Jardiance (empagliflozin) and metformin are two prescription drugs that treat Type 2 diabetes. Both drugs work by lowering blood sugar levels in the body. Jardiance is a brand-name medication, while metformin Hcl is a generic form of the brand-name medications like Fortamet, Glumetza, Glucophage, and Riomet. Jardiance is classified in a group of drugs called sodium-glucose co-transporter 2 (SGLT2) inhibitors, while metformin is classified as a biguanide drug.
Key Takeaways
Both Jardiance (empagliflozin) and Metformin are two drugs that are often sought out as opportunities to reduce body weight in patients. While both Type 2 diabetes medications do have some weight loss side effects, they are very different from one another in terms of the way they assist in weight loss.
Jardiance (empagliflozin), as an example, has far greater and larger side effects like ketoacidosis, dehydration, genital infection, and more. These side effects, while rare, are far more extreme than the side effects that Metformin patients experience.
Patients who are seeking the weight loss benefits of Jardiance and Metformin should explore Metformin as their primary option. This is due to the negative side effects that are lesser than Jardiance and the costs being significantly lower.
Jardiance vs. Metformin: Overview
Here’s a comparison overview of Jardiance and Metformin:
Comparison Metric | Jardiance (Empagliflozin) | Metformin |
Price | Typically ranges from $500 - $600/month (without insurance). Costs can be lower with insurance or patient assistance programs. | Usually $4 - $20/month (generic version). Often considered a low-cost medication. |
Side Effects | Common: Increased urination, urinary tract infections (UTIs), genital yeast infections, dehydration, low blood pressure
Rare: Diabetic ketoacidosis (DKA), acute kidney injury | Common: Gastrointestinal issues (nausea, diarrhea, stomach upset), metallic taste
Rare: Lactic acidosis (especially in patients with kidney problems), vitamin B12 deficiency |
Drug Class | SGLT2 Inhibitor (Sodium-glucose co-transporter 2 inhibitor) | Biguanide |
Drug Application Type | Oral tablet, once daily (sometimes twice daily depending on dose) | Oral tablet (immediate-release: 2-3 times daily, extended-release: once daily) |
Mechanism of Action | Lowers blood sugar by preventing glucose reabsorption in the kidneys, causing excess glucose to be excreted in urine | Reduces glucose production in the liver and improves insulin sensitivity |
Impact on Weight | Moderate weight loss due to calorie excretion (2-3% of body weight) | Generally weight-neutral or causes mild weight loss |
Primary Indications | Type 2 diabetes Reduces risk of cardiovascular death in patients with diabetes and heart disease Treats heart failure in patients with or without diabetes | Type 2 diabetes
Used off-label for polycystic ovary syndrome (PCOS) and prediabetes management |
Cardiovascular Benefits | Shown to reduce risk of heart attack, stroke, and cardiovascular death | Some cardiovascular protection, but not as strong as Jardiance |
Kidney Impact | Kidney-protective in patients with Type 2 diabetes and kidney disease | Can’t be used in advanced kidney disease due to risk of lactic acidosis |
Prescription Status | Brand-name only (no generic version available) | Generic available (low-cost option) |
Jardiance and Metformin for Weight Loss
Jardiance belongs to the SGLT2 inhibitor class. It works by preventing the kidneys from reabsorbing glucose, so excess glucose is excreted in the urine. As glucose (and calories) are lost through urination, patients lose weight as a side effect. This calorie-wasting mechanism results in modest but consistent weight loss.
Metformin, on the other hand, is a biguanide that primarily works by reducing the liver’s glucose production and improving insulin sensitivity. The weight loss associated with metformin patients is generally attributed to reduced insulin resistance, decreased appetite, and possibly alterations in the gut microbiome.
Metformin’s effect on weight is more indirect than Jardiance, and it’s generally seen as weight-neutral or causing mild weight loss.
Comparing the effectiveness of weight loss
Clinical studies have shown moderate weight loss with Jardiance. On average, patients may lose about 2-3% of their body weight over time, depending on individual factors. Weight loss with Jardiance tends to be gradual and may plateau after several months of use.
Metformin is generally associated with less significant weight loss. Some studies suggest an average weight loss of about 1-3 kg (2-6 pounds), but this varies by individual. Weight loss with metformin may be more noticeable in patients with insulin resistance or polycystic ovary syndrome (PCOS), but it’s usually not a primary treatment for weight loss.
Jardiance and Metformin Cost
Generally speaking, Jardiance (empagliflozin) comes in at a much higher cost than Metformin, usually in the $500 range per month depending on the type of insurance that the patient has. However, Metformin comes in at a much lower cost usually in the $9 to $21 range.
Patients who are comparing these two Type 2 diabetes medications are usually looking for the weight loss benefits that come from taking these medications. If you consider yourself one of the patients that’s looking to explore those options, Metformin is most likely the route for you. Both in the sense that its costs are very low. And that Metformin has been packaged and tested for the weight loss benefits more than Jardiance.
Common questions
Questions and answers about Jardiance and Metformin:
Can I consume alcohol on Jardiance and Metformin?
Patients who are taking Jardiance should not consume any alcohol as it can increase blood sugar levels in the body, making it more difficult for your kidney to process the glucose levels, increasing the chances of some of the more serious negative side effects that come with Jardiance.
However, patients who are taking Metformin can consume lower amounts of alcohol. Patients with any type of Type 2 diabetes should avoid excessive alcohol use. Both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) can occur depending on amount and frequency of alcohol consumption.
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Sources
Aggarwal, A., et al. (2019). High prevalence of genital mycotic infections with sodium-glucose co-transporter 2 inhibitors among Indian patients with type 2 diabetes. Indian Journal of Endocrinology and Metabolism.
Boehringer Ingelheim Pharmaceuticals. (2022). Jardiance [package insert].