Jardiance vs. metformin: Differences, similarities & side effects

In this article:

• Jardiance vs. metformin: Key differences
• Jardiance vs. metformin: Conditions treated
• Is Jardiance better than metformin?
• Jardiance vs. metformin: Insurance coverage and cost comparison
• Jardiance vs. metformin: Side effects
• Jardiance vs. metformin: Drug interactions
• Metformin vs. Jardiance: Drug warnings
• Bottom line 

In this article

• Jardiance vs. metformin: Key differences
• Jardiance vs. metformin: Conditions treated
• Is Jardiance better than metformin?
• Jardiance vs. metformin: Insurance coverage and cost comparison
• Jardiance vs. metformin: Side effects
• Jardiance vs. metformin: Drug interactions
• Metformin vs. Jardiance: Drug warnings
• Bottom line 

Jardiance (empagliflozin) and metformin are two prescription drugs indicated for the treatment of Type 2 diabetes. Both work by lowering blood sugar levels. Jardiance is a brand-name medication, while metformin Hcl is a generic form of the brand-name medications Fortamet, Glumetza, Glucophage, and Riomet. Jardiance is classified in a group of drugs called sodium-glucose co-transporter 2 (SGLT2) inhibitors, while metformin is classified as a biguanide drug.

Jardiance vs. metformin: Key differences

“Jardiance and metformin are two different diabetes medications from two different classes. They both work by reducing the amount of glucose in the blood; they just do it through different mechanisms,” said Jodie Pepin, Pharm.D., the clinical pharmacy program director at Harbor Health in Round Rock, Texas.

SGLT2 inhibitors like Jardiance lower blood sugar by helping the kidneys flush excess sugar rather than reabsorb it. Metformin, a common first-line treatment for diabetes, decreases the amount of sugar entering the bloodstream and increases insulin sensitivity.

Because Jardiance and metformin decrease blood glucose levels differently, some patients are recommended to take both. “In fact, there is a brand name medication that contains both Jardiance and metformin, and its name is Synjardy,” Dr. Pepin said. 

A final key difference between Jardiance and metformin is that Jardiance is not only prescribed for Type 2 diabetes but also for heart failure and chronic kidney disease, according to Angela Ginn-Meadow, a registered dietitian and certified diabetes educator.

Jardiance vs. metformin: Comparing key differences
	Jardiance	Metformin
Drug class	SGLT2 inhibitor	Biguanide
Brand/generic status	Brand	Generic
What is the generic name?	Empagliflozin	—
What form(s) does the drug come in?	Oral tablet	Oral tablet or oral solution (liquid)
What is the standard dosage?	10 mg or 25 mg once per day	850–1,000 mg twice per day (tablets) or  500–2,000 mg per day taken in two or three divided doses (liquid)
How long is the typical treatment?	Indefinite; long-term	Indefinite; long-term
Who typically uses the medication?	People ages 10 and older	People ages 10 and older

Jardiance vs. metformin: Conditions treated

“Metformin and Jardiance are two different types of oral medications used to treat Type 2 diabetes,” Ginn-Meadow said. “While Jardiance is primarily used for diabetes, it also provides additional benefits for individuals with heart failure or chronic kidney disease.”

Those are the Food and Drug Administration (FDA) approved indications for Jardiance and metformin. Some healthcare professionals also prescribe these medications off-label for conditions not approved by the FDA. 

“Some of the off-label uses for metformin include gestational diabetes, polycystic ovarian syndrome (PCOS), weight loss, and anti-aging. And some include it as a repurposed drug in various alternative cancer treatment regimens,” said Amy Offutt, MD, president of the International Lyme and Associated Diseases Society. “It has also been used off-label to treat fatty liver, and some have tried using it for post-COVID syndromes.”

Jardiance vs. metformin for weight loss

Though neither Jardiance nor metformin is FDA approved for weight loss, both drugs have weight loss as a side effect.

“Studies have shown that metformin can lead to modest weight loss of 5–10% over a two-year period,” Ginn-Meadow said. Jardiance, on the other hand, has been shown to cause up to 3% body weight loss in some patients, according to Dr. Pepin.

Prescribers may be more likely to prescribe these drugs off-label to people with prediabetes or metabolic syndrome since healthy weight management is important in the prevention and treatment of diabetes. 

Still, not all healthcare professionals will prescribe diabetes drugs for weight reduction. “I have seen patients lose weight while taking metformin over the years, but I would not prescribe it for this reason alone, and I have not prescribed Jardiance for weight loss,” Dr. Offutt said.

Jardiance vs. metformin: Comparing conditions treated
Condition	Jardiance	Metformin
Type 2 diabetes mellitus	Yes	Yes
Heart failure	Yes	No
A combination of Type 2 diabetes and cardiovascular disease	Yes	No
Chronic kidney disease (CKD)	Yes	No
Weight loss	Off-label	Off-label
PCOS	No	Off-label
Gestational diabetes	No	Off-label
Aging and aging-related diseases	No	Off-label
Cancer	No	Off-label
Nonalcoholic fatty liver	No	Off-label

Ultimately, the FDA has only approved metformin for the treatment of Type 2 diabetes and Jardiance for the treatment of Type 2 diabetes, heart failure, and CKD. Talk to your healthcare provider if you are curious about other health benefits linked to Jardiance or metformin.

Is Jardiance better than metformin?

Both Jardiance and metformin are effective at treating high blood sugar levels in people with Type 2 diabetes.

In one double-blind, placebo-controlled, 24-week clinical study of Jardiance, 986 people with Type 2 diabetes were treated with this drug, which resulted in lower HbA1c levels (a measurement of glucose control over time), lower fasting plasma glucose, and lower weight. 

In a double-blind, placebo-controlled, 14-week study of metformin in 451 people with Type 2 diabetes, treatment with this drug also resulted in lower HbA1c and fasting plasma glucose, generally in a dose-related manner (the higher the dose, the more dramatic the results). A more recent meta-analysis of 17 clinical trials with a sample size of 30,474 found that metformin use in people with prediabetes demonstrated a significant reduction in the risk of progressing to Type 2 diabetes mellitus.

The most effective medication should only be determined by a healthcare provider who fully understands your medical conditions and medical history and is aware of any other medications you’re taking.

Jardiance vs. metformin: Insurance coverage and cost comparison

Without insurance, Jardiance costs about $838, and metformin costs about $191 for a 30-day supply. However, drug prices vary. Check with your insurance company or Medicare Part D plan for information specific to your plan. 

RELATED: Jardiance cost with Medicare │Does Medicaid cover Jardiance?

You can use SingleCare coupons to save money on Jardiance, lowering the cost to about $530. SingleCare coupons can also potentially reduce your metformin cost to $3.62.

Jardiance vs. metformin: Comparing insurance & cost
	Jardiance	Metformin
Typically covered by insurance?	Yes	Yes
Typically covered by Medicare Part D?	Yes	Yes
Quantity	30, 25 mg tablets	60, 500 mg tablets
Typical Medicare copay	Varies by plan	Varies by plan
SingleCare cost	$530	$3.62

Jardiance vs. metformin: Side effects

Jardiance and metformin are both diabetes medications. However, they belong to different drug classes and thus have different adverse effects.

Common side effects of metformin include gastrointestinal problems like nausea, abdominal pain, and diarrhea. Signs of uncommon but serious adverse reactions to metformin include trouble breathing, slow heartbeat, weakness, and decreased urination.

Common side effects of Jardiance include urinary tract infections, yeast infections, upper respiratory infections, and nausea. Less common but serious side effects may include ketoacidosis, kidney injury, and complicated bacterial infections.

If you’re considering Jardiance versus metformin, it’s essential to consult your healthcare provider for a complete list of side effects.

Jardiance vs. metformin: Side effects comparison
	Jardiance (25 mg)		Metformin
Side effect	Applicable?	Frequency	Applicable?	Frequency
Urinary tract infection	Yes	7.6%	No	—
Yeast infection	Yes	6.4% (females) 1.6% (males)	No	—
Upper respiratory tract infection	Yes	4%	No	—
Increased urination	Yes	3.2%	No	—
Dyslipidemia	Yes	2.9%	No	—
Joint pain	Yes	2.3%	No	—
Nausea	Yes	1.1%	Yes	25.5%
Diarrhea	No	—	Yes	53.2%
Flatulence	No	—	Yes	12.1%
Asthenia (weakness)	No	—	Yes	9.2%
Indigestion	No	—	Yes	7.1%
Abdominal discomfort	No	—	Yes	6.4%
Headache	No	—	Yes	5.7%

Source: DailyMed (Jardiance/Metformin)

Jardiance vs. metformin: Drug interactions

Some medicines can  interact with Jardiance or metformin, possibly affecting the efficacy of the drugs or increasing the risk of side effects. 

Common drug interactions between Jardiance and metformin include insulin and other diabetes medications that trigger insulin secretion. In essence, taking too much of one or more diabetes medications may overcorrect high blood sugar and lead to dangerously low blood sugar. Jardiance and metformin may also interact with diuretics (drugs that cause urination) and several other classes of medications. 

The following is an incomplete list of the drugs that may interact with Jardiance or metformin. Always check with your pharmacist or healthcare provider about possible drug interactions.

Jardiance vs. metformin: Drug interactions comparison
Drug	Drug Class	Jardiance	Metformin
Farxiga (dapagliflozin) Invokana (canagliflozin) Steglatro (ertugliflozin)	SGLT2 inhibitors	Yes	No
Hydrochlorothiazide Chlorthalidone Indapamide	Diuretics	Yes	Yes
Marplan (isocarboxazid), Nardil (phenelzine) Linezolid	Monoamine oxidase inhibitors (MAOIs)	Yes	Yes
Ciprofloxacin  Levofloxacin	Quinolone antibiotics	Yes	Yes
Aspirin Ibuprofen Diclofenac	Salicylates	Yes	Sometimes
Dexamethasone Budesonide Hydrocortisone	Corticosteroids	Yes	Yes
Intravenous iodine-based dye	—	No	Yes
Ranolazine  Tagamet (cimetidine)	OCT inhibitors	No	Yes
Insulin and other diabetes medications		Yes	Yes

Metformin vs. Jardiance: Drug warnings

Jardiance and metformin are not suitable for everyone. If you have questions about the appropriateness of one of these drugs for your condition and situation, consult your healthcare provider.

Neither metformin nor Jardiance is recommended for people with Type 1 diabetes. They are also not recommended for patients with a sensitivity or allergy to their active ingredients.

Jardiance has fewer reported side effects than metformin. However, Jardiance has the potential to cause dangerously low blood pressure, kidney injury, and serious infections. Its use is also discouraged for pregnant or breastfeeding women. 

Metformin is not recommended for those with congestive heart failure, compromised kidney function, poor liver function, or people who may become dehydrated. Having these conditions increases the chance of developing lactic acidosis, a rare but potentially fatal condition linked to metformin use. Drinking alcohol while on metformin also increases the risk of lactic acidosis. 

Bottom line 

Jardiance and metformin are both FDA-approved treatments for Type 2 diabetes. Jardiance is also FDA approved for the prevention of cardiovascular disease and end-stage kidney disease in certain populations. Both of these diabetes drugs have also been shown to cause weight loss, but they are not FDA approved for weight reduction.

Jardiance has fewer reported side effects than metformin, but it is also much more expensive because Jadriance is a brand-name drug. Metformin is also prescribed off-label for a variety of nondiabetes-related uses, including the treatment of PCOS.

If you are interested in taking Jardiance or metformin, seek medical advice from your healthcare provider or pharmacist. Only a healthcare professional can advise which medications are right for your condition and overall health.