The most common side effect of Jardiance (empagliflozin) is genital yeast infections. In clinical trials, up to 6.4% of women and 3.1% of men developed these infections while taking the medication. This happens because of how the drug works: Jardiance lowers blood sugar by forcing excess glucose out through your urine, and that sugar-rich environment creates ideal conditions for yeast to grow.
Why Jardiance Causes Yeast Infections
Jardiance belongs to a class of drugs called SGLT2 inhibitors. These medications block a protein in your kidneys that normally reabsorbs glucose back into the bloodstream. With that protein blocked, glucose passes into your urine instead, which is exactly how the drug lowers blood sugar. The trade-off is that glucose sitting in the urinary and genital tract feeds the yeast (Candida) that naturally lives on your skin.
In pooled clinical trials of over 1,900 patients, vaginal yeast infections occurred in 5.4% of women taking the 10 mg dose and 6.4% of women on the 25 mg dose, compared to just 1.5% on placebo. Among more than 1,100 men studied, yeast infections of the penis occurred in 3.1% on the 10 mg dose and 1.6% on the 25 mg dose, versus 0.4% on placebo. Women are more susceptible overall, but men face a notably higher relative increase in risk compared to their baseline rate.
Increased Urination
Because Jardiance pulls extra glucose into your urine, it also pulls water along with it. About 3.4% of patients in 24-week trials reported increased urination, compared to 1% on placebo. This includes more frequent trips to the bathroom during the day and, for some, waking up at night to urinate.
The good news is that this effect tends to ease over time. In a short-term study, patients produced about 341 mL of extra urine on their first day of treatment, but that dropped to 135 mL of extra output by day five. Your body adjusts, though staying well hydrated during the first week or two helps your system adapt more comfortably.
Urinary Tract Infections
The same sugar-rich urine that feeds yeast can also encourage bacterial growth in the urinary tract. UTIs are a recognized side effect of all SGLT2 inhibitors, and they tend to occur more often in women and in people who have had UTIs before starting the medication. Symptoms to watch for include burning during urination, cloudy or strong-smelling urine, and pelvic pressure. Most cases are mild and respond to standard treatment.
Dehydration and Low Blood Pressure
The extra fluid loss from increased urination can lead to dehydration, especially in older adults or people already taking diuretics (water pills). Signs include dizziness when standing up, lightheadedness, and feeling unusually thirsty. This is more common in the first few weeks and in hot weather. Drinking enough water throughout the day, rather than waiting until you feel thirsty, is the simplest way to stay ahead of it.
Reducing Your Risk of Yeast Infections
You can’t eliminate the extra glucose in your urine (that’s the drug doing its job), but you can make the environment less hospitable to yeast. Keeping the genital area clean and dry is the most effective step. Wearing breathable cotton underwear, changing out of damp clothing quickly after exercise or swimming, and wiping front to back all reduce the chance of infection. Some people find that showering after physical activity rather than waiting until evening makes a noticeable difference.
If you develop a yeast infection while on Jardiance, it’s typically treatable with standard antifungal medications. Recurrent infections, though, are worth discussing with whoever prescribed the medication, since the pattern may influence whether Jardiance remains the best option for you.
Rare but Serious Side Effects
Most side effects of Jardiance are mild, but a few rare complications deserve attention because they require immediate medical care.
Ketoacidosis With Normal Blood Sugar
SGLT2 inhibitors can trigger a form of diabetic ketoacidosis where blood sugar stays below 200 mg/dL, which is lower than the levels typically associated with this condition. Because blood sugar doesn’t spike dramatically, it’s easy to miss. Warning signs include nausea, vomiting, abdominal pain, unusual fatigue, and difficulty breathing. This complication is uncommon but can become dangerous quickly if not treated.
Fournier’s Gangrene
An extremely rare but life-threatening infection of the genital or perineal area has been reported with SGLT2 inhibitors. UK safety data recorded just 6 cases across an estimated 548,565 patient-years of SGLT2 inhibitor use, so the absolute risk is very low. Symptoms include redness, swelling, tenderness, or fever in the genital area. Seek emergency care if these develop.
What Most People Actually Experience
For the majority of people taking Jardiance, side effects are manageable and often temporary. The increased urination tends to settle within the first week. Yeast infections, while more common than on placebo, still affect fewer than 1 in 15 women and fewer than 1 in 30 men. Many people taking the medication report no notable side effects at all. The cardiovascular and kidney benefits that Jardiance offers, particularly for people with heart failure or chronic kidney disease alongside diabetes, are the reason it remains widely prescribed despite these risks.