Jardiance vs. metformin: Differences, similarities & side effects

In this article:

• Conditions treated
• Insurance coverage and cost
• Side effects
• Interactions and warnings

In this article

• Conditions treated
• Insurance coverage and cost
• Side effects
• Interactions and warnings

Jardiance (empagliflozin) and metformin are two prescription drugs indicated for the treatment of Type 2 diabetes. Both work by lowering blood sugar, or glucose, levels. Jardiance is a brand-name medication, while metformin is a generic form of the brand-name medications 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.

Jardiance vs. metformin: Conditions treated

“Jardiance and metformin are two different diabetes medications from two different classes. They both work by reducing the amount of glucose in the blood; they just do it through different mechanisms,” said Jodie Pepin, Pharm.D., the clinical pharmacy program director at Harbor Health in Round Rock, Texas.

SGLT2 inhibitors like Jardiance lower blood sugar by helping the kidneys flush excess sugar into the urine, rather than reabsorb it. Metformin, a common first-line treatment for diabetes, decreases the amount of sugar created by the liver entering the bloodstream and increases insulin sensitivity.

Because Jardiance and metformin decrease blood glucose levels differently, some patients are recommended to take both. “In fact, there is a brand-name medication that contains both Jardiance and metformin, and its name is Synjardy,” Dr. Pepin said. 

A final key difference between Jardiance and metformin is that Jardiance is not only prescribed for Type 2 diabetes but also for heart failure and chronic kidney disease, according to Angela Ginn-Meadow, a registered dietitian and certified diabetes educator.

Jardiance vs. metformin for weight loss

Though neither Jardiance nor metformin is FDA approved for weight loss, both drugs have weight loss as a side effect.

“Studies have shown that metformin can lead to modest weight loss of 5–10% over a two-year period,” Ginn-Meadow said. Jardiance, on the other hand, has been shown to cause up to 3% body weight loss in some patients, according to Dr. Pepin.

Prescribers may be more likely to prescribe these drugs off-label to people with prediabetes or metabolic syndrome since healthy weight management is important in the prevention and treatment of diabetes. 

Still, not all healthcare professionals will prescribe diabetes drugs for weight reduction. “I have seen patients lose weight while taking metformin over the years, but I would not prescribe it for this reason alone, and I have not prescribed Jardiance for weight loss,” said Amy Offutt, MD, president of the International Lyme and Associated Diseases Society

Ultimately, the FDA has only approved metformin for the treatment of Type 2 diabetes and Jardiance for the treatment of Type 2 diabetes, heart failure, and CKD. Consult your healthcare provider if you are interested in learning about other health benefits associated with Jardiance or metformin.

Is Jardiance better than metformin?

Both Jardiance and metformin are effective at treating high blood sugar levels in people with Type 2 diabetes.

In a double-blind, placebo-controlled, 24-week clinical study of Jardiance, 986 people with Type 2 diabetes were treated with the drug, resulting in lower HbA1c levels (a measure of glucose control over time), lower fasting plasma glucose, and lower weight. 

In a double-blind, placebo-controlled, 14-week study of metformin in 451 individuals with Type 2 diabetes, treatment with this drug also resulted in lower HbA1c and fasting plasma glucose levels, generally in a dose-related manner (i.e., the higher the dose, the more dramatic the results). A more recent meta-analysis of 17 clinical trials with a sample size of 30,474 found that metformin use in people with prediabetes demonstrated a significant reduction in the risk of progressing to Type 2 diabetes mellitus.

The most effective medication should only be determined by a healthcare provider who fully understands your medical conditions and medical history and is aware of any other medications you’re taking.

Jardiance vs. metformin: Insurance coverage and cost comparison

Without insurance, Jardiance costs about $862, and metformin costs about $165 for a 30-day supply. However, drug prices vary. Check with your insurance company or Medicare Part D plan for information specific to your plan. 

RELATED: Jardiance cost with Medicare │Does Medicaid cover Jardiance? | Jardiance copay assistance

You can use SingleCare coupons to save money on Jardiance, lowering the cost to about $530. SingleCare coupons can also reduce your metformin cost to around $5.

Get coupons for popular diabetes drugs

Jardiance vs. metformin: Side effects

Jardiance and metformin are both diabetes medications. However, they belong to different drug classes and thus have different adverse effects.

Common side effects of metformin include gastrointestinal problems like diarrhea (IR tabs 53%, ER tabs 10%), intestinal gas (12%), nausea and vomiting (IR tabs 26%, ER tabs 7%), weakness (9%), and abdominal pain (7%). Signs of uncommon (<1%) but serious adverse reactions to metformin include trouble breathing, slow heartbeat, and decreased urination.

Common side effects of Jardiance include urinary tract infections (8-9%), yeast infections (2-6%), increased red blood cells (3-4%), and increased thirst (2%). Less common (<1%) but serious side effects may include ketoacidosis, kidney injury, and complicated bacterial infections.

If you’re considering Jardiance versus metformin, it’s essential to consult your healthcare provider for a complete list of side effects.

Jardiance vs. metformin: Drug interactions and warnings

Some medicines can interact with Jardiance or metformin, possibly affecting the efficacy of the drugs or increasing the risk of side effects. Common drug interactions between Jardiance and metformin include those with insulin and other diabetes medications that can trigger insulin secretion. In essence, taking too much of one or more diabetes medications may overcorrect high blood sugar and lead to dangerously low blood sugar. Jardiance may also interact with diuretics (drugs that cause urination) as well as   ACE inhibitors (e.g., lisinopril) and angiotensin receptor blockers (ARBs) (e.g., losartan), leading to dehydration and low blood pressure. Taking Jardiance with NSAIDs (e.g., ibuprofen, naproxen, etc.) can increase the risk of kidney damage, especially in patients with existing kidney conditions. Metformin can interact with some drugs, leading to decreased effectiveness, such as corticosteroids (e.g., prednisone) and hormones (e.g., estrogen), while other drugs, such as ACE inhibitors, can increase the effect of metformin potentially causing very low blood sugar levels. Always check with your pharmacist or healthcare provider about possible drug interactions.

Jardiance has fewer reported side effects than metformin. However, Jardiance has the potential to cause dangerously low blood pressure, kidney injury, and serious infections. Its use is also discouraged for pregnant or breastfeeding women. 

Metformin is not recommended for those with congestive heart failure, compromised kidney function, poor liver function, or people who may become dehydrated. Having these conditions increases the chance of developing lactic acidosis, a rare but potentially fatal condition linked to metformin use. Drinking alcohol while on metformin also increases the risk of lactic acidosis. 

Bottom line 

Jardiance and metformin are both FDA-approved treatments for Type 2 diabetes. Jardiance is also FDA approved for the prevention of cardiovascular disease and end-stage kidney disease in certain populations. Both of these diabetes drugs have also been shown to cause weight loss, but they are not FDA approved for weight reduction.

Jardiance has fewer reported side effects than metformin, but it is also much more expensive because Jardiance is a newer brand-name drug. Metformin is also prescribed off-label for a variety of nondiabetes-related uses.

If you are interested in taking Jardiance or metformin, seek medical advice from your healthcare provider or pharmacist. Only a healthcare professional familiar with your conditions and health history can advise which medications are right for your condition and overall health.