Proceed With Caution With These 6 Jardiance Interactions

Jardiance (empagliflozin) is a medication that has many uses. This includes treating Type 2 diabetes, chronic kidney disease, and heart failure. It can also help lower the risk of death or severe heart-related issues that these conditions can cause. While Jardiance has many possible benefits, it’s not free of risks, including interactions.

Jardiance is a sodium-glucose cotransporter-2 inhibitor (SGLT2 inhibitor or “flozin”). It mainly works in the kidneys to help stop the body from reabsorbing glucose (sugar) back into the blood. This helps lower blood sugar in people with Type 2 diabetes.

Because of how it works, Jardiance can interact with other medications that go through the kidneys or lower your blood sugar. What’s more, certain supplements, foods, and drinks may worsen its side effects or combat its benefits.

Jardiance interactions

The following medications and foods can interact with Jardiance:

• Diuretics (water pills), such as furosemide (Lasix)

• Insulin

• Sulfonylureas, such as glipizide (Glucotrol XL)

• Meglitinides (glinides), such as repaglinide

• Lithium (Lithobid)

• Vitamins and supplements that affect blood sugar levels, such as ginseng and ginkgo biloba

This isn’t a complete list. So be sure to tell your prescriber and pharmacist which medications and supplements you take before starting Jardiance.

Below, we’ll discuss these six Jardiance interactions, plus foods and drinks you may want to limit.

1. Diuretics (water pills)

Diuretics are a common group of medications that can help lower blood pressure. They’re also often prescribed for people with heart failure. One side effect of diuretics is having to pee more often. Jardiance also has this side effect. Taking Jardiance and a diuretic together may make you have to pee even more often than you would with just one.

But greater urination could be more than just an annoyance. It can lead to dehydration, which could cause dizziness or low blood pressure. There’s a risk of dehydration with Jardiance and diuretics when taken by themselves. The risk goes up more when combining them.

Another factor to consider is that some diuretics can raise your blood sugar. This could make it harder for Jardiance to manage diabetes.

Examples of common diuretics include:

• Chlorthalidone (Thalitone)

• Furosemide

• Hydrochlorothiazide (Microzide)

• Spironolactone (Aldactone)

There are times where you may need both Jardiance and a diuretic, especially if you have heart failure. If this is the case, your prescriber will likely watch you more regularly with blood tests. This will help them spot signs of dehydration and make medication changes if needed.

2. Insulin

Insulin is one of the oldest diabetes medications, and it’s still used today. One well-known side effect of insulin is that it can cause hypoglycemia (low blood sugar). Although Jardiance has a warning for this risk, it’s unlikely to cause low blood sugar on its own. But when taking Jardiance and insulin together, the risk goes up.

Low blood sugar can cause many symptoms, including dizziness, sweating, and shakiness. In severe cases, it can be fatal. So it’s important to be able to recognize and treat it quickly if it happens to you. Eating 15 g of fast-acting sugar (such as 4 glucose tablets, 1 tbsp of honey) can help raise your sugar back to a safe level.

Your prescriber may feel you need both Jardiance and insulin. In this case, they may help you make insulin dosage adjustments to help prevent low blood sugar. They may also ask you to check your blood sugar at home more often. If you notice your sugar levels are lower more often than usual, tell your healthcare team.

3. Sulfonylureas

Sulfonylureas, such as glipizide, are another group of diabetes medications. They work by helping your pancreas release more insulin in the body. Because of this, they can cause low blood sugar. The risk of this side effect goes up if you’re also taking Jardiance.

If you’ve been prescribed both Jardiance and a sulfonylurea, watch for symptoms of low blood sugar. Be sure to tell your healthcare team if your sugar levels have been low. They may suggest dosage changes to your sulfonylurea to help manage this Jardiance interaction.

4. Glinides

Glinides, such as repaglinide, are less commonly prescribed than other diabetes medications. They work similarly to sulfonylureas. So they can also lead to low blood sugar when taken with Jardiance.

Your prescriber may lower your glinide dosage when you first start Jardiance. Be sure to check your blood sugar as recommended while taking both medications. If you notice your sugar is often lower than your goal range, tell your healthcare team. You may need dosage adjustments.

5. Lithium

Lithium is a medication that’s prescribed for mental health conditions, such as bipolar disorder. It has a number of interactions because small changes in dose can significantly affect how it works. There are reports that Jardiance may make lithium less effective.

Your kidneys clear lithium from your body. When other medications affect the kidneys, they can change how much lithium is cleared. Some researchers have found that Jardiance causes the kidneys to remove lithium from the body faster. This could lead to lower lithium levels and possibly lower its effectiveness.

It’s unlikely that your prescriber would stop one of these medications to make up for this interaction. But they may recommend more frequent lithium blood tests if you’re also taking Jardiance. This can help them make sure your lithium dose isn’t too low or high. They may raise your dose if they notice your levels have dropped.

6. Supplements that affect blood sugar levels

If you’re taking Jardiance, you may want to avoid also taking vitamins or supplements that raise or lower blood sugar. This could affect how Jardiance works to manage your blood sugar.

Vitamins and supplements that may raise blood sugar include:

• Niacin (vitamin B3)

• Ginkgo biloba

Supplements that may lower blood sugar include:

• Ginseng

• Oral aloe vera

• Green tea extract

• Ginger

• Vitamin E

• Chromium

• Karela (bitter melon)

• Prickly pear cactus

• Garlic

Keep in mind that research on how vitamins and supplements interact with specific diabetes medications is limited.

Make sure to tell your prescriber and pharmacist about all vitamins and supplements you’re taking. They can take this into consideration when screening for Jardiance interactions and providing tips for managing them.

Good to know: Consuming these items in your diet is unlikely to cause significant changes to your blood sugar. It’s more of a concern if you’re taking them in supplement form or consuming them in very large amounts.

Can you take Jardiance and Ozempic together?

Yes, you can take Jardiance and Ozempic (semaglutide) together if needed. In fact, combining these medications can be helpful if you’re not meeting your goal blood sugar range with just one medication. But not everyone needs both medications. It’s recommended to try Jardiance or Ozempic by itself before taking both together.

Both Jardiance and Ozempic have a low risk of low blood sugar. But this side effect is possible with either medication. So if you do start taking both, be sure to check your sugar levels as instructed by your prescriber.

Can you take Jardiance and St. John’s wort together?

There are no confirmed interactions between Jardiance and St. John’s wort. But you should still speak to your prescriber and pharmacist before taking them together.

St. John’s wort may interact with other commonly prescribed diabetes medications. This includes metformin, a medication that many people living with Type 2 diabetes take. In some cases, St. John’s wort makes certain diabetes medications less effective. Other times, it raises the risk of other medication side effects. St. John’s wort also interacts with hundreds of other medications that treat conditions other than diabetes.

So while St. John’s wort may not interact with Jardiance, there’s a chance that it may interact with another medication you take.

Can you take losartan and Jardiance together?

Most people can safely take losartan (Cozaar) and Jardiance together. But there may be times when people may need to approach the combination with caution.

Rarely, Jardiance can cause dehydration, which can strain the kidneys. If you experience this serious side effect, you may need to temporarily stop taking losartan or lower your dosage. Losartan works primarily in the kidneys. If you’re dehydrated, taking medications that work in the kidneys could cause even more strain. And in severe cases, this could result in kidney damage.

Keep in mind that this side effect is very rare. And in many cases, the benefits of taking both medications outweigh the potential risks. So don’t stop taking this combination unless your prescriber tells you to do so.

Are there foods you should avoid while taking Jardiance?

Yes, there are foods you may want to avoid while taking Jardiance. But these aren’t direct interactions, meaning they don’t change how Jardiance works in your body. These foods or beverages can either worsen Jardiance’s side effects or reduce its potential benefits.

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Written 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:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

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