Table of Contents

I. What is Jardiance?

II. Jardiance and Infection Risk

III. Clinical Evidence for Jardiance and Infection Risk

IV. Tips To Minimize Infection Risk

V. Conclusion

Jardiance, also known as empagliflozin, is a medication commonly prescribed for managing type 2 diabetes, heart disease, and chronic kidney disease. [1] While it has proven effective in controlling blood sugar levels, concerns have been raised about its potential to increase the risk of infections.

In this article, we will explore what Jardiance is, delve into the relationship between Jardiance and infection risk, examine clinical evidence, and provide tips to minimize any potential risks associated with this medication.

What is Jardiance?

Jardiance is a prescription medication used to help manage type 2 diabetes, heart failure, and chronic kidney disease. It belongs to a class of drugs known as sodium-glucose co-transporter 2 (SGLT2) inhibitors. Jardiance is taken once daily in tablet form. [1]

The U.S. Food and Drug Administration (FDA) approves Jardiance for the following uses:

• To lower blood sugar levels in adults with type 2 diabetes, in combination with diet and exercise.

• To reduce the risk of cardiovascular death in adults with type 2 diabetes and heart disease.

• To decrease the risk of hospitalization and death from heart failure in adults with heart failure.

• To treat chronic kidney disease in adults. [1]

Jardiance works uniquely compared to other diabetes medications. Instead of directly affecting insulin levels, Jardiance inhibits the SGLT2 protein found in the kidneys. The kidneys normally filter waste and excess fluid from the blood and reabsorb glucose and certain other substances back into the body. Jardiance prevents the kidneys from reabsorbing glucose excreted in the urine, lowering blood sugar levels throughout the body. [1]

Jardiance and Infection Risk

When taking Jardiance, it's important to be aware of the potential side effects of increased glucose in your urine. While this may seem concerning, it's how Jardiance works to lower glucose levels in your body. However, extra glucose in your urine can make the area more susceptible to bacterial and fungal infections, such as urinary tract infections and yeast infections. [2]

If you experience symptoms of an infection, don't hesitate to contact your doctor. Most infections are minor and can be easily treated with antibiotics or antifungal medication. However, it's important not to ignore potential symptoms, as untreated infections can lead to more severe complications. [2]

Urinary Tract Infection (UTI)

Urinary tract infections (UTIs) are common for those living with diabetes. A UTI occurs when bacteria enter the urinary tract, which includes the urethra, bladder, ureters, and kidneys. [3] While UTIs can happen to anyone, those with diabetes face a greater risk for a few reasons. [4]

• Neuropathy: High blood sugar levels can damage the nerves that control bladder function over time. This nerve damage, called diabetic neuropathy, makes it difficult to sense a full bladder and empty it entirely. Residual urine allows more time for bacteria to grow and cause infection. 

• Weakened immune system: Healthy immune cells and antibodies usually prevent the spread of bacteria in the urinary tract. However, high blood sugar reduces the levels of natural antibiotics like psoriasin in the body, making it easier for bacteria to bind to bladder cells and multiply. [4]

In addition to this higher baseline risk, the diabetes drug Jardiance also raises the chances of getting a UTI. Jardiance causes excess sugar to be lost through the urine, creating the perfect breeding ground for bacteria. This is an important point to be aware of when taking this medication. [2]

Watch out for potential UTI symptoms like:

• Burning during urination
• Needing to urinate frequently or urgently
• Pain in the lower abdomen
• Cloudy, bloody, or foul-smelling urine [4]

Getting quick treatment with antibiotics is crucial, as an untreated UTI can lead to severe complications such as a kidney infection. [3]

Yeast Infection

Yeast is naturally present on our skin and helps regulate bacteria growth. However, when an excess of yeast accumulates, it can lead to a yeast infection. Research has shown that individuals with diabetes are more susceptible to yeast infections than those without diabetes. This is primarily due to a few key reasons. [5]

• Compromised immune system: Poorly controlled diabetes, often characterized by high blood sugar levels, hinders the immune response. The elevated sugar levels can suppress certain immune proteins, such as beta-defensins, which play a crucial role in helping immune cells locate and eliminate infections.

• High sugar in the genital area: The presence of excess sugar in the body provides yeast with a plentiful food source. As a result, yeast can easily cling to skin cells and mucus glands, increasing the risk of infection.

• Previous infection: Once a yeast infection has established itself in a particular area, future infections are more likely to occur. This is especially true for individuals with difficulty managing their diabetes, as they are more susceptible to recurring problems. [5]

It is important to note that SGLT2 inhibitors like Jardiance can further increase the risk of yeast infections in individuals with diabetes. These medications release glucose in the urine, providing an additional food source for yeast to thrive in the genital area. As a result, individuals taking these medications should be particularly vigilant in monitoring for any signs of infection. [2]

Symptoms of a yeast infection differ between men and women but cause discomfort in both. 

Women may notice:

• white or yellow discharge from the vagina
• itching
• redness
• burning [5]

Men can experience:

• redness on the underside of the penis
• scaling on the underside of the penis
• painful rash on the underside of the penis [5]

The good news is yeast infections are manageable with proper precautions. Getting blood sugar under control is key. Your doctor may also recommend antifungal creams or oral medications. [5]

Fournier Gangrene

Fournier Gangrene is a bacterial infection of the soft tissues surrounding the genitals and rectum. The bacteria enter through a cut or wound in the skin and spread rapidly, destroying tissue. While the infection is rare, the symptoms are severe and include: [6]

• Fever
• Tenderness
• Redness
• Swelling of the genital and rectal area [6]

If you experience any of these symptoms, seek emergency medical care immediately. Your doctor will stop the Jardiance treatment and start you on antibiotics immediately to combat the infection. Fournier Gangrene progresses extremely quickly, so fast diagnosis and treatment are essential. [6]

The good news is that Fournier Gangrene is often curable with prompt treatment. However, in some cases, it may require surgical debridement or removal of the damaged tissue. The most critical first step is to get to your doctor or emergency room as soon as possible if you notice symptoms. [6]

Clinical Evidence for Jardiance and Infection Risk

In 2018, researchers reviewed data from four phase 3 empagliflozin (Jardiance) trials. The data showed that patients on empagliflozin therapy had a higher risk of genital infections compared to patients on placebo therapy. [2] The study also found that:

• Genital infections were more common in women than men
• Most patients only had one episode of genital infection
• A few patients discontinued empagliflozin due to genital infections [2]

The study also found that certain groups are more vulnerable to developing infections while using Jardiance:

• Uncircumcised men
• Post-menopausal women who had hormonal changes which decreased immunity in the female reproductive tract [2]

Tips To Minimize Infection Risk

When taking Jardiance, it's essential to be aware that it can increase the risk of genital infections. However, you can take several proactive measures to reduce your chances of experiencing any infections. By following these simple tips, you can help keep yourself healthy and minimize the risk:

• Wash up regularly: Be sure to wash your genitals after using the bathroom. For uncircumcised men, gently pull back the foreskin and wash thoroughly with water and a mild soap. Keep the area clean and dry to avoid creating an environment where infections can thrive. [2]

• Use the right products: When washing, it's crucial to use clean water and a mild soap. Harsh chemicals or strong fragrances can disrupt the natural balance and increase the likelihood of infections. Use gentle, hypoallergenic options to protect your delicate skin. [7]

• Wipe properly: Always wipe from front to back after using the bathroom. This technique helps prevent bacteria from the anal area from spreading to the genitals, reducing the risk of infections. [2]

• Choose breathable underwear: Wear cotton underwear, as it allows for proper ventilation and moisture absorption. Synthetic materials can trap heat and moisture, creating an environment that promotes bacterial growth. By choosing breathable fabrics, you can help prevent infections. [7]

Conclusion

Jardiance has emerged as a reliable solution for effectively managing blood sugar levels in individuals with type 2 diabetes. However, it is crucial to remain vigilant about potential side effects, particularly the increased risk of infections. Practicing good hygiene and reporting any problematic symptoms immediately to your doctor can help mitigate infection risk.

To learn more about Jardiance, visit our dedicated Jardiance blog.

The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis, or treatment.