Key Points

• Lifestyle suggestions to help prevent yeast infections with Jardiance include: choosing loose-fitting cotton garments instead of synthetic fabrics, keeping your genital area dry and maintaining good hygiene. Also, keep your blood sugar levels in check. You may not always be able to prevent a yeast infection, but treatment is usually very quick and effective.
• You may be more susceptible to genital yeast (mycotic) infections when using Jardiance (empagliflozin). Yeast infections with Jardiance appear to be mild, treatable, and rarely lead to discontinuation of treatment, and may be more common in women than men.
• Jardiance is in a class of drugs known as sodium-glucose cotransporter-2 (SGLT-2) inhibitors. This entire class of drugs is associated with a higher incidence of gential yeast infections when compared to an inactive placebo, so these side effects are uncommon but not unexpected.

What is Jardiance used for?

Jardiance (empagliflozin) is a prescription drug used to help control glucose (blood sugar) in adults and children 10 years of age and older with type 2 diabetes. Jardiance is also approved by the FDA to lower the risk of cardiovascular (heart-related) death in adults with heart disease and type 2 diabetes. It is also approved to reduce the risk of death and hospitalization due to heart failure in adults with heart failure.

Jardiance is given as an oral tablet once daily and is used in addition to diet and exercise. In adults, it can be added to other medicines for type 2 diabetes such as metformin, sulfonylureas, pioglitazone, and insulin. In children, the only other oral medicine approved for type 2 diabetes is metformin.

Jardiance, classified as an SGLT-2 inhibitor, is made by Boehringer Ingelheim Pharmaceuticals and Eli Lilly.

SGLT-2 inhibitors have been shown to be effective at lowering hemoglobin A1c levels, improving weight loss and lowering blood pressure in type 2 diabetes. They typically carry a low risk of hypoglycemia (low blood sugar levels) when used alone (used as monotherapy).

The safety of Jardiance was similar in children when compared to adults, with the exception of an increased risk of hypoglycemia (low blood sugar) whether or not children also used insulin.

SGLT-2 inhibitors come as single-ingredient products or combined with other diabetes medicines. Other single-ingredient FDA approved medications in the SGLT-2 inhibitor class include:

• canagliflozin (Invokana)
• dapagliflozin (Farxiga)
• ertugliflozin (Steglatro)

Why do yeast infections occur with Jardiance?

The mechanism of how SGLT-2 inhibitors work in type 2 diabetes may be responsible for how the yeast infection occurs.

• SGLT-2 proteins are located in the renal tubules of the kidneys and are responsible for reabsorbing glucose back into the blood.
• Jardiance blocks the action of the SGLT-2 proteins. As a result, more glucose is excreted in the urine.
• Increased levels of glucose in the urine (glycosuria) can lead to these mycotic (yeast) infections.

Does Jardiance cause yeast infections in both women and men?

Yes, genital mycotic (yeast) infections have been reported by the manufacturer in both men and women; however, they occur more frequently in women.

Patients with a history of recurrent or chronic yeast infections may be at greater risk, too.

What do studies say about genital yeast infections with Jardiance?

The manufacturer assessed five placebo-controlled clinical trials as a whole (pooled analysis) to look at the incidence of genital yeast infections with Jardiance. Overall, the incidence of genital mycotic infections (also referred to as vaginal mycotic infection, vaginal infection, genital infection fungal, vulvovaginal candidiasis, and vulvitis in study analysis) was increased in patients treated with Jardiance compared to taking a placebo.

Table 1. Incidence of Genital Yeast (Mycotic) Infections with Jardiance