Jardiance Side Effects: What to Expect and When to Call Your Doctor

If your doctor just prescribed Jardiance for type 2 diabetes or heart failure, it’s natural to want to know what to expect before you start. Jardiance side effects range from mild and manageable to rare but serious, and knowing the difference ahead of time makes it much easier to use this medication safely and know when something needs a call to your doctor rather than a wait-and-see approach. Here’s a clear, practical breakdown of what the evidence actually shows.

How Jardiance Works

Jardiance belongs to a class of medications called SGLT2 inhibitors (sodium-glucose cotransporter-2 inhibitors). Rather than working on insulin production or sensitivity the way many other diabetes medications do, it works in the kidneys — blocking the reabsorption of glucose back into the bloodstream, so excess sugar is instead flushed out through urine. This mechanism is also why many of its side effects are related to increased urination and genital or urinary tract infections: there’s simply more sugar present in the urinary tract than usual, which can encourage bacterial and yeast growth. Beyond blood sugar control, Jardiance is also prescribed for certain types of heart failure and chronic kidney disease, reflecting benefits researchers discovered beyond its original diabetes indication.

Common Side Effects

These are the side effects most frequently reported in clinical trials, generally affecting more than 1 in 100 users:

• Genital yeast infections. Both vaginal yeast infections in women and penile yeast infections in men are more common with Jardiance than with many other diabetes medications, particularly in people with a history of yeast infections or in uncircumcised men.
• Urinary tract infections. Increased risk of UTIs, including more serious kidney infections (pyelonephritis) in some cases.
• Increased urination. A direct result of how the medication works — most people notice needing to urinate more often, especially in the first few weeks.
• Thirst and mild dehydration symptoms. Increased urination can lead to a degree of fluid loss, making it important to drink enough water throughout the day.
• Nausea. Usually mild and often improves after the first few weeks of treatment.
• Joint pain. Some users report new or worsened joint discomfort, though the mechanism isn’t fully understood.
• Upper respiratory infections. Reported somewhat more often in clinical trials, though a direct causal link isn’t firmly established.
• Changes in cholesterol and blood counts. Mild increases in LDL cholesterol and hematocrit (red blood cell concentration) are sometimes seen on routine labs.

Hypoglycemia Risk

On its own, Jardiance carries a relatively low risk of causing dangerously low blood sugar, since it doesn’t directly increase insulin levels. However, when it’s combined with insulin or with sulfonylurea medications such as glipizide or glyburide, the combined blood-sugar-lowering effect can push glucose too low. Signs of hypoglycemia include shakiness, sweating, confusion, rapid heartbeat, and in severe cases, loss of consciousness. If you’re taking Jardiance alongside insulin or a sulfonylurea, your doctor may adjust those other medications’ doses to reduce this risk, and it’s worth knowing the signs of low blood sugar well before you need to recognize them in the moment.

Serious Side Effects That Need Prompt Attention

These are less common but important to recognize, since several can become dangerous if not addressed quickly:

• Diabetic ketoacidosis (DKA). This is one of the most important risks to understand with SGLT2 inhibitors. Unusually, DKA associated with Jardiance can occur even when blood sugar is normal or only mildly elevated — a pattern sometimes called “euglycemic DKA” — which means it can be missed if you’re only watching your glucose numbers. Warning signs include nausea, vomiting, abdominal pain, unusual tiredness, and difficulty breathing. This requires emergency medical attention.
• Dehydration and low blood pressure. Because Jardiance increases fluid loss through urination, it can lead to volume depletion — symptoms include dizziness, lightheadedness especially when standing up, and fainting. This risk is highest in people who are also taking diuretics (“water pills”), are elderly, or have kidney impairment.
• Fournier’s gangrene. A rare but serious bacterial infection of the tissue around the genitals and perineum. It can progress quickly and requires emergency surgical treatment. Symptoms include severe pain, swelling, redness, and fever in the genital or perineal area. While rare, it’s considered a medical emergency.
• Lower-limb infections and amputation risk. Some SGLT2 inhibitors, including Jardiance, have been associated with an increased risk of foot and leg infections that, in rare cases, have led to amputation. Anyone taking Jardiance should promptly report any new sores, ulcers, redness, or swelling in the feet or legs.
• Acute kidney injury. Reported after the medication reached the market, often associated with dehydration. Staying well hydrated and reporting reduced urination or swelling can help catch this early.
• Allergic reactions. Rare, but can include angioedema (swelling of the face, lips, tongue, or throat), which is a medical emergency if breathing is affected.

Jardiance Compared to Other Diabetes Medications

Several newer-generation diabetes medications work through different mechanisms, and understanding where Jardiance fits can help put its side-effect profile in context:

Doctors sometimes choose between these classes, or combine them, based on a person’s individual risk factors — someone prone to UTIs or yeast infections might do better on a GLP-1 medication, while someone who needs the heart and kidney benefits SGLT2 inhibitors provide may find Jardiance the better overall fit despite the infection risk.

Why Doctors Weigh the Risks Against Real Benefits

Jardiance’s side-effect profile is easier to put in perspective once you understand why it’s prescribed so widely despite the infection and DKA risks. In the EMPA-REG OUTCOME trial, a large cardiovascular safety study, empagliflozin reduced the relative risk of cardiovascular death by 38% and reduced hospitalization for heart failure by 35% in people with type 2 diabetes and existing heart disease. Later trials in people with heart failure — both with and without diabetes — found similar protective effects, which is why Jardiance is now approved specifically for heart failure, not just diabetes. Separate kidney-focused research has also shown it meaningfully slows the progression of chronic kidney disease. For many patients, especially those with diabetes and existing heart or kidney concerns, these benefits are a major part of why a doctor recommends Jardiance over an option with a milder side-effect profile but less protective data behind it.

Who Should Use Extra Caution With Jardiance

Jardiance isn’t the right fit for everyone, and certain groups face a higher risk of its more serious side effects:

• People with type 1 diabetes. Jardiance is approved only for type 2 diabetes. Using SGLT2 inhibitors off-label in type 1 diabetes carries a notably higher risk of ketoacidosis and isn’t recommended outside of specialized care.
• People with significantly reduced kidney function. Jardiance’s blood-sugar-lowering effect depends partly on kidney function, and your doctor will check kidney function before starting and periodically afterward.
• Anyone with a history of recurrent genital yeast infections or UTIs. These risks are meaningfully higher on Jardiance, so a history of frequent infections is worth discussing before starting.
• People scheduled for surgery. Jardiance is typically paused for a few days before planned surgery or any procedure requiring fasting, since fasting raises DKA risk. Make sure every member of your care team knows you’re taking it.
• People on a low-carbohydrate or ketogenic diet. Very low carbohydrate intake combined with Jardiance can raise ketoacidosis risk even further, so this combination is worth discussing with your doctor rather than starting on your own.
• Older adults, especially those on diuretics. The combined dehydration and low-blood-pressure risk is higher in this group, so closer monitoring, particularly in the first few weeks, is often recommended.

Practical Tips for Taking Jardiance Safely

• Stay well hydrated. Since the medication increases urination, drinking enough water throughout the day helps offset fluid loss and reduces the risk of dehydration and kidney strain.
• Practice good genital hygiene. Gentle, regular washing and keeping the area dry can help reduce the risk of yeast infections, which are the most common side effect.
• Check your feet regularly. Especially if you have diabetic neuropathy, inspect your feet daily for any new cuts, sores, or redness, and report them promptly.
• Know the signs of DKA. Because it can occur without dramatically high blood sugar, don’t dismiss nausea, vomiting, or unusual fatigue just because your glucose reading looks fine.
• Tell every provider you see that you’re taking it. Before surgery or any procedure requiring fasting, Jardiance is often paused temporarily because fasting increases DKA risk — your surgical team needs to know you’re taking it in advance.
• Review other medications with your doctor. Combining Jardiance with diuretics, insulin, or sulfonylureas changes your risk profile for dehydration and hypoglycemia, so make sure your care team has your full medication list.

When to Call Your Doctor

Most people tolerate Jardiance well once their body adjusts, but certain symptoms warrant a prompt call — or emergency care — rather than waiting for a routine follow-up:

• Nausea, vomiting, or abdominal pain, especially combined with unusual tiredness (possible DKA, even with normal-looking blood sugar)
• Severe pain, swelling, or redness in the genital or perineal area, with or without fever (possible Fournier’s gangrene — seek emergency care)
• Signs of a urinary tract infection that doesn’t improve, or recurs frequently
• New sores, redness, or swelling on the feet or legs
• Dizziness, lightheadedness, or fainting, especially when standing up
• Signs of a severe allergic reaction, such as swelling of the face or throat, or difficulty breathing
• Reduced urination or unusual swelling, which can point to kidney involvement

Frequently Asked Questions

Do Jardiance side effects go away over time?

Many of the milder side effects, like nausea and increased urination, tend to improve within the first few weeks as your body adjusts. Infection risk and the more serious risks like DKA, however, don’t necessarily decrease over time and require ongoing attention for as long as you’re taking the medication.

Can Jardiance cause weight loss?

Yes, modest weight loss is a commonly observed effect, partly related to the extra glucose (and the calories it represents) being eliminated through urine, along with some fluid loss. This is generally considered a secondary benefit rather than a side effect to worry about, though significant unintentional weight loss should still be mentioned to your doctor.

Is it safe to take Jardiance long-term?

Jardiance has been studied in large, long-term clinical trials and is approved for ongoing use in type 2 diabetes, heart failure, and chronic kidney disease. Like any long-term medication, it requires periodic monitoring of kidney function and overall health, which your doctor will typically build into your regular follow-up visits.

What should I do if I think I have a yeast infection from Jardiance?

Mention it to your doctor or pharmacist rather than simply stopping the medication on your own. Yeast infections related to Jardiance are usually treated the same way as any other yeast infection, and your doctor can advise on whether any adjustment to your diabetes regimen is needed.

Can I drink alcohol while taking Jardiance?

Moderate alcohol use is generally considered acceptable for most people on Jardiance, but alcohol can affect blood sugar and increase dehydration risk, so it’s worth discussing your specific situation with your doctor, especially if you also take insulin or a sulfonylurea.

This article is for general educational purposes and isn’t a substitute for personalized medical advice. Never start, stop, or change a prescription medication without talking to your doctor first.

Jardiance is an effective medication for many people managing type 2 diabetes, heart failure, or chronic kidney disease, and most who take it experience only mild, manageable side effects like increased urination or an occasional yeast infection. The handful of more serious risks — particularly diabetic ketoacidosis and Fournier’s gangrene — are rare, but knowing their warning signs means you can act quickly if they ever show up, which is really the main thing that stands between a rare complication and a well-managed one.