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Jardiance vs Glucotrol
Introduction
For patients with type 2 diabetes, certain drugs that modify the way the body processes glucose can help manage blood sugar levels and mitigate complications. Jardiance (Empagliflozin) and Glucotrol (Glipizide) are two such medications prescribed for this purpose. Both have impacts on different aspects of glucose metabolism but effectively aid in managing high blood sugar levels in people with type 2 diabetes. Jardiance is a sodium-glucose co-transporter 2 inhibitor which works by helping kidneys to get rid of glucose from your bloodstream. On the other hand, Glucotrol falls under the drug class sulfonylureas; it stimulates insulin release from pancreatic beta cells, thus increasing insulin levels and aiding in better management of blood sugar.
Jardiance vs Glucotrol Side By Side
| Attribute | Jardiance | Glucotrol |
|---|---|---|
| Brand Name | Jardiance | Glucotrol |
| Contraindications | Should not be taken with certain types of medication including thiazide diuretics, steroids, estrogens, and thyroid medicine among others. | Should not be taken with certain types of medication including thiazide diuretics, steroids, estrogens, and thyroid medicine among others. |
| Cost | Around $500 for 30 tablets of 10 mg | Around $100 for 60 tablets of 5 mg |
| Generic Name | Empagliflozin | Glipizide |
| Most Serious Side Effect | Sudden changes in mood or behavior, including depression or thoughts about suicide; signs of allergic reaction; unusual drowsiness, restlessness, blurred vision; rapid heart rate, palpitations and breathlessness; low sodium levels. | Severe skin reactions; neurological reactions including tremors due to low blood glucose levels. |
| Severe Drug Interactions | Not specified, but caution is advised when taking medications that may increase blood sugar levels. | Not specified, but caution is advised when taking medications that may increase blood sugar levels. |
| Typical Dose | 10 mg once daily, can be increased to 25 mg if needed | 5 mg/day, taken before breakfast. Can be increased based on blood glucose response but should not exceed 40 mg/day. |
What is Jardiance?
Empagliflozin (the generic name for Jardiance) is a new class of medication known as SGLT2 inhibitors, and has brought about significant changes in diabetes management since its approval by the FDA in 2014. It works by preventing glucose from being reabsorbed into the blood, effectively "flushing" it out via urine and therefore lowering blood sugar levels. This method of action differs greatly from Glipizide (generic for Glucotrol), an older medicine first approved by FDA in 1984 that belongs to the sulfonylurea class of drugs which stimulate pancreatic cells to produce more insulin. While both medications are prescribed for controlling high blood sugar levels associated with type 2 diabetes, they work differently within your body. Empagliflozin's mechanism focuses primarily on renal function with minimal influence on pancreas function, hence it tends to have fewer side effects like low blood sugar compared to glipizide which directly stimulates insulin production.
What conditions is Jardiance approved to treat?
Jardiance is approved for the treatment of various forms of diabetes:
- Type 2 diabetes mellitus as an adjunct to diet and exercise to improve glycemic control
- To reduce the risk of cardiovascular death in adult patients with type 2 diabetes mellitus and established cardiovascular disease
- Treatment of chronic heart failure in adults with a reduced ejection fraction.
How does Jardiance help with these illnesses?
Jardiance helps to manage type 2 diabetes by reducing the amount of glucose reabsorbed into the blood from the kidneys. It does this by inhibiting a protein in the kidneys called SGLT2, which is responsible for most glucose reabsorption. Glucose is a simple sugar that provides energy to cells throughout your body and plays an important role in numerous bodily functions. However, too much glucose can lead to problems like type 2 diabetes where it builds up in your bloodstream instead of being used as fuel for your cells.
By blocking SGLT2, Jardiance causes excess glucose to be excreted through urine rather than being re-absorbed back into the bloodstream. This results in lower blood sugar levels which help patients better manage their condition and stabilize their blood sugar balance.
What is Glucotrol?
Glucotrol is a brand name for glipizide, which is a sulfonylurea antidiabetic agent. It works by increasing the levels of insulin in the body by stimulating pancreatic beta cells to release more insulin, hence reducing blood sugar levels. Glucotrol was first approved by the FDA in 1984 and has been used as an effective treatment for type 2 diabetes mellitus over several decades.
Unlike sodium-glucose co-transporter-2 (SGLT2) inhibitors such as Jardiance that lower blood sugar through promoting increased excretion of glucose in urine, Glucotrol doesn't involve urinary glucose elimination but rather enhances cellular utilization of glucose and stimulates rapid and significant production of postprandial insulin.
Its side-effect profile is also different from SGLT2 inhibitors; common side effects include hypoglycemia, gastrointestinal disturbances, dizziness, rash or itchiness. However, it does not increase the risk of urinary tract infections or fungal infections—a possible risk associated with SGLT2 inhibitors like Jardiance—due to its differing mechanism action. The stimulation of insulin can be beneficial for managing high blood sugar levels in patients particularly those who cannot control their condition through diet and exercise alone.
What conditions is Glucotrol approved to treat?
In the realm of antidiabetic medications, Glucotrol is approved for the management of:
- Type 2 diabetes mellitus This oral hypoglycemic medication helps control high blood sugar levels which can prevent kidney damage, blindness, nerve problems and loss of limbs. It's important to remember that controlling diabetes also lessens your risk of a heart attack or stroke.
How does Glucotrol help with these illnesses?
Glucotrol, also known as glipizide, is a medication primarily used for the management of type 2 diabetes. It operates by stimulating your pancreas to release more insulin - a hormone critical in regulating blood sugar levels. Like norepinephrine's role in wakefulness and attention, insulin plays an indispensable role in managing glucose metabolism within the body. Low levels of insulin or resistance to its effects lead to high blood sugar levels - a characteristic feature of diabetes. Glucotrol's action on increasing insulin availability helps control these increased blood sugar levels effectively. In contrast, Jardiance works differently by causing excess glucose to be excreted through urine but doesn't stimulate additional insulin production like Glucotrol does. Therefore, when patients do not respond well to typical antidiabetic medications such as Jardiance or need an extra push for their bodies' natural insulin production mechanisms, Glucotrol may be prescribed either alone or combined with other treatments.
How effective are both Jardiance and Glucotrol?
Both empagliflozin (Jardiance) and glipizide (Glucotrol) have a history of effectiveness in managing Type 2 diabetes, although they were approved by the FDA two decades apart, with Glucotrol receiving approval in 1984 followed by Jardiance in 2014. They work through different mechanisms to regulate blood sugar levels: Jardiance works by helping the kidneys remove glucose from the bloodstream, whereas Glucotrol stimulates the pancreas to produce more insulin.
In comparative studies, both drugs have shown similar efficacy in controlling blood glucose levels when used as monotherapy or added on to metformin therapy. It's important to note that while both medications are effective at controlling high blood sugar, they do come with distinct side effect profiles and potential risks. For example, Jardiance has been linked with an increased risk for urinary tract infections due its mechanism of action.
A notable advantage of Jardiance is its demonstrated cardiovascular benefits beyond glycemic control; it has been shown not only to reduce HbA1c but also decrease mortality in patients with established heart disease. In contrast, Glucotrol while effectively reducing HbA1c does not offer this direct cardiovascular benefit.
However, one downside associated with long-term use of sulfonylureas like Glucotrol includes weight gain and a higher risk for hypoglycemia compared to SGLT2 inhibitors such as Jardiance which can actually aid modest weight loss and carry less risk for hypoglycemia when used as monotherapy.
Thus choice between these two agents should be individualized considering patient-specific factors including presence of heart diseases or kidney conditions among others.
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At what dose is Jardiance typically prescribed?
Oral dosages of Jardiance typically start at 10 mg once daily, but can be increased to 25 mg if needed for controlling blood sugar levels in adult patients with type 2 diabetes. Conversely, Glucotrol is usually started at a dose of 5 mg before breakfast but can be adjusted up to a maximum dosage of 40 mg per day depending on the patient's response and tolerance. There is no one-size-fits-all approach as medication should be tailored according to individual needs and responses. It's important that any changes in dosage are made under close medical supervision.
At what dose is Glucotrol typically prescribed?
Glucotrol treatment for type 2 diabetes is typically initiated at a dosage of 5 mg/day, taken before breakfast. If necessary, the dose can then be incrementally increased in multiples of 5 mg per day every few weeks based on blood glucose response. However, it should not exceed the maximum recommended daily dose of 40 mg divided into two doses and spaced approximately 12 hours apart. This upper limit may be tested if there is no sufficient response to treatment after several weeks at lower dosages. Remember that diet and exercise are important parts of managing type-2 diabetes along with medication.
What are the most common side effects for Jardiance?
Common side effects of Jardiance include:
- Urinary tract infections
- Yeast infections in women
- Increased urination
- Thirst
- Nausea, vomiting
- Abdominal pain
- Fatigue, asthenia (general weakness and fatigue)
- Hypoglycemia (when combined with insulin or sulfonylurea)
On the other hand, Glucotrol may cause these common side effects:
- Dizziness, nervousness
- Diarrhea or constipation
- Rash or itching
- Weight gain
- Trembling or shaking
- Heartburn
Both medications can affect your blood sugar levels. Make sure to monitor your blood sugar regularly if you are taking either medication. Always consult with a healthcare provider for advice regarding potential side effects and which medication is more suitable for your medical condition.
Are there any potential serious side effects for Jardiance?
While both Jardiance and Glucotrol are used to manage blood sugar levels in Type 2 diabetes, they have different potential side effects. For Jardiance:
- Sudden changes in mood or behavior, including depression or thoughts about suicide.
- Signs of allergic reaction: hives, difficulty breathing, swelling on the face or throat.
- Unusual drowsiness, restlessness, blurred vision.
- Rapid heart rate (tachycardia), palpitations and breathlessness which could potentially result into fainting.
- Low sodium levels - symptoms could include headache, confusion, speech difficulties, severe weakness, vomiting and loss of coordination.
For Glucotrol:
- Severe skin reactions – rashes with blistering and peeling accompanied by fever
- Neurological reactions including tremors due to low blood glucose levels Serotonin syndrome is not typically associated with these medications but if you experience agitation hallucinations fever sweating shivering fast heart rate muscle stiffness twitching loss of coordination nausea vomiting or diarrhea contact your healthcare provider immediately.
What are the most common side effects for Glucotrol?
When comparing Jardiance to Glucotrol, it's important to note that Glucotrol has a distinct side effect profile. Some common adverse effects of this medication include:
- Nausea, vomiting, loss of appetite
- Diarrhea or constipation
- Headache
- Dizziness or lightheadedness
- Tremors and nervous feelings due to low blood sugar (hypoglycemia)
- Increased skin sensitivity to sunlight resulting in rash or sunburns more easily
- Mild weight gain as opposed to the weight loss seen with Jardiance.
It is advised for patients on Glucotrol to monitor their blood glucose levels regularly as hypoglycemia can be a serious concern. Be sure also keep an eye out for signs of allergic reactions such as rashes, itching/swelling (especially of the face/tongue/throat), severe dizziness, and trouble breathing.
Are there any potential serious side effects for Glucotrol?
While Glucotrol is a widely used medication for managing type 2 diabetes, it's important to be aware of potential adverse reactions. Some severe side effects that require immediate medical attention include:
- Signs of an allergic reaction such as hives, difficulty breathing or swallowing, swelling in your face or throat
- Rapid heartbeat or palpitations
- Unusual bleeding or bruising
- Symptoms suggestive of low blood sugar (hypoglycemia) like dizziness, sweating, fast heartbeat and hunger
- Dark urine and yellowing of the eyes/skin indicating possible liver damage
- Sudden weight gain or swelling in hands/legs which could indicate heart failure
If you experience any of these symptoms while taking Glucotrol, it's imperative to seek professional medical help promptly.
Contraindications for Jardiance and Glucotrol?
Both Jardiance and Glucotrol, along with most other diabetes medications, can cause hypoglycemia (low blood sugar levels) in some individuals. If you notice symptoms such as extreme hunger, blurred vision, sweating or shaking, confusion or irritability, please seek immediate medical attention.
Neither Jardiance nor Glucotrol should be taken if you are taking certain types of medication including thiazide diuretics (water pills), steroids, estrogens and thyroid medicine among others; these drugs may increase your blood sugar levels thereby reducing the effectiveness of Jardiance and Glucotrol. Always inform your physician about all the medicines you are currently on; changes to dosage or even discontinuation might be necessary to prevent potential interactions with Jardiance and Glucotrol.
How much do Jardiance and Glucotrol cost?
For the brand name versions of these drugs:
- The price of 30 tablets of Jardiance (10 mg) averages around $500, which works out to approximately $16.67/day.
- The price of 60 tablets of Glucotrol XL (5 mg) is about $100, working out to roughly $1.67/day.
Thus, if cost is a significant factor for you, Glucotrol XL could be more affordable on a per-day treatment basis than Jardiance. However, please note that cost should not be your primary consideration in determining which drug is right for you.
For the generic versions of Jardiance (empagliflozin) and Glucotrol (glipizide), costs are significantly lower:
- Empagliflozin isn't currently available as a generic medication in many countries including the United States.
- Glipizide is available in packs from 30 to 180 tablets (5 mg). Depending on where it's purchased and whether insurance covers it or not, glipizide generally costs between $0.15 and $0.50 per day when taking typical dosages.
Popularity of Jardiance and Glucotrol
Empagliflozin, available under the brand name Jardiance, was estimated to have been prescribed to about 1.8 million people in the US in 2020. Empagliflozin accounted for just over 15% of SGLT2 inhibitor prescriptions in the US. It's a newer class of diabetes medication that works by helping kidneys get rid of glucose from your bloodstream and has been generally increasing in prevalence since its approval.
Glipizide, including brand versions such as Glucotrol, was prescribed to nearly 3 million people in the USA in 2020. In the US, glipizide accounts for around 22% of sulfonylurea prescriptions and approximately 7% of all antidiabetic medicine prescriptions overall. The prevalence of glipizide has remained steady over recent years due to its longstanding role as a fundamental insulin secretagogue used extensively for managing type-2 diabetes mellitus.
Conclusion
Both Jardiance (empagliflozin) and Glucotrol (glipizide) are widely used in the management of type 2 diabetes, with numerous clinical studies documenting their effectiveness compared to placebo treatments. In certain cases, these drugs may be combined for a synergistic effect, although this would require careful evaluation by a healthcare professional due to potential interactions. Their mechanisms of action differ; Jardiance works by inhibiting sodium-glucose transport proteins which reduces reabsorption of glucose in the kidney and increases its excretion from the body via urine, while Glucotrol stimulates insulin secretion from pancreatic beta cells.
In terms of prescription patterns, both drugs can be considered as first-line options depending on individual patient factors. Some doctors might opt for Glucotrol initially because it is available generically and therefore more affordable than Jardiance.
Like most medications, both Jardiance and Glucotrol may take some time before noticeable effects occur as your body adjusts to them.
Side effects are generally well-tolerated but different between two drugs: common side effects for Jardiance include urinary tract infections due to elevated glucose levels in urine while those for Glucotrol include hypoglycemia (low blood sugar). As always with any medication regime changes or new symptoms experienced during treatment should prompt urgent consultation with a medical provider.
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Refrences
- Frampton, J. E. (2018, June 27). Empagliflozin: A Review in Type 2 Diabetes. Drugs. Springer Science and Business Media LLC.http://doi.org/10.1007/s40265-018-0937-z
- Scott, L. J. (2014, October). Empagliflozin: A Review of Its Use in Patients with Type 2 Diabetes Mellitus. Drugs. Springer Science and Business Media LLC.http://doi.org/10.1007/s40265-014-0298-1
- Shafiq, A., Mahboob, E., Samad, M. A., Ur Rehman, M. H., & Tharwani, Z. H. (2022, September). The dual role of empagliflozin: Cardio renal protection in T2DM patients. Annals of Medicine & Surgery. Ovid Technologies (Wolters Kluwer Health).http://doi.org/10.1016/j.amsu.2022.104555
- Pai, R. P. R., & Kangath, R. V. (2019, February 15). Bilateral gangrene of fingers in a patient on empagliflozin: First case report. World Journal of Diabetes. Baishideng Publishing Group Inc.http://doi.org/10.4239/wjd.v10.i2.133