Jardiance (empagliflozin) is a prescription medication with four FDA-approved uses: managing type 2 diabetes, treating heart failure, slowing chronic kidney disease, and reducing cardiovascular death risk in people with type 2 diabetes and established heart disease. It works by blocking a protein in the kidneys that normally reabsorbs sugar back into the bloodstream, causing excess glucose to leave the body through urine instead.
How Jardiance Works in the Body
Your kidneys filter blood constantly, and a protein called SGLT2 normally recaptures glucose during that filtering process, sending it back into your bloodstream. Jardiance blocks SGLT2, so instead of being reabsorbed, glucose passes out in your urine. This lowers blood sugar levels without relying on insulin.
The effect starts immediately. After the first dose, glucose begins appearing in urine, and blood sugar drops within the same day. The medication stays active for about 24 hours (its half-life is roughly 12.4 hours), which is why it’s taken once daily. Because the drug works on the kidneys rather than on insulin production, it has benefits that extend well beyond blood sugar control, which is why its approved uses have expanded significantly over the years.
Type 2 Diabetes
Jardiance is approved for adults and children aged 10 and older with type 2 diabetes, used alongside diet and exercise. In clinical trials, patients taking Jardiance saw an average A1c reduction of about 0.84 percentage points over 26 weeks compared to placebo. Most participants in those studies were already on background diabetes medications like metformin or insulin, so the A1c drop came on top of their existing treatment.
The standard starting dose is 10 mg once daily, taken in the morning with or without food. If blood sugar control is still insufficient and you’re tolerating the medication well, your prescriber can increase the dose to 25 mg.
Heart Failure
Jardiance is approved for adults with heart failure regardless of whether they also have diabetes. This is one of the broader indications for the drug and reflects a shift in how this class of medication is understood: the heart benefits appear to be independent of blood sugar lowering.
In the EMPEROR-Reduced trial, which studied people whose hearts pumped blood less effectively than normal, Jardiance cut the combined risk of cardiovascular death or hospitalization for heart failure by 25% compared to placebo. The biggest driver was fewer hospitalizations: 13.2% of patients on Jardiance were hospitalized for heart failure versus 18.3% on placebo, a 31% relative reduction. Cardiovascular death rates were similar between the two groups in that trial, but the reduction in hospital admissions alone represents a meaningful change in quality of life for people living with heart failure.
Chronic Kidney Disease
Jardiance is approved to slow kidney disease progression in adults whose kidneys are at risk of worsening. A large meta-analysis of individual patient data found that empagliflozin reduced the risk of kidney disease progression by 30% and the risk of kidney failure by 34%. Perhaps most striking, it slowed the annual rate of kidney function decline by 64% compared to placebo.
This matters because chronic kidney disease often progresses silently over years, and slowing that decline can delay or prevent the need for dialysis. The kidney benefits appear to come from reduced pressure inside the kidney’s filtering units, a downstream effect of how the drug changes sodium and fluid handling, not just from lower blood sugar.
Cardiovascular Protection in Diabetes
For adults who have both type 2 diabetes and established cardiovascular disease (meaning they’ve already had a heart attack, stroke, or have significant arterial disease), Jardiance carries an additional specific approval: reducing the risk of cardiovascular death. This was one of the earliest non-diabetes indications for any SGLT2 inhibitor, and it changed how doctors think about diabetes treatment. For people with type 2 diabetes and heart disease, Jardiance isn’t just a blood sugar drug; it’s a cardiovascular drug that also happens to lower glucose.
Weight Loss and Blood Pressure Effects
While not an approved use, Jardiance consistently produces modest weight loss and blood pressure reduction in clinical studies. Patients on the 10 mg dose lost an average of 2.8% of their baseline body weight, and those on 25 mg lost about 3.2%. For context, that’s roughly 5 to 7 pounds for someone weighing 200 pounds. The weight loss is driven partly by calorie loss through glucose in the urine and partly by mild fluid reduction.
Systolic blood pressure (the top number) dropped by about 2.6 mmHg on the 10 mg dose and 3.4 mmHg on 25 mg compared to placebo. Neither effect is dramatic on its own, but both are welcome bonuses for people who are already managing diabetes, heart failure, or kidney disease.
Common Side Effects
Because Jardiance pushes extra sugar into the urinary tract, it creates an environment where infections are more likely. The two most common side effects are urinary tract infections and yeast infections (genital mycotic infections). Women are more affected by yeast infections than men, though men can develop them too. Staying well-hydrated and practicing good hygiene can reduce the risk, but these side effects are common enough that they’re worth knowing about before starting the medication.
A rarer but serious risk is ketoacidosis, a condition where the blood becomes dangerously acidic. This can happen even when blood sugar levels appear normal, which makes it tricky to catch. Symptoms include nausea, vomiting, abdominal pain, unusual fatigue, and difficulty breathing. Ketoacidosis with Jardiance is uncommon but requires emergency treatment.
Because the drug causes your body to excrete more fluid along with glucose, dehydration and low blood pressure can occur, particularly in older adults or people already taking diuretics. Drinking enough water throughout the day helps offset this effect.
Who Should Not Take Jardiance
Jardiance is not used for type 1 diabetes. It is also not appropriate for people on dialysis. Because the drug works through the kidneys, its blood sugar lowering effect diminishes as kidney function declines, though its heart and kidney protective benefits may still apply at lower levels of kidney function. Your prescriber will check kidney function before starting the medication and periodically afterward.