Jardiance interactions: Alcohol, medications, and other factors

Jardiance (empagliflozin) is a brand-name prescription drug used to:

• manage blood sugar levels in people with type 2 diabetes
• decrease the risk of death due to heart problems in people with both heart disease and type 2 diabetes
• decrease the risk of hospitalization or death due to heart problems in people with heart failure

As with other medications, Jardiance can interact with certain drugs. It can also interact with some supplements and foods. An interaction occurs when one substance causes another substance to have a different effect than expected.

For details about Jardiance’s interactions, keep reading. For additional information about Jardiance, including details about its uses and limitations of use, see this article.

In some cases, factors or conditions could prevent your doctor from prescribing Jardiance due to the risk of harm. These are known as contraindications. The contraindications of Jardiance include:

Kidney dialysis

If you’re undergoing kidney dialysis, tell your doctor before starting Jardiance treatment. It’s possible for Jardiance to cause kidney problems. And if you already have kidney problems, taking Jardiance can worsen your condition. Due to this risk, doctors usually won’t prescribe Jardiance to people having dialysis.

Having had an allergic reaction to Jardiance or any of its ingredients

If you’ve had an allergic reaction to Jardiance or any of its ingredients, your doctor will likely not prescribe Jardiance. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note: Before you start treatment with Jardiance, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe Jardiance. If you have any questions about who should not take Jardiance, talk with your doctor or pharmacist.

There aren’t any known interactions between Jardiance and alcohol. However, it’s possible that drinking alcohol while taking Jardiance may increase your risk of side effects from the drug. (For details about Jardiance’s side effects, see this article.)

Examples of side effects that may be worse when drinking alcohol and taking Jardiance include:

• headaches
• ketoacidosis (high level of acid in your blood, which can be life threatening)
• urinating more often than usual

In addition, alcohol may cause an increase or decrease in your blood sugar levels. If you already have diabetes, drinking alcohol may make it harder to manage your blood sugar.

If you’d like to drink alcohol while taking Jardiance, talk with your doctor to determine how much, if any, is safe for you.

Before you start treatment with Jardiance, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. To learn whether Jardiance interacts with supplements, herbs, or vitamins, see the “Jardiance and other interactions” section below.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Jardiance. Keep in mind that this table doesn’t include all drugs that may interact with Jardiance. Some of these interactions are described in detail just below in “Drug interactions in depth.”

* For details about the side effects of Jardiance, see this article.

Here’s a closer look at how certain drugs interact with Jardiance.

Other diabetes drugs

Talk with your doctor about any other diabetes medications that you take before starting Jardiance. Often, your doctor may recommend taking multiple medications to manage your diabetes.

Interaction result. Taking Jardiance with some diabetes medications may increase your risk of side effects, such as hypoglycemia (low blood sugar). (For details about Jardiance’s side effects, see this article.)

Interaction explained. Jardiance works to decrease your blood sugar levels. Other diabetes drugs can also decrease your blood sugar. So, combining Jardiance with other diabetes drugs may decrease your blood sugar levels too much. This can cause hypoglycemia, which can be serious or life threatening if left untreated.

Examples of other diabetes drugs. Here are some other diabetes drugs that may interact with Jardiance:

• semaglutide (Ozempic)
• canagliflozin (Invokana)
• linagliptin (Tradjenta)

Steps you or your doctor may take. Your doctor can help determine the best diabetes treatment plan for you. If they recommend taking Jardiance with another diabetes drug, they may recommend monitoring your blood sugar levels more often. This is to make sure that your blood sugar doesn’t get too low. If you do develop low blood sugar, your doctor may recommend changing your dose of either medication or changing your treatment plan. (For details about Jardiance’s dosages, see this article.)

If you have questions about your diabetes treatment plan, talk with your doctor.

Insulin

It’s possible for your doctor to recommend using Jardiance and insulin together. Insulin is a hormone that’s often prescribed to help lower blood sugar.

Interaction result. Taking insulin with Jardiance can increase the risk of side effects from both of these medications. This includes low blood sugar. (For details about Jardiance’s side effects, see this article.)

Interaction explained. Both insulin and Jardiance work to manage diabetes by decreasing blood sugar levels. However, taking these drugs together can cause your blood sugar levels to become too low, which can be serious.

Examples of insulins. Here are some insulins that may interact with Jardiance:

• insulin lispro (Humalog)
• insulin detemir (Levemir)
• insulin degludec (Tresiba)

Steps you or your doctor may take. Before you start Jardiance, your doctor will discuss the best treatment plan for you. They may recommend that you take Jardiance with insulin. However, they may recommend checking your blood sugar levels more often if you take this drug combination. This will help make sure that your blood sugar doesn’t get too low. If you develop low blood sugar, your doctor may recommend changing your dose of either medication. In some cases, they may recommend a change in your treatment plan.

Talk with your doctor if you have questions about taking insulin with Jardiance.

Fluoxetine (Prozac)

Tell your doctor if you’re taking fluoxetine (Prozac) before starting Jardiance treatment. Fluoxetine is a medication that’s approved to treat depression, obsessive-compulsive disorder (OCD), bulimia, or panic disorder.

Interaction result. Taking fluoxetine along with Jardiance can increase the risk of side effects from both of these medications. This includes low blood sugar. (For details about Jardiance’s side effects, see this article.)

Interaction explained. It’s possible for fluoxetine to decrease your blood sugar levels. Since Jardiance also works to decrease your blood sugar, taking a combination of these drugs may cause your blood sugar levels to become too low. In some cases, low blood sugar can be serious.

Steps you or your doctor may take. If your doctor recommends taking Jardiance with fluoxetine, they may recommend monitoring your blood sugar levels more often. This can help make sure that your blood sugar doesn’t get too low. If you do develop low blood sugar, your doctor may recommend a change in your treatment plan.

If you have concerns about taking fluoxetine with Jardiance, talk with your doctor.

Jardiance may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Jardiance.

Jardiance interactions with supplements

Before you start treatment with Jardiance, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Jardiance and herbs

There are no specific reports of herbs interacting with Jardiance. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. It’s important to check with your doctor or pharmacist before taking any of these products during Jardiance treatment.

Jardiance interactions with vitamins and minerals

Jardiance may interact with a mineral called chromium. Some people take this supplement to help manage their blood sugar levels.

However, if you take chromium with Jardiance, both products can decrease your blood sugar levels. This can increase your risk of having hypoglycemia (low blood sugar). Due to this, your doctor may recommend avoiding chromium supplements while taking Jardiance.

It’s also important to note that some multivitamins may also contain minerals, such as chromium. Talk with your doctor to determine which multivitamin is best for you.

Jardiance interactions with food

It’s possible for Jardiance to interact with certain foods. Specifically, this medication can interact with:

• garlic
• green tea
• caffeine, which may be in coffee, tea, or chocolate

Consuming garlic or green tea, including in supplement form, during Jardiance treatment may increase your risk of side effects.* Garlic and green tea may lower your blood sugar levels. Jardiance also works to lower blood sugar. The combination may decrease your blood sugar to an unsafe level. So your doctor may recommend avoiding or limiting the amount of garlic or green tea you consume.

Also, both caffeine and Jardiance can cause side effects, such as urinating more often than usual. As this can increase your risk of dehydration, your doctor may recommend limiting how much caffeine you eat or drink while taking Jardiance.

* For details about the side effects of Jardiance, see this article.

Jardiance and vaccines

Jardiance isn’t known to interact with any vaccines. To find out if you’re up to date on your vaccines, talk with your doctor or pharmacist.

Jardiance interactions with lab tests

Jardiance can interact with certain lab tests. If you need to have lab tests done, tell your doctor that you’re taking Jardiance. Specifically, Jardiance can interact with:

• urine glucose test
• 1,5-anhydroglucitol (1,5-AG) assay

Your doctor may recommend a urine glucose test to measure how much glucose (sugar) is in your urine. This test can be used to monitor kidney health in people with diabetes. Jardiance works by increasing the amount of glucose that you eliminate through your urine. This means the drug may show higher glucose levels on your urine glucose test than expected. In this case, your doctor may recommend using a blood sample instead of a urine sample to measure your glucose levels.

Jardiance can also interact with the 1,5-AG assay. This is a blood test that can help doctors determine how well your blood sugar levels are being managed in a specific period. Taking Jardiance can make this test less reliable, so your results may not be accurate. Due to this, your doctor may recommend a different blood test, such as the A1C test, to monitor your diabetes management.

JARDIANCE AND CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Jardiance. However, as with any drug or supplement, talk with your doctor before taking cannabis in combination with Jardiance. The impact of cannabis may affect how well you stick to your Jardiance treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many U.S. states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Jardiance. Before you take this drug, be sure to talk with your doctor about your health history. Jardiance may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Jardiance include:

• Kidney problems. Tell your doctor about any kidney problems that you have before starting Jardiance. This medication may cause kidney problems and may worsen existing kidney problems. In some cases, your doctor may recommend a different treatment option for you.
• Urinary conditions. If you have a urinary condition or frequent urinary tract infections (UTIs), tell your doctor before starting Jardiance. This medication can cause UTIs. And if you already have a urinary condition, taking Jardiance can increase your risk even further. In this case, your doctor can help determine whether Jardiance is safe for you.
• Upcoming surgery. Tell your doctor about any surgery that you have planned. If you take this medication too close to surgery, you may have an increased risk of ketoacidosis. This side effect can be serious. Depending on what type of surgery you’re having, your doctor may recommend pausing Jardiance treatment for a few days before your surgery. They’ll recommend the best treatment plan for you.
• Diet changes. Be sure to tell your doctor about any diet changes that you make. Changes in your diet can alter your blood sugar levels. This may cause high or low blood sugar, which sometimes can be serious. In some cases, your doctor may adjust your dose of Jardiance based on your diet change.
• Pancreas problems. Tell your doctor about any pancreas problems that you have, including if you’ve ever had pancreatitis. People who have had certain pancreas problems may have an increased risk of developing ketoacidosis, a serious condition. Due to this, your doctor may recommend more frequent monitoring while you’re taking Jardiance. In some cases, they may recommend a different treatment option for you.
• Type 1 diabetes. If you have type 1 diabetes, your doctor will not prescribe Jardiance. This is because the drug can increase the risk of ketoacidosis in people with type 1 diabetes. If you do have type 1 diabetes, your doctor will likely recommend a different treatment plan for you.
• Low blood pressure. It’s possible for Jardiance to cause low blood pressure. If you already have low blood pressure, taking this medication may cause your blood pressure to become even lower. This can be dangerous. Due to this, your doctor may recommend monitoring your blood pressure more often while you’re taking Jardiance. Or they may recommend a different medication for you.
• Genital yeast infections. Tell your doctor if you’ve ever had genital yeast infections. This medication may increase your risk of developing a genital yeast infection. And if you’ve ever had these infections, taking Jardiance may further increase your risk. In this case, your doctor may monitor you more frequently for infection. Or they may recommend a different treatment option for you.
• Pregnancy. It’s not known for sure if Jardiance is safe to take during pregnancy. However, animal studies show that the drug may cause fetal harm if taken during the second or third trimesters of pregnancy. It’s important to note that animal studies don’t always indicate what may happen in humans. Diabetes that’s not managed during pregnancy can also cause fetal harm. So, if you’re pregnant or planning to become pregnant, talk with your doctor about the best treatment plan for you.
• Breastfeeding. It’s not known if Jardiance passes into human breast milk or what effects the drug may have on a child who is breastfed. In animal studies, Jardiance was shown to pass into breast milk. Animal studies don’t always indicate what may happen in humans. However, due to the possible risks, your doctor likely won’t recommend breastfeeding while taking Jardiance. If you’re interested in breastfeeding, talk with your doctor about the best treatment for you.
• Allergic reaction. If you’ve had an allergic reaction to Jardiance or any of its ingredients, your doctor will likely not prescribe Jardiance. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

You can take certain steps to help prevent interactions with Jardiance. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or take cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s important to read the Jardiance label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions. (If Jardiance doesn’t come with paperwork, you can ask your pharmacist to print a copy.) If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Jardiance by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Jardiance. These resources might help:

• Overview of Jardiance. For a general overview of Jardiance, read this article.
• Side effects. If you’re interested in the side effects of Jardiance, see this article. Another option is to refer to the Jardiance prescribing information.
• Dosage specifics. To learn about the dosage of Jardiance, see this article.
• Drug comparison. For information about how Jardiance compares with Farxiga, which is also used to treat type 2 diabetes, read this article.
• Cost. You can learn about Jardiance and cost by referring to this article.
• Facts about your condition. To learn more about your condition, see our diabetes hub and cardiovascular health hub.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.