Jardiamet

Also called empagliflozin + metformin

Key points about Jardiamet

  • Jardiamet is used to treat type 2 diabetes.
  • It is a combination of 2 medicines, empagliflozin and metformin, in a single tablet.
  • Find out how to take it safely and possible side effects.
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Jardiamet is used to treat type 2 diabetes and protect your kidneys and heart. It's a combination of 2 medicines, empagliflozin and metformin, in a single tablet. Read more about type 2 diabetes

Jardiamet lowers your blood glucose and blood pressure by helping your kidneys get rid of glucose, salt and fluid when you pass urine (pee/mimi). Jardiamet has other benefits such as weight loss, helping your kidneys work better and lowering your chance of having a heart attack or stroke. It may also help you to live longer. Jardiamet is best used together with healthy eating and regular exercise. 

Note: Empagliflozin on its own is called Jardiance. Read more about empagliflozin.


Video: How to take empagliflozin (Jardiance and Jardiamet) in English (may take a few moments to load)

   


Video: How to take empagliflozin (Jardiance and Jardiamet) in te reo Māori (may take a few moments to load)

(Healthify He Puna Waiora, NZ and PHARMAC, 2022)

View descriptive transcript in English.

In Aotearoa New Zealand Jardiamet tablets are available in 4 strengths
  • Jardiamet 5 mg/500 mg

  • Jardiamet 12.5 mg/500 mg
  • Jardiamet 5 mg/1,000 mg

  • Jardiamet 12.5 mg/1,000 mg


Check with your doctor or pharmacist which strength you are taking.

  • The usual dose of Jardiamet is 1 tablet twice a day.
  • Always take Jardiamet exactly as your doctor has told you. 
  • The pharmacy label on your medicine will tell you how much to take, how often to take it and any special instructions.

  • Timing: Take Jardiamet 2 times a day – in the morning and the evening. Jardiamet is best taken with or just after food or a meal, to lessen the chance of stomach upset.
  • Drink enough water so you don't get thirsty: When you start taking Jardiamet, you may pee more but this gets better over a few weeks. If you’ve been told to limit how much you drink, talk to your healthcare team.
  • Avoid or limit alcohol while you are taking Jardiamet: It may affect your blood glucose control and increase your risk of side effects. Drinking alcohol very often or drinking a lot of alcohol over a short time (binge drinking) can affect your diabetes and lead to high ketone levels. This can cause a serious but rare side effect called ketoacidosis.
  • Missed dose: If you forget your dose, take it as soon as you remember that day. But if it's nearly time for your next dose, just take the next dose at the usual time. Don't take double the dose.
  • Don't run out of tablets: Jardiamet works best when taken every day. See your healthcare team every 3 months for a new prescription.

Here are some things to know when you're taking Jardiamet. Other things may be important as well, so ask your healthcare provider what you should know about.

You are at increased risk of fungal genital infections (thrush)

Jardiamet causes you to pee more and have more glucose in your urine, which increases your risk of getting thrush around the vagina or penis. Germs (bacteria and fungus) like to grow in body fluids with a high sugar content. As your blood glucose level decreases, this tends to settle.

Washing your genital area with warm water using non-perfumed soap and avoiding wearing tight underwear will reduce your risk. Also any drops of pee left behind on the penis or vagina need to be removed.

  • People with a vagina, should wash their vulval area twice a day. After peeing, rinse the area with water and then pat dry. If rinsing is not possible, pat dry carefully with toilet paper.
  • People with a penis should wash their groin area at least once a day. After peeing, rinse your penis with water and then pat dry. If rinsing is not possible, pat dry carefully with toilet paper. Uncircumcised people need to fully retract the foreskin before they pee, to avoid drops of urine spilling into the foreskin fold.

If you get any irritation or itching in your genital area, contact your healthcare provider immediately. Thrush is easily treated with an anti-fungal cream.

Have a sick day plan

If you are unwell, stop taking Jardiamet. Taking Jardiamet when you are unwell increases your risk of high ketones levels, which can cause a serious but rare side effect called diabetic ketoacidosis (DKA). Only restart your Jardiamet when you are well AND eating and drinking normally.

If you have nausea (feeling sick), vomiting (being sick) or tummy pain, you need to have a finger prick blood test immediately to check your ketone levels. This can be done at your GP clinic, after hours medical centre or hospital.

Talk to your healthcare team before making any big changes to your diet

If you start eating less or go on a keto (low carbohydrate) diet or you're fasting, this may increase your risk of diabetic ketoacidosis. Talk to your healthcare team before making any big changes.

Prepare before an operation or a procedure

If you're going to have an operation or a procedure where you will need to stop eating for 12 hours or more (eg, a colonoscopy or dental surgery), ask your healthcare team when you should stop and restart your Jardiamet. You may need to stop your Jardiamet 3 days before the operation or procedure.

Fasting during Ramadan

If you are fasting during Ramadan and you're still getting enough carbohydrates, you can keep taking Jardiamet. It's important to talk to your healthcare provider about getting enough carbohydrates and drinking plenty of water while taking Jardiamet. It’s not recommended to start Jardiamet as a new medicine immediately before or during Ramadan.

Are you pregnant, trying for a baby or breastfeeding?

It's important to talk to your healthcare provider as soon as possible if you're trying to get pregnant, are pregnant or breastfeeding. You may need to change to another diabetes medicine.

Tell your healthcare team if you are taking any other medicines

Jardiamet may interact some medicines and herbal supplements, so check with your doctor or pharmacist before starting Jardiamet and before starting any new medicines.

Exercising and diet

It's important to keep up your healthy diet and exercise while you're taking Jardiamet. Jardiamet works best when used in combination with good nutrition and regular exercise. It's a good idea to cut down on foods with added sugar if you have diabetes. However, ask your healthcare provider for advice before starting a low-calorie, reduced carbohydrate or keto diet. Having too few carbohydrates in your diet while you are taking Jardiamet may increase your risk of ketoacidosis.

Note: You should avoid a low carbohydrate (ketogenic or keto) diet while you're taking Jardiamet as it may increase your risk of ketoacidosis.

Marathon or long distance runners

Being dehydrated and not eating enough carbohydrates can lead to high ketone levels, which can cause a serious but rare side effect called ketoacidosis. If you are going to run a long distance or marathon while you are taking Jardiamet, it's important to let your healthcare provider know. You may need to stop Jardiamet the day before the marathon and restart 24 hours or so afterwards when you are well hydrated and eating normally.

Blood glucose testing with a glucometer

Jardiamet won't cause low blood glucose levels (hypoglycaemia) unless you're also taking insulin and/or sulfonylureas (eg, glipizide or gliclazide tablets). If so, you still need to check your glucose levels with a glucometer regularly to make sure they are safe.

If you're not on insulin or sulfonylureas, you may still choose to check your glucose levels to see the effects of Jardiamet. It's also important to check your HbA1c 3 months after starting Jardiamet.

You may need a blood glucose test and a ketone test if you are unwell with vomiting (being sick) or diarrhoea (runny poo). Ask your healthcare provider for advice. Read more about diabetes blood glucose testing and diabetes sick day plan.

Like all medicines, Jardiamet can cause side effects, although not everyone gets them. 

Side effects What should I do?
  • Peeing more often than usual.
  • Pain or burning feeling when you pee.
  • Mild skin rash or itchy skin.
  • Feeling dizzy.
  • These are quite common when you start taking Jardiamet, but they are usually mild and go away with time.
  • Talk to your healthcare team if these side effects cause you problems or don’t go away.
  • Don’t drink alcohol if you are feeling dizzy, this can increase your risk of falls.

Signs and symptoms of diabetic ketoacidosis (DKA) such as:

  • being sick (vomiting)
  • feeling very thirsty (dehydrated)
  • being confused or unusually tired or sleepy
  • tummy (abdominal) pain
  • sweet-smelling breath
  • deep or fast breathing.
  • This is a rare but serious side effect of Jardiamet.
  • You are at increased risk if you are dehydrated or have a sudden illness, have just had surgery, have reduced your calorie intake, or are on a low carbohydrate diet or if your insulin requirements have increased. 
  • If you get these signs and symptoms, stop taking Jardiamet and tell your healthcare team or Healthline 0800 611 116 immediately and tell them you are taking Jardiamet.

Signs of Fournier’s gangrene such as:

  • swelling, pain, itching or tenderness in or around your vagina, penis, testicles or bottom
  • changes to the colour of your skin, such as redness or darkened areas around your vagina, penis, testicles or bottom
  • fever or high temperature
  • general unwellness or tiredness.
  • This is a rare but serious side effect of Jardiamet.
  • If you get these signs and symptoms, stop taking Jardiamet and tell your healthcare team or Healthline 0800 611 116 immediately and tell them you are taking Jardiamet.
  • Read more about Fournier’s gangrene(external link).

Read more about medicines and side effects and reporting a reaction you think might be a side effect

Jardiamet(external link) Medsafe Consumer Information, NZ
Jardiamet factsheet [PDF, 272 KB] Healthify He Puna Waiora, NZ


References

  1. Empagliflozin + metformin hydrochloride(external link) NZ Formulary 
  2. Sweet urine, bitter outcome: Empagliflozin and balanoposthitis New Zealand Doctor, February 2024
  3. Reminder: Flozins and the risks of diabetic ketoacidosis and Fournier’s gangrene(external link) Medsafe, NZ, 2022
  4. Spotlight on empagliflozin(external link) Medsafe, NZ, December 2020
  5. Periprocedural diabetic ketoacidosis (DKA) with SGLT2 inhibitor use(external link) NZSSD, 2020
  6. SGLT2 inhibitors(external link) Type 2 Diabetes Management, NZSSD, 2021
  7. Diabetes management during Ramadan(external link) Research Review, NZ, 2023

Brochures

jardiamet v21 2021 cover

Jardiamet factsheet

Healthify He Puna Waiora, NZ, 2021

At home sick day advice
Health New Zealand | Te Whatu Ora, 2023

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Credits: Sandra Ponen, Pharmacist, Healthify He Puna Waiora. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Angela Lambie, Pharmacist, Auckland

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