Jardiance and Metformin: Do I Need Both?

If you’re living with Type 2 diabetes, there’s a good chance you’re taking metformin. After all, it’s one of the most commonly prescribed medications in the U.S. It works well to lower blood glucose (sugar) levels. And it’s available as a lower-cost generic, too.

But if metformin isn’t enough, or if you have Type 2 diabetes and other health conditions, your healthcare provider may decide to add another medication. Jardiance (empagliflozin) is one option they may consider.

So, why are Jardiance and metformin sometimes prescribed together, and do you really need both?

How do Jardiance and metformin work?

Jardiance is not the same as metformin, but they are both FDA approved to treat Type 2 diabetes. Both metformin and Jardiance help lower your blood glucose levels and hemoglobin A1C (HbA1C or A1C) — your average blood glucose levels over 3 months. But they accomplish this in different ways.

Metformin works by making it easier for your cells to absorb and use glucose from your blood. It also decreases the amount of glucose made by your liver and absorbed in your intestines.

Jardiance is a sodium-glucose cotransporter 2 (SGLT2) inhibitor. It works in your kidneys to prevent glucose from being reabsorbed so it ends up in your urine. What’s more, Jardiance has a similar effect on sodium (salt), which has benefits for heart failure, heart disease, and kidney disease.

When taken together, the way Jardiance and metformin work can have additional benefits for your heart and kidneys.

Why are Jardiance and metformin sometimes prescribed together?

The American Diabetes Association (ADA) typically recommends metformin as a first-choice medication, depending on your blood glucose goals and other factors. 

But there are certain reasons why adding a medication like Jardiance may make sense — either initially or later on.

1. You also have heart failure. Jardiance is approved to treat two of the most common types of heart failure. People with and without Type 2 diabetes can take it for this reason. But if you’re living with both conditions, Jardiance can lower the likelihood of being hospitalized for heart failure. And it can lower the risk of death related to heart disease, too.

2. You also have heart disease. Even if you don’t have heart failure, you can also benefit from Jardiance. If you have existing heart disease, it can lower the risk of death related to the condition.

3. You also have kidney disease. Other SGLT2 inhibitors, like Invokana (canagliflozin) and Farxiga (dapagliflozin), are approved for chronic kidney disease (CKD). Jardiance isn’t approved for CKD yet, but it may be soon. Studies show that it can slow down kidney problems from getting worse and lower the risk of heart disease-related death in people with CKD.

4. You aren’t able to meet your blood glucose goals with metformin alone. If you’re not quite at your goal, adding another medication may help. Jardiance isn’t the preferred choice in this situation, but it may be considered if other options aren’t appropriate.

Keep in mind: There are other medications with similar benefits for heart and kidney disease, including glucagon-like peptide-1 (GLP-1) agonists. Your healthcare provider will decide if adding Jardiance or different medication is right for you.

Do you need to take metformin with Jardiance?

Short answer: It depends. If you were initially prescribed metformin, you’ll usually keep taking it as long as it’s safe for you — even as other medications are added. But if you can’t tolerate metformin’s side effects, your healthcare provider may have you stop taking it.

If you have heart disease, heart failure, or kidney disease, your healthcare provider may prescribe Jardiance — with or without metformin. But depending on your treatment goals, you may benefit from both. Your healthcare provider will decide which medications are right for you.

How are metformin and Jardiance taken?

Metformin is available as an immediate-release (IR) tablet, and several different extended-release (ER) tablets. The IR tablets are typically taken once or twice a day with food. And the ER tablets are taken once daily with an evening meal.

Jardiance is also available as a tablet. You’ll typically take it once in the morning, with or without food. For convenience, Jardiance is also available in combination pills with metformin as Synjardy and Synjardy XR. Synjardy is taken twice daily with meals, and Synjardy XR is taken once a day with your morning meal.

If you’re prescribed metformin and Jardiance together, you may take them separately or as a combination pill. Your healthcare provider and pharmacist can work with you to find the most affordable option.

Are there any specific risks with taking Jardiance and metformin together?

Generally, Jardiance and metformin are safe to take together. But as with most medications, they can cause their own unique side effects. Common metformin side effects include diarrhea, nausea and vomiting, and gas. Common Jardiance side effects include urinary tract infections, weight loss, genital infections, and peeing more often. Very rarely, Jardiance can cause low blood glucose (sugar), dehydration, ketoacidosis (too much acid in the blood), serious UTIs, and life-threatening infections of the genitals.

Both Jardiance and metformin have a low risk of hypoglycemia (low blood glucose) when taken on their own. But when combined, this risk can go up. And if you have kidney problems, you may be more likely to experience side effects from both medications.

Your healthcare provider will weigh the potential benefits and risks of this combination when prescribing metformin and Jardiance for you.

How to save on Jardiance and metformin

Jardiance and certain forms of metformin are available as brand-name medications. But you can also find metformin as a lower-cost generic. GoodRx can help you navigate the many ways to save on your prescription.

• Save with GoodRx. GoodRx can help you save over 89% off the average retail price of the generic version of metformin. Generic metformin’s price at certain pharmacies is as low as $9.00 with a free GoodRx discount.

• Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $10 for Jardiance using a savings card from the manufacturer.

• Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for Jardiance’s patient assistance program, which offers the medication free of cost.

Why trust our experts?

Written by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. A pulmonologist and hospitalist, she practiced and taught clinical medicine at hospitals in London for a decade before entering a career in health education and technology.

Our editorial standards

Meet our experts