Jardiance vs. Entresto: Differences, similarities & side effects

In this article:

• Key differences
• Conditions treated
• Entresto vs. Jardiance: Which is better?
• Insurance coverage and cost comparison
• Side effects
• Drug interactions
• Drug warnings

In this article

• Key differences
• Conditions treated
• Entresto vs. Jardiance: Which is better?
• Insurance coverage and cost comparison
• Side effects
• Drug interactions
• Drug warnings

Jardiance and Entresto are two brand-name medications used to treat heart failure and other conditions. These heart failure medications may be prescribed by a primary healthcare provider or a specialist such as a cardiologist. While both drugs are approved by the Food and Drug Administration (FDA) for use in patients with heart failure, they have notable differences, such as in other approved uses, dosages, side effects, and warnings. Continue reading to learn more about both medications.

Jardiance vs. Entresto: Key differences

Jardiance is a brand-name prescription medication made by Boehringer Ingelheim Pharmaceuticals, Inc. It contains the active ingredient empagliflozin and is part of a drug class called sodium-glucose cotransporter 2 (SGLT2 ) inhibitors, which is the same class as drugs like Farxiga (dapagliflozin) and Invokana (canagliflozin). 

Entresto, made by Novartis, is a brand-name combination drug that contains two medications—sacubitril, a neprilysin inhibitor, and valsartan, an angiotensin II receptor blocker (ARB). It is classified as an angiotensin receptor/neprilysin inhibitor, or ARNI and is the only medication in the ARNI class of drugs. 

Jardiance vs. Entresto: Conditions treated

Both Jardiance and Entresto are FDA approved in adults with heart failure to lower the risk of cardiovascular death and hospitalization for heart failure. Both drugs also have other FDA-approved indications for use, as shown in the table below.

Entresto vs. Jardiance: Which is better?

There isn’t published data directly comparing the two drugs; however, both have been proven to be safe and effective in clinical trials. Some research has found that patients with both diabetes and heart failure with reduced ejection fraction (HFrEF) who took both an ARNI and an SGLT2 inhibitor had significant improvement in cardiac function and prognosis. The researchers concluded that combining these two medications can result in improvement in these patients. However, not everyone is a candidate for either or both medications, and the choice of medications depends on various individual factors. Consult your healthcare provider about the best treatment options for your medical condition or conditions.

Jardiance vs. Entresto: Insurance coverage and cost comparison

According to the Jardiance manufacturer’s website, about 85% of people with commercial health insurance and 60% with Medicare prescription drug coverage pay $50 or less per month for Jardiance, while others will pay more. For cash-paying customers without insurance, a one-month supply of Jardiance costs about $836. But, using a free SingleCare card or coupon can bring the price down to as low as $527 per month. 

Entresto’s manufacturer offers a one-month free trial for all new patients. After that, people with commercial insurance can look into the copay program and pay as little as $10 for a 30-, 60-, or 90-day supply of Entresto. Most patients with Medicare prescription coverage will pay the lowest brand copay. For customers without insurance, a one-month supply of Entresto costs approximately $913, but using a free SingleCare card or coupon can bring the price down to as little as $668 monthly.

RELATED: Does Medicaid cover Jardiance?

As plan details can change, you can contact your health insurance provider for the most recent information on pricing estimates. You may also want to visit the manufacturer’s website for each drug to learn about other ways to save on your medicine, such as copay cards, free trial offers, and patient assistance programs. 

Jardiance vs. Entresto side effects

Common side effects of Jardiance include increased urination, urinary tract infections (UTIs), yeast infections, and joint pain.

Common Entresto side effects include hypotension (low blood pressure), hyperkalemia (high potassium levels), cough, dizziness, and kidney failure.

This is not a full list of side effects, and others may occur. Consult your healthcare provider or pharmacist for more information about the side effects of Jardiance and Entresto.

*Frequency depends on dosage

Source: DailyMed (Jardiance), DailyMed (Entresto)

Jardiance and Entresto drug interactions

Before taking Jardiance or Entresto, tell your healthcare provider about all the medicines you take, including prescription drugs, over-the-counter medications, vitamins, and supplements. 

When taking Jardiance or Entresto with insulin or a sulfonylurea diabetes medication (such as glimepiride, glipizide, or glyburide), there is an increased risk of hypoglycemia (low blood sugar). Close monitoring and a dosage adjustment may be required. 

Taking Jardiance with a diuretic (also known as a water pill) can increase urination and urine volume, which may lead to dehydration. Jardiance also interacts with the mood stabilizer lithium, potentially resulting in decreased lithium levels and making lithium less effective. Careful monitoring will be required.

Entresto should not be used with ACE inhibitors or other ARBs. People who take Entresto and have diabetes or kidney problems should not take aliskiren. Entresto may also interact with potassium-sparing diuretics, potassium supplements, and salt substitutes that contain potassium, which could lead to increased potassium levels. Combining a nonsteroidal anti-inflammatory drug (NSAID) with Entresto, especially in older adults or those with other risk factors, can lead to kidney problems, including kidney failure. Entresto also interacts with lithium, leading to increases in lithium levels and possibly resulting in lithium toxicity.

This is not a full list of drug interactions, and others may occur. Consult your healthcare professional for more information about drug interactions and how they may affect you.

Jardiance and Entresto drug warnings

Before you take Jardiance or Entresto, tell your healthcare provider about your medical conditions and medical history, including if you are pregnant, planning to become pregnant, or breastfeeding.

With either medicine, if you have symptoms of an allergic reaction, such as hives, trouble breathing or swallowing, or swelling of the face, lips, tongue, or throat, you should get emergency medical attention.

Jardiance

Jardiance can increase the risk of:

• Diabetic ketoacidosis (DKA), which can be life-threatening and lead to death – Certain individuals are at higher risk for DKA, including those with Type 1 diabetes or who have Type 2 diabetes and are sick or following a ketogenic diet. Stop taking Jardiance and get emergency medical help if you are experiencing nausea, vomiting, abdominal pain, fatigue, trouble breathing, or ketones in the urine or blood.
• Kidney damage in certain groups of people – Before taking Jardiance, your healthcare provider will check your kidney function, especially if you are an older adult, take a diuretic, or have any type of kidney problems. They will also monitor you during treatment with Jardiance.
• Urinary tract infections (UTIs), which can be severe – Notify your healthcare provider right away if you experience frequent urination, pelvic pain, burning or pain during urination, or blood in the urine.  
• Fournier’s Gangrene (necrotizing fasciitis of the perineum), a serious and potentially life-threatening condition – Get emergency medical attention if you have pain, tenderness, redness, or swelling around the anus or genitals, along with fever and extreme tiredness.
• Yeast infections of the genitals – Notify your healthcare provider if you have symptoms. Women may notice vaginal odor, cottage cheese-like discharge, and itching. Men may notice foul-smelling discharge from the penis, skin pain around the penis, or rash, swelling, redness, or itching of the penis. 
• Infections or ulcers of the lower limbs – Jardiance may increase the risk of lower limb amputations, especially if you have a history of amputation, have blocked or narrowed blood vessels, or have had diabetic-related foot problems such as infections, ulcers, or sores. 

Entresto 

Entresto has a boxed warning, also called a black box warning, which is the most serious warning required by the FDA. The warning states that Entresto can cause harm to a fetus, including possible death, and should not be taken by pregnant individuals. If you already take Entresto and find out you are pregnant, consult your healthcare provider right away. 

Entresto can also increase the risk of:

• Low blood pressure, especially in certain people who are at higher risk – This includes people who are volume-depleted or salt-depleted from high-dose diuretic treatment. Those at high risk will be carefully monitored.
• Impaired kidney function – Entresto acts on the renin-angiotensin-aldosterone system (RAAS), a system that regulates blood pressure and other functions. However, kidney problems may also occur in certain individuals. Patients who take Entresto will be monitored for kidney function.
• Hyperkalemia, or high potassium levels – Potassium levels will be monitored during treatment, and individuals at higher risk (such as those with kidney problems or diabetes) may need more frequent monitoring.