis is somewhat unique because it can occur even when blood sugar levels are not extremely high, which is atypical for traditional diabetic ketoacidosis (DKA).

In 2015, the FDA issued a warning that SGLT2 inhibitors can increase the risk of ketoacidosis. The FDAs warning advised healthcare professionals to monitor patients closely for signs and symptoms of ketoacidosis, particularly in situations like surgery, extreme illness, or dietary changes where insulin demand may be altered.

Common onset signs of ketoacidosis include:

• Nausea and vomiting

• Abdominal pain

• Difficulty breathing (shortness of breath)

• Fruity-scented breath (due to ketone production)

• Confusion or fatigue

If you experience any of these while on Jardiance (empagliflozin) it's important to contact your primary care provider immediately and enact any type of emergency cutoff plan that your provider may have given you to stop taking the medication.

3. Genital infections

SGLT2 inhibitors can increase the risk of genital infections. Particularly, urinary tract infections (UTIs) and genital yeast infections. This side effect arises from the SGLT2 inhibitor class of drug's mechanism of action, which causes more glucose to be excreted through the urine, creating an environment that promotes the growth of bacteria and fungi in the genital and urinary areas.

In particular, Jardiance (empagliflozin) will block the reabsorption of glucose in the kidneys, meaning that excess glucose is removed from the bloodstream and excreted in the urine. This causes an increase in the amount of glucose in the urinary tract and genital areas.

Common onset signs of any type of genital infection are:

• Itching and irritation in the genital area.

• Redness or swelling of the vulva (in women) or penis (in men).

• Thick, white discharge (in women).

• Pain during intercourse or urination.

Women are generally at higher risk of these yeast infections and UTIs due to the anatomy of the urinary and genital tract. In addition, men who are uncircumcised are more likely to develop fungal infections in the genital area because the moist environment under the foreskin can trap glucose, promoting fungal growth.

If you experience any of these onset issues you should contact your primary care provider immediately and discontinue your use.

4. Fasciitis

In 2018, the FDA issued a warning about the increased risk of serious genital infections, including necrotizing fasciitis of the perineum (Fournier's gangrene), a rare but life-threatening bacterial infection of the tissue under the skin between the anus and genitals. Although Fournier’s gangrene is rare, it has been reported in patients taking SGLT2 inhibitors like Jardiance.

Necrotizing fasciitis occurs when bacteria (such as Streptococcus or Staphylococcus) enter through a break in the skin or mucous membranes, such as a minor cut, sore, or infection in the genital area. And once bacteria invade the tissue, they multiply at a rapid rate and release toxins that destroy the surrounding skin area, fat tissue, and fascia (the connective tissue surrounding muscles and organs).

As the infection spreads, it leads to tissue death (necrosis), potentially progressing to other areas of the body if left untreated. The presence of excess glucose from Jardiance (empagliflozin) contributes to the ability of bacteria to proliferate rapidly and evade the body’s normal immune responses, particularly in individuals with weakened immune systems or diabetes.

Urinary tract infections (UTIs) 

Urinary tract infections are only seen in around 5-9% of patients who take Jardiance. Symptoms to look out for would include painful urination, frequent urination, cloudy or foul-smelling urine.

Genital infections (yeast infections)

Genital infections are only seen in around 4-7% of patients who take Jardiance. Both men and women may experience yeast infections due to excess glucose in the urine, which promotes fungal growth.

Increased urination

Increased urination is only seen in around 3-4% of patients who take Jardiance. Jardiance works by increasing the excretion of glucose in urine, which leads to more frequent urination.

Dehydration

Dehydration is one the more common side effects seen in most patients who take Jardiance. Symptoms to look out for would include dizziness, lightheadedness, and general thirst.

Hypotension (low blood pressure)

Only seen in around 1-4% of patients who take Jardiance. Jardiance may cause a drop in blood pressure, especially in patients with existing conditions or those on diuretics.

Elevated cholesterol levels

Seen in around 4-5% of patients who take Jardiance. Jardiance can increase both HDL (good) and LDL (bad) cholesterol levels.

Upper respiratory tract infections

Only seen in around 3-4% of patients who take Jardiance. Onset symptoms include colds, sore throats, or sinusitis.