Jardiance 25 mg is the higher-strength tablet of empagliflozin, a medication with four FDA-approved uses: improving blood sugar control in type 2 diabetes, reducing cardiovascular death in people with type 2 diabetes and established heart disease, treating heart failure in adults, and slowing the progression of chronic kidney disease. It’s taken once daily by mouth and works by changing how your kidneys handle sugar and sodium.
How Jardiance Works
Your kidneys normally filter glucose out of the blood, then reabsorb almost all of it back into the body. Jardiance blocks the protein responsible for that reabsorption, causing excess glucose to leave through urine instead. This lowers blood sugar without relying on insulin, which makes it fundamentally different from most diabetes medications. The same mechanism also reduces sodium reabsorption, which contributes to modest drops in blood pressure and fluid volume. These combined effects help explain why the drug benefits the heart and kidneys beyond just blood sugar control.
Type 2 Diabetes
Most people start on the 10 mg dose. If blood sugar targets aren’t met, the dose can be increased to 25 mg once daily. When used alone, Jardiance lowers A1C by 0.7 to 0.9 percentage points, though the jump from 10 mg to 25 mg produces only a small additional reduction. It’s approved for adults and children aged 10 and older with type 2 diabetes, always alongside diet and exercise.
For people with type 2 diabetes who also have established cardiovascular disease (prior heart attack, stroke, or peripheral artery disease), Jardiance carries an additional indication: reducing the risk of cardiovascular death. This makes it one of the few diabetes medications chosen specifically because it protects the heart, not just because it lowers glucose.
Heart Failure
Jardiance is approved to reduce the risk of cardiovascular death and hospitalization in adults with heart failure, regardless of whether they have diabetes. This covers both types of heart failure: the kind where the heart pumps weakly (reduced ejection fraction) and the kind where the heart is stiff and doesn’t fill properly (preserved ejection fraction).
The clinical evidence behind this is substantial. In the EMPEROR-Reduced trial, 19.4% of patients on empagliflozin experienced cardiovascular death or hospitalization for heart failure, compared to 24.7% on placebo, a 25% relative risk reduction. In the EMPEROR-Preserved trial, the rate was 13.8% versus 17.1%, a 21% relative risk reduction. An earlier trial found that hospitalization for heart failure occurred in 2.7% of the empagliflozin group versus 4.1% on placebo, a 35% reduction in that specific outcome. These are meaningful differences for a condition where even small improvements in hospitalization rates matter.
Chronic Kidney Disease
Jardiance is also approved to slow kidney disease progression in adults whose kidneys are at risk of getting worse. Specifically, it reduces the risk of sustained decline in kidney filtration rate, progression to end-stage kidney disease, cardiovascular death, and hospitalization. This indication applies whether or not you have diabetes.
Kidney function is measured by eGFR, a number that estimates how well your kidneys filter waste. Jardiance should not be started if your eGFR is below certain thresholds, and your doctor will monitor kidney function periodically. If kidney function drops too low while you’re taking it, the medication may need to be stopped.
Weight Loss and Blood Pressure Effects
Jardiance isn’t prescribed for weight loss, but it reliably causes modest weight reduction as a secondary effect. In clinical trials, people taking the 25 mg dose lost an average of 3.2% of their body weight, compared to 0.4% in the placebo group. For someone weighing 200 pounds, that’s roughly 6 to 7 pounds. When combined with metformin, the 25 mg dose produced a 2.9% loss from baseline. The weight loss comes primarily from calorie loss through urinary glucose excretion and some reduction in fluid retention.
Blood pressure also drops modestly. The 25 mg dose reduced systolic blood pressure (the top number) by an average of 3.4 mmHg compared to placebo. That’s not enough to replace blood pressure medication, but it’s a useful bonus for people who already run high.
Common Side Effects
The most distinctive side effect of Jardiance is genital yeast infections, a direct consequence of extra sugar passing through the urinary tract. In pooled clinical trials, vaginal yeast infections occurred in 6.4% of women taking the 25 mg dose. Penile yeast infections occurred in 1.6% of men on the same dose. These infections are usually mild and treatable, but they can be recurrent. Staying well-hydrated, wearing breathable underwear, and practicing good hygiene can help reduce the risk.
Urinary tract infections also occur more frequently. Increased urination is common, especially in the first few weeks, and some people experience dehydration or dizziness from fluid loss, particularly older adults or those taking diuretics.
Ketoacidosis Risk
A rare but serious concern with Jardiance is a condition called diabetic ketoacidosis, where acids build up dangerously in the blood. What makes this particularly tricky is that it can happen even when blood sugar levels appear normal or only slightly elevated, which can delay recognition. Risk factors include having low natural insulin production, suddenly reducing your insulin dose, illness, surgery, heavy alcohol use, severe dehydration, or not eating enough. If you’re scheduled for major surgery or hospitalized for a serious illness, Jardiance is typically paused temporarily. Symptoms to watch for include nausea, vomiting, abdominal pain, unusual fatigue, and difficulty breathing.