Jardiance 10 mg vs 25 mg: Which dose is right for you?

In this article:

• Differences
• Dosage for diabetes
• Dosage for CKD and heart disease
• Does the dose affect weight loss?
• Side effects
• FAQs

In this article

• Differences
• Dosage for diabetes
• Dosage for CKD and heart disease
• Does the dose affect weight loss?
• Side effects
• FAQs

Jardiance is the brand name for empagliflozin, a sodium-glucose co-transporter 2 (SGLT2) inhibitor. It’s FDA approved to treat Type 2 diabetes in adults and children who are at least 10 years of age, in conjunction with diet and exercise. Jardiance is also approved to reduce the risk of cardiovascular death in adults with Type 2 diabetes and cardiovascular disease, to reduce the risk of worsening kidney function in adults with chronic kidney disease, and to reduce the risk of hospitalization and cardiovascular death in adults with heart failure or chronic kidney disease. Jardiance works by removing excess glucose (sugar) from the body through the kidneys.

Jardiance is taken orally once per day at either a 10 mg or 25 mg dose. Wondering what the difference is between Jardiance 10 mg vs. 25 mg? Most people who take Jardiance take a 10 mg dose, but a 25 mg dose is sometimes used in patients with Type 2 diabetes who need more help reducing their blood sugar.

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What’s the difference between Jardiance 10 mg versus 25 mg?

The 10 mg dose of Jardiance is the typical starting dose, says Linda Khoshaba, NMD, naturopathic endocrinologist and founder of Natural Endocrinology Specialists (NES). “It’s sort of a ‘let’s see how your body does with this’ approach,” she says. If your blood sugar levels aren’t being lowered sufficiently with the 10 mg dose, your healthcare provider may bump you up to 25 mg for a more potent effect. “The higher dose isn’t automatically better for everyone—it’s usually reserved for when the smaller dose isn’t enough,” says Dr. Khoshaba.

According to the prescribing information, 10 mg once daily is the recommended dose for all four approved uses of Jardiance. An increased dosage of 25 mg per day is listed as an option for those who need additional glycemic control.

Here’s what to know about conditions that Jardiance treats and 10 mg vs. 25 mg dosing.

Jardiance dosage for Type 2 diabetes

When it comes to diabetes management, research has shown that higher doses of Jardiance can be more effective for glycemic control. For example, a study published in the Journal of Clinical Pharmacy and Therapeutics found that higher doses of empagliflozin (the active ingredient in Jardiance) result in more substantial decreases in hemoglobin A1C, a blood test that measures your average glucose level from the past three months. Over 12 weeks, empagliflozin doses of 10, 25, and 50 mg were more effective at lowering A1C than 1, 2.5, and 5 mg. Among these doses, 25 mg performed the best overall when both efficacy and side effects were considered.

According to the drug label, the 25 mg dose is typically reserved for offering extra support to patients with Type 2 diabetes. Most people start with 10 mg once daily in the morning, with or without food. The dosage may be increased in people who tolerate the lower dose and need more blood sugar control.

Jardiance dosage for heart failure and chronic kidney disease

For people with heart failure and chronic kidney disease, the recommended dose is 10 mg once daily. In practice, 10 mg per day is also the maximum effective dosage for these conditions.

The EMPEROR-Reduced and EMPEROR-Preserved heart failure trials both used a once-daily dose of 10 mg. In addition, the EMPA-KIDNEY trial in people with chronic kidney disease found a 28% lower risk of kidney disease progression or cardiovascular death with 10 mg of empagliflozin than with placebo.

The 25 mg dose comes into play for people with heart failure or chronic kidney disease who also have Type 2 diabetes. In this case, a higher dosage may be prescribed if blood sugar levels remain uncontrolled at the lower dose.

Does the dose affect weight loss?

The different doses may slightly affect weight loss. In monotherapy trials, people taking Jardiance 10 mg lost an average of 2.8% of their body weight, while those on the 25 mg dose lost 3.2% of their body weight. When Jardiance was taken with metformin, the figures were 2.5% on the lower dose versus 2.9% on the higher one. For someone weighing 200 pounds, that difference between doses works out to roughly one pound over the study period.

Jardiance is not a weight-loss medication and is not FDA approved for this purpose. If weight loss is a specific goal of your treatment plan, you may want to consider discussing other medications with a healthcare provider, not a different dose.

Are side effects different between the 10 mg and 25 mg dose?

Like all medications, Jardiance can have side effects. The most common side effects of Jardiance are:

• Urinary tract infections (UTIs)
• Increased urination
• Yeast infections
• Upper respiratory infections
• Increases in blood cholesterol
• Joint aches and pains
• Nausea
• Changes in kidney function

Less commonly, Jardiance can cause dehydration and hypotension (low blood pressure). Other rare, but serious side effects of both doses include diabetic ketoacidosis and a rare infection of the tissue between the genitals and rectum called necrotizing fasciitis of the perineum.

The side effects shouldn’t vary too much between Jardiance 10 mg vs. 25 mg. The drug’s label cites similar incidence rates for the most common adverse reactions. “The side effects don’t really change between the two doses—it’s the same drug,” Dr. Khoshaba says. “At the 25 mg dose, some people may feel these effects a little more strongly, but many tolerate both doses without much issue.”

Research backs this up. A systematic review and meta-analysis published in Diabetes Therapy examined the adverse effects associated with a 10 mg versus a 25 mg dose of empagliflozin, the active ingredient of Jardiance. After reviewing side effects in 8,514 patients who used empagliflozin for Type 2 diabetes, the researchers found no significant difference in adverse drug events (ADEs) between patients taking 10 mg of empagliflozin and those taking 25 mg.

Jardiance is not recommended for everyone. For example, it is not recommended if a person’s estimated glomerular filtration rate (eGFR), a measure of kidney function, is below 30 mL/min/1.73 m². It should also be avoided in people with Type 1 diabetes.

How much does Jardiance cost and does the dose change the price?

Most major health insurance plans cover Jardiance, though coverage will depend on your plan, and some providers may require step therapy, meaning that you must try other less expensive medications first to prove that Jardiance is a better match for your health needs. What about Medicare and Medicaid? “Medicare Part D and Medicaid also usually cover Jardiance, though the exact out-of-pocket cost can depend on your plan and state,” Dr. Khoshaba says.

As for whether coverage varies based on a 10 mg vs. 25 mg dose of Jardiance, that shouldn’t make much of a difference. “In most cases, both 10 mg and 25 mg doses are covered since they’re the same medication in different strengths,” Dr. Khoshaba explains. “Sometimes it requires prior approval, but typically, patients can get access to either dose.”

In terms of out-of-pocket costs, copays for Jardiance vary from one insurance company to another. Medicaid recipients typically do not have copayments for medications. People on Medicare Part D may have Jardiance copayments ranging from $0 to $170 a month.

Jardiance without insurance can be costly. For example, the average cost of Jardiance is about $768 for 30, 25 mg tablets. However, with a SingleCare savings card, you may be able to pay around $277 for 30 tablets of either strength. Keep in mind that there is currently no generic version of Jardiance available in the U.S., so a discount card or a manufacturer savings program is usually the most helpful way to lower the price.

Frequently asked questions

Can you take more than 25 mg of Jardiance a day?

No, the maximum recommended dose of Jardiance is 25 mg once daily. There is no evidence that shows that taking more than 25 mg has any benefits.

What happens if 25 mg doesn’t control blood sugar?

A healthcare provider will typically recommend switching medications or adding another medication. Options include metformin, a GLP-1 receptor agonist, or insulin, depending on your A1C and other health conditions.

Can I switch from 10 mg to 25 mg on my own?

No, switching doses should be done with guidance from a healthcare provider. Your healthcare provider may want to check your kidney function and overall condition before prescribing a higher dose.

Does Jardiance 25 mg cost more than 10 mg?

Both doses of Jardiance are typically priced the same, whether you’re paying cash or through insurance. A SingleCare coupon may help lower the retail price of both strengths of Jardiance.