Jardinance

[snowball12]

Is anyone taking Jardinance as well as Metformin? The side effects scare me

 

[Stitch147]

Yep, as well as gliclizide and linagliptin. I've not experienced any adverse side effects.

 

[snowball12]

Thank you that's good to know. I take 1500mg of Metformin but when Dr tried to increase it I had terrible gastro problems. The same thing happened with another drug that I can't remember. Diagnosed in April 2011 last HbA1c last November was 60mmol Cholesterol 2.3 this was only 4 at the start!!!

 

[everydayupsanddowns]

Hope you get on OK with the Jardinance @snowball12

Let us know how you get on 🙂

 

[timewins]

Just started Jardinance, been 3 days now.

Previously on 2xGliclazide, 4xMetformin (Type 2) ... before lockdown. Levels were low, so I was taken off the Gliclazide, weight dropped 3.5st ! Anyway 2-3 years later levels have started to rise again Still not put weight on. So I have been put on Jardinance + 4xMetformin. Max dose too at 25mg.

Was away from home first day I took it, had a lunchtime meal, but nothing major in the evening, and a few beers .... guess what .. felt terrible in the morning .. was sick, light headed, symptoms of a Hypo or low blood sugar I guess. Felt better after a small amount of a glucose drink.

This has never happened before, or since. So I guess its an advert to stick to regular meals, and of course less beers.

 

[IrvineHimself]

I take 25 mg daily + 1500 mg of Metformin and not had any problems

@timewins said:

Was away from home first day I took it, had a lunchtime meal, but nothing major in the evening, and a few beers .... guess what .. felt terrible in the morning .. was sick, light headed, symptoms of a Hypo or low blood sugar I guess. Felt better after a small amount of a glucose drink.

This has never happened before, or since. So I guess its an advert to stick to regular meals, and of course less beers.

Since this is of concern to me and I had not been warned about this particular risk, I looked a little further. From the NHS page. it is unclear what the risks are with just Metformin:

Low blood sugar​

If you take empagliflozin with other diabetes medicines, including insulin or sulphonylureas like gliclazide, your blood sugar can sometimes go too low.

The insulin and sulphonylureas on their own will cause hypoglycaemia, and, according to Wikipedia Empagliflozin does increases the risk of this. However it does not appear to increase the risk of hypoglycaemia. when combined with Metformin

Empagliflozin can increase people' risk of low blood sugar when it is used together with a sulfonylurea or insulin.[32] When used by itself or in addition to metformin it does not appear to increase the risk of hypoglycemia.[21]

Fact checking against the US Library of Medicine:

Severe hypoglycemia is limited when empagliflozin is administered alone or in combination with metformin alone, metformin with a sulfonylurea, or pioglitazone with or without metformin. However, the risk of hypoglycemia is increased when empagliflozin is used in combination with insulin secretagogues or insulin.11

Putting all this together, it seems a there is a very minor, limited risk of hypoglycaemia when combined with Metformin that I was unaware of, so thanks for pointing that out.

Come to think of it, I seem to recall the Doc mentioning something about it being very important to eat breakfast with it, but I was kind of over-whelmed at the time. I was, and still am, much more concerned about the fungal infections.

Edited: because I accidentally pushed "post" before I had finished writing

 

[timewins]

Yes, should be OK on the Metformin with Empagliflozin I think. Gliclazide would be a problem. Perhaps I had a 'first day of use' reaction .... not been a problem since.

I trust my Diabetes Nurse to know whats is best.

 

[IrvineHimself]

Yes, should be OK on the Metformin with Empagliflozin

Thanks for the reassurance, I accidentally pushed "post" before I had finished writing. As my edit makes clear, I am still more worried about the possibility of bad fungal infection. Like you. I trust my medical team.

 

[timewins]

Yes, infection is a worry, keep clean I suppose. I have just purchsed some of those urine test strips they use at the surgery to keep an eye on that.

My old mum (now passed) used to get urine infections, and she went a little bit 'forgetful' to say the least whilst she had it. She had undiagnosed Dementia at the time

 

[IrvineHimself]

Being a guy, urinary tract infections are much less of an issue for me, but Fournier's Gangrene definitely has me waking up in cold sweats.

The docs gave me this link for washing advice with Empagliflozin, the female version is here. My Pharmacist gives me Dermol 500 as a whole body wash and Hydromol as a genital moisturiser. Both of which I use assiduously. (see signature for links)

I also used Lamisil Once as a prophylactic when starting the Empagliflozin. It is an off-label use, but: athlete's foot, ring worm, jock itch and genital thrush are all the same family of fungi. I've used it for a number of years on jock itch. Prior to being diabetic, if I put it on at the beginning of summer it would keep me symptom free for the rest of the year. When starting the Empagliflozin, I suggested this to my Doc and she was quite happy to write me a prescription for it. My Pharmacist was also very interested and quite happy with the idea.

Note: Using Lamisil Once like this is an off-label use, so check with your Doc and Pharmacist beforehand

 

[timewins]

Thanks for the advice