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Jardiance vs Trulicity
Introduction
For patients diagnosed with type 2 diabetes, specific drugs that regulate blood sugar levels can help manage the disease and prevent complications. Jardiance and Trulicity are two such medications commonly prescribed for this condition. Both have distinct modes of action but aim to achieve better glycemic control in patients with type 2 diabetes.
Jardiance is a sodium-glucose transport protein-2 (SGLT-2) inhibitor which works by preventing the kidneys from reabsorbing glucose back into the bloodstream, hence promoting its excretion in urine. On the other hand, Trulicity falls under a class of drugs known as glucagon-like peptide-1 (GLP-1) receptor agonists which stimulate insulin production while also reducing glucose production in the liver.
Jardiance vs Trulicity Side By Side
| Attribute | Jardiance | Trulicity |
|---|---|---|
| Brand Name | Jardiance | Trulicity |
| Contraindications | History of pancreatitis, certain types of cancer, severe kidney disease or on dialysis | History of pancreatitis, certain types of cancer, severe kidney disease or on dialysis |
| Cost | $585 for 30 tablets (10 mg) | $800 for four injectable pens (0.75 mg) |
| Generic Name | Empagliflozin | Dulaglutide |
| Most Serious Side Effect | Signs of dehydration, symptoms of a urinary tract infection, unusual sudden body weight loss | Severe allergic reaction, pancreatitis symptoms, kidney problems signs, changes in vision, rapid heartbeat, mood swings |
| Severe Drug Interactions | Insulin can interact and increase the risk of hypoglycemia | Not specifically mentioned, but as with all medications, interactions can occur |
| Typical Dose | 10 mg once daily in the morning, up to 25 mg per day if necessary | 0.75 mg once per week, can be increased to 1.5 mg once weekly |
What is Jardiance?
Empagliflozin (the generic name for Jardiance) is a sodium-glucose co-transporter 2 inhibitor, which marked a significant development in the treatment of type 2 diabetes. It was first approved by the FDA in 2014. Jardiance works by helping kidneys get rid of glucose from your bloodstream, effectively lowering blood sugar levels and A1C percentage. It is prescribed to manage type 2 diabetes and to reduce cardiovascular death in adults with heart disease related to type 2 diabetes.
On the other hand, Dulaglutide (the generic name for Trulicity), another medication used to control high blood sugar level but it belongs to a different class called glucagon-like peptide-1 receptor agonists, approved by FDA in 2014 as well. Administered once weekly through an injection under the skin, Trulicity slows digestion and prevents liver from making too much glucose thereby managing insulin levels more naturally than direct insulin administration.
Both have different mechanisms of action but aim towards controlling blood glucose levels effectively while having minimal side effects on patients' overall health status.
What conditions is Jardiance approved to treat?
Jardiance is approved for the treatment of certain conditions related to diabetes:
- Type 2 Diabetes Mellitus in adults as an adjunct to diet and exercise
- Lowering the risk of cardiovascular death in adult patients with type 2 diabetes mellitus and established cardiovascular disease
- Heart failure (reduction in cardiovascular death or hospitalization) for adults with either preserved or reduced ejection fraction
How does Jardiance help with these illnesses?
Jardiance aids in the management of type 2 diabetes by increasing the amount of glucose excreted in urine. It does this by blocking a protein called SGLT2, which is responsible for reabsorbing glucose back into the blood from the kidneys. By inhibiting this process, Jardiance can help maintain lower blood sugar levels over longer periods of time. Glucose is a simple sugar that serves as a primary energy source for many bodily functions and plays an important role in metabolism, energy production, cell signaling and more. Uncontrolled high levels of glucose in individuals with diabetes can lead to various health complications over time including nerve damage, kidney disease and cardiovascular problems. Therefore, by facilitating greater glucose excretion via urine using Jardiance, patients can manage their condition effectively while mitigating potential health risks associated with prolonged high blood sugar.
What is Trulicity?
Trulicity, a brand name for dulaglutide, is an injectable drug used to manage blood sugar levels in adults with type 2 diabetes. It falls under the class of medication known as glucagon-like peptide-1 (GLP-1) receptor agonists, functioning by stimulating the body's insulin production and reducing the amount of glucose released into your bloodstream. Trulicity was first approved by FDA in 2014.
As it is not an SGLT2 inhibitor like Jardiance, it does not work by causing the kidneys to get rid of more glucose. Its method of action means that its side effects are also different from those seen with SGLT2 inhibitors; particularly, it has less potential for urinary tract and genital infections but may cause gastrointestinal issues such as nausea or vomiting more frequently than Jardiance. The positive impacts on insulin production can be highly beneficial in managing type 2 diabetes, especially among patients who do not respond well to "typical" SGLT2 inhibitors like Jardiance.
What conditions is Trulicity approved to treat?
Trulicity is a medicine that has been approved by the FDA for treating:
- Type 2 diabetes mellitus as an adjunct to diet and exercise
- To reduce the risk of major cardiovascular events in adults with type 2 diabetes mellitus who have established cardiovascular disease or multiple cardiovascular risk factors.
How does Trulicity help with these illnesses?
Glucagon-like peptide-1 (GLP-1) is a hormone that plays significant roles in the regulation of blood glucose levels, including stimulating insulin secretion and suppressing glucagon production. Low levels of this hormone have been implicated in type 2 diabetes. Trulicity works by mimicking the effects of GLP-1, thereby helping to regulate blood sugar levels and possibly contributing to weight loss. It acts on pancreatic cells to stimulate insulin release following meals, while also slowing gastric emptying which can help control appetite and lead to modest weight loss. Unlike Jardiance, which operates via a different mechanism (as an SGLT2 inhibitor causing increased excretion of glucose in urine), Trulicity may be prescribed when patients do not respond well or are intolerant to metformin or other first-line treatments for type 2 diabetes.
How effective are both Jardiance and Trulicity?
Both empagliflozin (Jardiance) and dulaglutide (Trulicity) have proven efficacy in managing type 2 diabetes, having achieved FDA approval within a few years of each other. Empagliflozin and dulaglutide act on different pathways of glucose regulation, meaning they may be prescribed under different circumstances or even together for additive effects.
Empagliflozin works by inhibiting the sodium-glucose co-transporter 2 (SGLT2), leading to increased urinary glucose excretion and thereby reducing blood glucose levels. A meta-analysis from 2017 reported that empagliflozin also offered cardiovascular benefits beyond just blood sugar control, helping reduce heart failure hospitalizations among high-risk patients with type 2 diabetes.
Dulaglutide is an injectable glucagon-like peptide-1 receptor agonist which stimulates insulin release while suppressing glucagon secretion when blood sugar is elevated. The REWIND study in 2019 demonstrated that Trulicity not only improved glycemic control but also reduced major adverse cardiovascular events in people with type 2 diabetes at risk for cardiovascular disease.
While both medications are effective at controlling hyperglycemia in patients with type 2 diabetes, their mechanisms of action differ substantially. As such, they can often be used together to achieve superior blood sugar control compared to monotherapy options. Both drugs appear generally well-tolerated although side effect profiles do differ somewhat; Jardiance may increase risk of urinary tract infections due to its mechanism of increasing urinary glucose excretion whereas Trulicity can lead to gastrointestinal side effects like nausea or vomiting.
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At what dose is Jardiance typically prescribed?
The recommended oral dosage of Jardiance for adults with type 2 diabetes is 10 mg once daily in the morning, but it can be increased to a maximum of 25 mg per day if necessary. It is not appropriate for use in children or adolescents under the age of 18 years. In contrast, Trulicity should be injected subcutaneously and its starting dose typically is at 0.75 mg once weekly, which may be increased to a maximum of 1.5 mg per week as needed and based on tolerability. Trulicity isn't recommended for individuals below the age of 18 either.
At what dose is Trulicity typically prescribed?
Trulicity treatment for type 2 diabetes is usually initiated with a dosage of 0.75 mg once per week. If the desired effect on blood glucose levels is not achieved, this dose can be increased to 1.5 mg once weekly. Trulicity comes in an easy-to-use pen that doesn't require any mixing or measuring, making administration simple and convenient. The maximum recommended dose is 1.5 mg once weekly - a higher dosage might increase side effects without providing additional benefits on glucose control. As always, it's important to monitor your response to medication and discuss any concerns with your healthcare provider.
What are the most common side effects for Jardiance?
Common side effects of Jardiance can include:
- Urinary tract infections
- Yeast infections in women and men
- Increased urination
- Nausea, vomiting or stomach upset
- Thirst and dry mouth due to dehydration
- Fatigue or general weakness
On the other hand, Trulicity may cause:
- Nausea, vomiting, abdominal pain
- Diarrhea
- Decreased appetite which could lead to weight loss
- Indigestion (discomfort in the upper stomach) -Injection site reactions such as rash or itching.
Please note that this is not a complete list. Some individuals might experience different side effects or none at all. Always consult with your healthcare provider for personalized advice.
Are there any potential serious side effects for Jardiance?
While both Jardiance and Trulicity are used to manage blood sugar levels in people with Type 2 diabetes, they can also have some potential side effects. For Jardiance:
- Signs of dehydration: extreme thirstiness, very dry or sticky mouth, not being able to urinate or passing a lot less urine than usual.
- Symptoms of a urinary tract infection may include burning sensation while urinating, frequent urge to urinate but without much output, cloudy or strong-smelling urine.
- Unusual sudden body weight loss.
For Trulicity:
- Significant signs of an allergic reaction: hives; difficulty breathing; swelling on your face, lips, tongue, or throat.
- Severe stomach pain that will not get better even after medication which might be pancreatitis
- Changes in vision If you experience any such symptoms from either drug it's important to seek immediate medical help.
What are the most common side effects for Trulicity?
Common side effects of Trulicity may include:
- Nausea, vomiting, diarrhea
- Decreased appetite and weight loss
- Abdominal pain or discomfort
- Fatigue or weakness
- Headache
- Dizziness
- Increased heart rate Although many people have few to no side effects with Trulicity, this medication can potentially cause serious complications such as kidney problems or pancreatitis. Furthermore, its impact on heart rate should be monitored closely especially in patients with existing cardiovascular conditions. It's crucial to always consult your healthcare provider when considering new medications like Trulicity.
Are there any potential serious side effects for Trulicity?
While Trulicity is generally well-tolerated, some patients may experience serious side effects. These can include:
- Signs of a severe allergic reaction: difficulty breathing or swallowing, swelling in the face or throat, hives, skin rash with itching and peeling
- Pancreatitis symptoms: severe abdominal pain that radiates to your back and accompanied by vomiting
- Kidney problems signs: changes in urination frequency or amount, swelling in ankles or feet, feeling tiredness
- Changes in vision like blurred vision due to low blood sugar levels (hypoglycemia)
- Rapid heartbeat
- Mood swings including depression and suicidal thoughts.
If you experience these symptoms while taking Trulicity, contact your healthcare provider immediately.
Contraindications for Jardiance and Trulicity?
Both Jardiance and Trulicity, along with most other diabetes medications, may cause serious side effects in some people. If you notice symptoms such as severe stomach pain, nausea or vomiting, shortness of breath, unusual tiredness or weakness, please seek immediate medical attention.
Neither Jardiance nor Trulicity should be taken if you have a history of pancreatitis or certain types of cancer. Always tell your physician which medications you are taking; drugs like insulin can interact with these medications and increase the risk of hypoglycemia (low blood sugar).
Additionally, both medicines are not recommended for patients with severe kidney disease or on dialysis. It's crucial to remember that managing type 2 diabetes involves regular monitoring and adjustments to treatment plans under the guidance of healthcare providers.
How much do Jardiance and Trulicity cost?
For the brand name versions of these drugs:
- The price of 30 tablets of Jardiance (10 mg) averages around $585, which works out to approximately $19.50 per day.
- The price for four injectable pens of Trulicity (0.75 mg) is about $800, equating to roughly $28/day.
Therefore, if you are prescribed a standard dosage for both medications, then brand-name Trulicity is more expensive on a per-day treatment basis than Jardiance. However, it's important to remember that cost should not be the primary factor in choosing between these two medications.
Currently there are no generic forms available for either Jardiance or Trulicity as they are still under patent protection. Consequently, costs remain relatively high and vary depending on individual health insurance coverage and pharmacy pricing practices.
Popularity of Jardiance and Trulicity
Empagliflozin, available under the brand name Jardiance, was prescribed to about 2.4 million people in the US in 2020. Empagliflozin is an SGLT-2 inhibitor used for managing type 2 diabetes and heart failure. It accounts for approximately 15% of SGLT-2 inhibitor prescriptions in the US.
On the other hand, dulaglutide, marketed as Trulicity, was prescribed to around 3.5 million people in the USA during that same year. Dulaglutide belongs to a class of medications called GLP-1 receptor agonists and it is primarily utilized for treating type 2 diabetes but has also been approved by FDA recently for reducing cardiovascular events like stroke or heart attack among high-risk patients with Type-2 diabetes. It represents just over one-fifth (20%) of GLP-1 receptor agonist prescriptions and its use has generally seen an increase since its introduction.
Conclusion
Both Jardiance (empagliflozin) and Trulicity (dulaglutide) have strong records of usage in patients with type 2 diabetes, supported by numerous clinical studies indicating that they are more effective than placebo treatments. They may be used together in some cases, but this decision should be made carefully by a physician due to potential interactions between the two drugs. Their differing mechanisms of action mean they tend to be prescribed under different circumstances: Jardiance works primarily as an SGLT-2 inhibitor which helps lower blood sugar levels by causing the kidneys to remove sugar from the body through urine, whereas Trulicity is a GLP-1 receptor agonist that slows down digestion and can help reduce appetite.
Jardiance has generic versions available, providing cost savings especially for patients who must pay out of pocket. Both Jardiance and Trulicity might require an adjustment period before effects become noticeable.
The side effect profiles are similar for both drugs; however, each carries its own unique risks. For instance, while both medicines generally have good tolerability profiles, Jardiance is associated with increased risk of urinary tract infections due to its mode of action whereas Trulicity's common side effects include nausea or vomiting because it slows down digestion. As with any medication regime change or initiation of new drug therapy, patients should closely monitor their symptoms and reach out immediately to their healthcare provider if there’s worsening control over blood glucose levels or other concerning side effects.
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Refrences
- 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
- 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
- Nauck, M. A. (2004, November). Glucagon-like Peptide 1 (GLP-1) in the Treatment of Diabetes. Hormone and Metabolic Research. Georg Thieme Verlag KG.http://doi.org/10.1055/s-2004-826175
- 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