Jardiance vs. Entresto: Differences, similarities & side effects

In this article:

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

In this article

• Jardiance vs. Entresto: Key differences
• Jardiance vs. Entresto: Conditions treated
• Entresto vs. Jardiance: Which is better?
• Jardiance vs. Entresto: Insurance coverage and cost comparison
• Jardiance vs. Entresto side effects
• Jardiance and Entresto drug interactions
• Jardiance and Entresto 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: Comparing key differences
	Jardiance	Entresto
Drug class	Sodium-glucose cotransporter 2 (SGLT2) inhibitor	Angiotensin receptor neprilysin inhibitor (ARNI)
Brand/generic status	Brand	Brand
What is the generic name?	The active ingredient is empagliflozin, but there is no generic available	The active ingredients are sacubitril/valsartan, but there is no generic available
What form(s) does the drug come in?	Oral tablets: 10 mg, 25 mg	Oral tablets (listed as sacubitril dose/valsartan dose): 24/26 mg, 49/51 mg, 97/103 mg Sprinkle capsules: 6/6 mg, 15/16 mg
What is the standard dosage?	Varies by use; the starting dose is 10 mg by mouth once daily. Some people will require 25 mg daily for blood sugar control.	For adults, the starting dose is 49/51 mg by mouth twice daily. A healthcare provider may increase the dose if needed. For pediatric patients, dosage depends on weight.
How long is the typical treatment?	Long-term	Long-term
Who typically uses the medication?	Adults and children 10 years and older, depending on the indication	Adults and children 1 year and older, depending on the indication

 

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.

Jardiance vs. Entresto: Comparing conditions treated
Condition	Jardiance	Entresto
To reduce the risk of cardiovascular death and heart failure hospitalization in adult heart failure patients	Yes	Yes (prescribing information notes that the benefits are most evident in patients with a below-normal left ventricular ejection fraction (LVEF)
To treat symptomatic heart failure with systemic left ventricular systolic dysfunction in pediatric patients ages 1 and older	No	Yes
Type 2 diabetes mellitus (in combination with diet and exercise)	Yes (adults and children ages 10 and older)	No
Reduce the risk of heart attack, stroke, or death in adult patients with Type 2 diabetes and heart disease	Yes (adults only)	No
To lower the risk of kidney disease progression, cardiovascular death, and hospitalization in adults with chronic kidney disease	Yes	No

 

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: Comparing insurance & cost
	Jardiance	Entresto
Typically covered by insurance?	Yes (usually; may require a prior authorization)	Yes (usually; may require a prior authorization)
Typically covered by Medicare Part D?	Yes	Yes
Quantity	30, 25 mg tablets	60, 24-26 mg tablets
SingleCare cost	$527	$668

 

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.

Jardiance vs. Entresto: Comparing side effects
	Jardiance		Entresto
Side effect	Applicable?	Frequency*	Applicable?	Frequency*
Nausea	Yes	1.1–2.3%	No	N/a
Urinary tract infection	Yes	7.6–9.3%	No	N/a
Increased urination	Yes	3.2–3.4%	No	N/a
Female yeast infection	Yes	5.4–6.4%	No	N/a
Male yeast infection	Yes	1.6–3.1%	No	N/a
Joint pain	Yes	2.3–2.4%	No	N/a
High cholesterol	Yes	2.9–3.9%	No	N/a
Low blood pressure	Yes	% not reported	Yes	18%
High potassium levels	No	N/A	Yes	12%
Cough	No	N/A	Yes	9%
Dizziness	May result as a related complication such as dehydration or low blood sugar, but not reported as a side effect	N/A	Yes	6%
Kidney failure	No	N/a	Yes	5%

*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 vs. Entresto: Comparing drug interactions
Drug	Drug class	Interacts with Jardiance?	Interacts with Entresto?
Humalog Lantus Novolog	Insulin	Yes	Yes
Amaryl (glimepiride) Glucotrol (glipizide) Glyburide	Sulfonylureas	Yes	Yes
Hydrochlorothiazide Lasix (furosemide)	Diuretics	Yes	Yes
Enalapril  Lisinopril  Ramipril	Angiotensin-converting enzyme (ACE) inhibitors	Yes	Yes
Irbesartan  Olmesartan  Valsartan	ARBs	Yes	Yes
Spironolactone	Potassium-sparing diuretic	Yes	Yes
Potassium	Potassium supplements	No	Yes
Ibuprofen  Meloxicam  Naproxen	NSAIDs	No	Yes
Aliskiren	Renin inhibitor	Yes	Yes
Lithium	Mood stabilizer	Yes	Yes

 

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.