Empagliflozin + metformin

Commonly called Jardiamet

Easy-to-read medicine information about empagliflozin + metformin – what it is, how to take it safely and possible side effects. Empagliflozin + metformin is commonly called Jardiamet.

Type of medicine Also called
  • Medication for type 2 diabetes
  • Jardiamet®

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

What is Jardiamet?

Jardiamet is a combination of 2 medicines, empagliflozin and metformin, in a single tablet. Jardiamet is used to treat type 2 diabetes. Read more about type 2 diabetes.

Jardiamet helps to control your blood glucose level by helping your kidneys remove glucose when you pee (an effect of empagliflozin) and by helping your body to make better use of the insulin it produces (an effect of metformin). Jardiamet is best used along with good nutrition and regular exercise.  In New Zealand Jardiamet is funded for some people with diabetes that meet certain criteria. Talk to your doctor about whether it is suitable for you.

Dose

In New Zealand Jardiamet is available as tablets in different strengths: 
Jardiamet 5 mg/500 mg, Jardiamet 5 mg/1,000 mg, Jardiamet 12.5 mg/500 mg and 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 2 times 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.

How to take Jardiamet

  • 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 plenty of water: Jardiamet may make you pee more often. Make sure you drink plenty of water so you don't get dehydrated.
  • Limit or avoid drinking alcohol while you are taking Jardiamet: It may affect the control of your blood glucose and increases your risk of side effects such as increased ketones (see below).
  • Missed dose: If you forget your dose, take it as soon as you remember that day. But if it is nearly time for your next dose, just take the next dose at the right time. Do not take double the dose.
  • Keep taking Jardiamet regularly: To control your diabetes, you must keep taking Jardiamet every day. 

Precautions before starting Jardiamet

  • Do you have problems with your liver or kidneys?
  • Do you have kidney stones?
  • Are you pregnant or breastfeeding?
  • Do you get frequent infections of your genitals (vagina or penis), such as thrush?
  • Do you get frequent urinary tract infections (infections of your bladder, kidney or the tubes that carry pee)?
  • Are you planning to have surgery?
  • Do you have a heart condition?
  • Are you are taking or using any other medicines? This includes any medicines you are using that are available to buy from a pharmacy, supermarket or natural health store without a prescription.

If so, it’s important that you tell your doctor or pharmacist before you start taking Jardiamet. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.

Precautions while taking Jardiamet

Blood tests: You may need blood tests before you start and while you are taking Jardiamet to see how well your kidneys are working.
If you are unwell and dehydrated: If you are unwell and dehydrated from vomiting (being sick) or diarrhoea (runny poos), ask your healthcare provider for advice. They may recommend that you stop taking Jardiamet until you are better. Read more about having a diabetes sick day plan.
Changes to your diet: Tell your healthcare provider if you are eating less or there is a change in your diet, especially if you are planning to start a keto diet (low carbohydrate diet).
Check your feet regularly: Examine your feet regularly including checking under your feet, between your toes and around your nails. Tell your healthcare provider if you notice any problems with your feet such as blisters, breaks in your skin, pain and signs of infection (swelling, heat or redness). Read more about diabetes and foot care.
If you are going to have surgery (operation) or a colonoscopy: Tell your doctor if you are going to have surgery or a procedure such as colonoscopy that requires bowel preparation. You may have to stop Jardiamet before the operation or the procedure.

Side effects

Like all medicines, Jardiamet can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Low blood glucose (hypoglycaemia)

Jardiamet may lower your blood glucose too much. This is called hypoglycaemia. 

  • Hypoglycaemia may cause you to feel weak, faint, dizzy or irritable. You may get a headache, tremor (shakes) or blurred vision.
  • If this happens, drink something sweet such as a small glass of sweetened soft drink or fruit juice, or eat something sweet like lollies.
  • Follow this up with a snack such as a sandwich.
  • Tell your doctor or nurse if this happens.
  • Read more about hypoglycaemia and having a diabetes sick day plan.

Increased ketones

Jardiamet can very rarely cause an increase in ketones in your blood or pee. This is called ketoacidosis. This increase in ketones can occur even if your blood glucose levels don't go up.

  • If you are feeling sick (nausea), being sick (vomiting), lose weight, have pain in your tummy area, feel very thirsty, have difficulty breathing, feel very tired or sleepy or are confused, you should contact your doctor immediately. These are the signs of increased ketones and this can lead to a serious condition called diabetic ketoacidosis.
  • You are at highest risk of increased ketones if you have been unwell with a severe infection or dehydration, had surgery, had diabetic ketoacidosis in the past or are on a keto diet (a very low carbohydrate diet).
  • Tell your healthcare provider before starting a low-carbohydrate diet.

Other side effects

Side effects What should I do?
  • Peeing more often than usual
  • Pain or burning feeling when you pee
  • These are quite common when you first start taking Jardiamet.
  • Drink enough water to prevent dehydration. 
  • Tell your doctor if troublesome.
  • Nausea (feeling sick) or vomiting (being sick)
  • Diarrhoea (runny poos)
  • Sweet or metallic taste in your mouth
  • Contact your doctor for advice.
  • To prevent nausea, take Jardiamet with food.
  • Mild skin rash or itchy skin
  • Thrush (fungal infection of your vagina or penis)
 
  • Tell your doctor.
  • Signs of increased ketones, which can cause your blood to be too acidic (see increased ketones above):
    • feeling sick (nausea) or being sick (vomiting)
    • pain in your tummy area
    • feeling very thirsty
    • having difficulty breathing or short of breath
    • feeling very tired or sleepy
  • Tell your doctor immediately or phone Healthline 0800 611 116.
  • Jardiamet can rarely cause a serious skin infection in the area around your anus and genitals (vagina and penis). Signs of infection include severe swelling, pain or redness in your genital area.
  • Tell your doctor immediately or phone Healthline 0800 611 116.
  • Signs of an allergic reaction such as skin rash, itching, swelling of your lips, face and mouth, or difficulty breathing.
  • Tell your doctor immediately or phone Healthline 0800 611 116.

Interactions

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

Learn more

Jardiamet Medsafe Consumer Information, NZ

References

  1. Empagliflozin + metformin hydrochloride NZ Formulary 
  2. Spotlight on empagliflozin Medsafe, NZ, December 2020
  3. Periprocedural diabetic ketoacidosis (DKA) with SGLT2 inhibitor use NZSSD, January 2020
  4. SGLT2 inhibitors Type 2 Diabetes Management, NZSSD, 2021
Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 03 Feb 2021