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Metformin vs. Jardiance: A Comprehensive Comparison

More often than not, many diabetic patients want to manage their condition with a well-orchestrated routine that doesn’t feel like a constant battle. This treatment efficiency is the promise that modern diabetic medication strives to deliver. Metformin and Jardiance (Empagliflozin) are two such medications.

Both drugs are FDA-approved to lower blood sugar levels and hemoglobin A1c (HbA1c) for patients with type 2 diabetes. Metformin has been on the market longer, and doctors also prescribe it off-label to manage polycystic ovarian syndrome and gestational diabetes.

In contrast, Jardiance (Empagliflozin) is distinctive in that it also helps mitigate the risks of cardiovascular complications in adults with type 2 diabetes comorbid with cardiovascular diseases.

However, is there a superiority in insulin management regarding whether Jardiance is better than metformin or vice versa? It’s commonly understood that not every diabetes drug is appropriate for all individuals with type 2 diabetes. Yet, if a drug isn’t working for you, it’s only natural your healthcare provider would want to explore other options, too.

In these instances, it’s essential to understand your medication. There are differences in the mechanism of action, the conditions treated, and the warnings and precautions to consider if you’re switching from metformin to Jardiance, for example. This article will compare Jardiance vs. metformin to help you determine which best suits your needs or why your healthcare provider has a preferred prescription for you.

Metformin is a commonly prescribed medication for type 2 diabetes and is often the first choice for managing the condition. It can also be used off-label to treat gestational diabetes, polycystic ovarian syndrome, and anti-aging. The drug is also repurposed for cancer treatment, fatty liver treatment, and post-COVID syndromes.

As an FDA-approved antidiabetic agent from the Biguanide class, it lowers blood sugar levels by reducing glucose absorption from the intestines, decreasing liver glucose production, and improving insulin sensitivity. This dual mechanism helps maintain more stable blood sugar levels. The liver is crucial in regulating blood sugar, especially during fasting periods.

In type 2 diabetes, the liver can produce excess glucose. Metformin slows down this process, reducing the liver’s contribution to high blood sugar levels. This stabilization is essential for preventing the severe health complications associated with type 2 diabetes.

Effective blood sugar management with Metformin helps prevent complications such as kidney damage, blindness, nerve issues, amputations, and sexual dysfunction and reduces the risk of strokes and heart attacks. For optimal results, you should administer Metformin alongside dietary changes and exercise.

Jardiance Overview

Jardiance is an FDA-approved medication for type 2 diabetes that controls blood sugar levels. Adults who are comorbid with type 2 diabetes and heart failure or cardiovascular disease can also use it to mitigate cardiovascular risk factors. Doctors prescribe 10mg tablets for adults with chronic kidney disease to slow disease progression and reduce the risk of eGFR decline, end-stage kidney disease, cardiovascular death, and hospitalization.

As a sodium-glucose cotransporter-2 (SGLT-2) inhibitor, Jardiance blocks proteins in the renal tubules that reabsorb glucose back into the bloodstream. It works by helping the kidney excrete more glucose in the urine, lowering glucose levels (BbA1c).

Jardiance also benefits heart health by altering heart muscle metabolism using a balanced combination of energy sources such as fatty acids, branched-chain amino acids (BCAA), glucose, and ketones, improving diastolic function. Effective blood sugar control with Jardiance helps mitigate complications of diabetes, such as heart disease, vision loss, and kidney disease. For optimal results, you should use Jardiance with proper diet and exercise.

Warning and Precautions for Metformin Use

When using metformin, one must be aware of particular warnings and precautions to guarantee safe and effective treatment. Below are key points you should consider before and during metformin use:

Do not use metformin if you have:

  • Severe kidney disease
  • Metabolic acidosis
  • Diabetic ketoacidosis (contact your doctor for treatment)


Temporary Discontinuation:

  • Stop taking metformin temporarily if you need an x-ray or CT scan with injected dye.
  • Inform healthcare providers about your metformin use before such procedures.


Lactic Acidosis Risk:

  • Although uncommon, metformin can cause lactic acidosis, a harmful accumulation of lactic acid in the blood.
  • Seek emergency medical help if you experience:
    • Unusual muscle pain
    • Stomach pain
    • Trouble breathing
    • Feeling cold
    • Dizziness
    • Extreme weakness or tiredness


Before Taking Metformin:

  • Do not use it if you are allergic to metformin.
  • Notify your doctor if you have a history of:
    • Kidney disease (you may need to evaluate your kidney function)
    • High ketone levels in blood or urine
    • Heart disease or congestive heart failure
    • Liver disease
    • Use of insulin or other oral diabetes medications


Special Considerations:

  • Increased risk of lactic acidosis if you have other medical conditions, severe infections, chronic alcoholism, or are 65 or older.
  • Follow the doctor’s instructions if you are pregnant or planning to become pregnant, as controlling diabetes is crucial during pregnancy.
  • Metformin may stimulate ovulation, increasing the risk of unintended pregnancy.
  • Do not breastfeed while using metformin.

Warning and Precautions for Jardiance Use

When taking Jardiance, it’s crucial to understand the specific warnings and precautions associated with its use to ensure safety and effectiveness. Consider the following key points before and during your treatment with Jardiance:

Do not use Jardiance if you have:

  • Severe kidney disease or are on dialysis
  • Diabetic ketoacidosis
  • Type 1 diabetes mellitus (due to increased risk of diabetic ketoacidosis)


Serious Side Effects:

  • Call your doctor if you experience:
    • Stomach pain
    • Vomiting
    • Tiredness
    • Trouble breathing
  • Jardiance can cause serious genital infections. Seek medical help if you have:
    • Burning, discharge, itching, odor, pain, redness, tenderness, or swelling of the genital or rectal area
    • Fever or feeling unwell


Before Taking Jardiance:

  • Do not use it if you are allergic to empagliflozin or any inactive tablet ingredients.
  • Inform your doctor if you have a history of:
    • Bladder or urination problems
    • Genital infections (penis or vagina)
    • Pancreatic issues, including surgery
    • Amputation
    • Type 1 diabetes or diabetic ketoacidosis
    • Changes in diet or reduced food intake
    • Alcoholism or heavy alcohol consumption
    • Low salt diet
    • Liver or kidney disease
    • Higher risk of issues if you are 65 or older.


Pregnancy and Breastfeeding:

  • Avoid using Jardiance during the second or third trimester of pregnancy, as it could harm the unborn baby.
  • Do not breastfeed while taking Jardiance, as it can pass into breast milk and cause the baby harm.

Jardiance vs Metformin for Weight Loss

Like Ozempic, metformin and Jardiance are not explicitly approved for weight loss, but are prescribed off-label. Weight loss can be a side effect. In clinical studies, people taking Jardiance alone or with other diabetes medications lost between 1.8% and 3.2% of their body weight over 24 weeks.

On the other hand, metformin has shown more consistent results. A long-term study involving those taking metformin saw an average weight loss of about one-third of the participants, losing at least 5% of their body weight after a year. Long-term use (up to 15 years) resulted in an average weight loss of 6.2%.

Administration Methods of Jardiance Versus Metformin

Jardiance and Metformin are essential in diabetes management, but their administration methods differ. Jardiance is taken as a once-daily oral tablet, making it simple to integrate into daily routines without strict timing.

Metformin requires a more complex schedule. It’s usually taken in multiple daily doses with meals to improve effectiveness. The need for a more regimented dosing schedule can be a significant factor for patients switching from metformin to Jardiance.

Metformin is available in various forms, including standard pills, extended-release tablets, and liquid solutions. Standard tablet dosages range from 850–1,000 mg twice daily or 500–2,000 mg daily in three divided doses for the liquid form. Jardiance is typically prescribed in 10 mg or 25 mg doses once daily.

Costs and Combined Administration

Jardiance is a brand-name product that’s more expensive than generic metformin. The average monthly cost of Jardiance ranges from $50 to $230, while metformin costs between $15 and $20. Jardiance and Metformin are typically safe to use concurrently, but it’s crucial to consult your healthcare provider.

The Bottom Line

Both Metformin and Jardiance offer significant benefits for managing type 2 diabetes. They effectively lower blood sugar levels and reduce HbA1c, contributing to overall diabetes management.

Metformin is typically the first-line treatment and has been used for many years. It’s also effective in managing other conditions, such as polycystic ovarian syndrome and gestational diabetes. Jardiance provides additional cardiovascular benefits, making it a preferred option for patients with heart disease.

When comparing Jardiance vs metformin, it’s essential to consider their distinct mechanisms of action. Metformin mitigates glucose production in the liver and augments insulin sensitivity, while Jardiance helps the kidneys remove excess glucose through urine. This difference can influence your doctor’s decision on whether Jardiance instead of metformin is better for your specific health needs.

Additionally, both medications can aid in weight loss, with Jardiance showing weight loss of 1.8% to 3.2% and metformin demonstrating long-term weight loss of up to 6.2%. The administration methods also differ, with Jardiance taken once daily, while metformin requires multiple doses.

Be mindful of the warnings and precautions associated with each drug. Metformin carries a risk of lactic acidosis, while Jardiance can cause serious genital infections. Whether Jardiance is better than metformin depends on individual health conditions and treatment goals.

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