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Jardiance vs Actos
Introduction
For patients with Type 2 diabetes, certain drugs that alter the response to insulin or regulate glucose in the blood can help in managing blood sugar levels and associated symptoms. Jardiance and Actos are two such drugs that are prescribed for this condition. They each affect different aspects of glucose metabolism but both have beneficial effects on glycemic control in patients with diabetes.
Jardiance is a sodium-glucose transport protein-2 (SGLT2) inhibitor which works by preventing the kidneys from reabsorbing glucose back into the blood thereby promoting its excretion through urine. This eventually lowers elevated blood sugar levels.
On other hand, Actos falls under a class of medications called thiazolidinediones (TZDs), it improves sensitivity to insulin at receptor sites, allowing more glucose to enter cells where it can be used as energy, thus reducing overall blood sugar levels.
What is Jardiance?
Empagliflozin (the generic name for Jardiance) is a newer class of medication known as SGLT2 inhibitors that was approved by the FDA in 2014. Jardiance works by preventing glucose from being reabsorbed into the blood, which allows it to be excreted via urine instead, effectively “trapping” it outside of the bloodstream for longer than usual. It is prescribed for the treatment of type 2 diabetes and heart failure. Compared to Pioglitazone (Actos), an older drug that belongs to the thiazolidinediones class and operates primarily by reducing insulin resistance, Jardiance has been found to have additional benefits such as weight loss and reduction in cardiovascular mortality. While Actos can cause side effects like weight gain and an increased risk of bone fractures due to its influence on fat cells, these are less likely with Jardiance because its mechanism doesn't strongly interact with these areas.
What conditions is Jardiance approved to treat?
Jardiance is approved for the management and treatment of certain conditions:
- Type 2 diabetes as an adjunct to diet and exercise
- To reduce the risk of cardiovascular death in adult patients with type 2 diabetes mellitus and established cardiovascular disease
- Heart failure in adults with a reduced ejection fraction to decrease the risk of cardiovascular death and hospitalization for heart failure.
How does Jardiance help with these illnesses?
Jardiance assists in managing type 2 diabetes by increasing the amount of glucose excreted through urine. It achieves this by inhibiting a protein called sodium-glucose co-transporter 2 (SGLT2) found in the kidneys, which blocks glucose from being reabsorbed back into the bloodstream and instead ensures it is passed out with urine. Glucose is a type of sugar that acts as a primary energy source for your body, but can cause harm when levels are too high over prolonged periods, such as those seen in diabetes. Therefore, Jardiance aids diabetic patients by lowering their blood sugar levels and providing better glycemic control.
What is Actos?
Actos, the brand name for pioglitazone, is a thiazolidinedione-type drug that helps to control high blood sugar in patients with type 2 diabetes. By acting as an insulin sensitizer, it aids in reducing glucose production and absorption while increasing the body's sensitivity to insulin. Actos was first approved by the FDA in 1999. As it doesn't stimulate insulin secretion directly from pancreatic beta cells like sulfonylureas or meglitinides, it doesn't induce hypoglycemia when taken alone without other antidiabetic medications; however, this can occur if combined with such drugs. The side-effect profile of Actos differs from that of SGLT2 inhibitors like Jardiance (empagliflozin). It does not cause urinary tract infections or yeast infections which are common side effects associated with SGLT2 inhibitors but may lead to weight gain and fluid retention (which could exacerbate heart failure). Its beneficial effects on glycemic control can be particularly useful for treatment of type 2 diabetes especially in patients who do not respond well to "typical" metformin therapy or cannot tolerate metformin due to its gastrointestinal side effects.
What conditions is Actos approved to treat?
Actos is a popular medication utilized in the treatment of type 2 diabetes. It functions by improving sensitivity to insulin, helping to manage blood sugar levels effectively. The conditions it has been approved for are:
- Type II Diabetes Mellitus
- Polycystic Ovary Syndrome (off-label usage).
How does Actos help with these illnesses?
Actos works primarily by increasing insulin sensitivity, which plays a vital role in the regulation of blood glucose levels. Actos is part of a class of drugs known as thiazolidinediones and acts mainly on fat cells to reduce insulin resistance, thereby lowering blood sugar levels. It also has some effects on the liver's production of glucose as well as muscle tissue's use of sugar. Unlike Jardiance, which removes excess glucose through urine, Actos manipulates the body’s internal processes for using and producing insulin to maintain optimal blood sugar levels. This makes it an important medication when patients with type 2 diabetes do not respond effectively to other medications or need additional support in managing their condition.
How effective are both Jardiance and Actos?
Both Empagliflozin (Jardiance) and Pioglitazone (Actos) have established histories of efficacy in managing blood sugar levels in patients with type 2 diabetes, having been approved by the FDA in 2014 and 1999 respectively. Given they act on different mechanisms within the body to achieve glycemic control, they may be prescribed under varied circumstances. The effectiveness of Jardiance and Actos was directly compared in a double-blind clinical trial conducted in 2015; both drugs showed similar efficacy at controlling HbA1c levels - a long-term measure of blood glucose control.
A review from 2018 reported that Jardiance demonstrates significant benefits beyond just blood sugar control, such as reducing cardiovascular mortality risks among type-2 diabetics with heart disease. It has also shown potential kidney protective effects. Its side effect profile includes genital yeast infections due to increased urinary glucose excretion but is generally well-tolerated by most patients.
On the other hand, a meta-analysis study from 2006 stated that Actos is more effective than placebo at improving insulin resistance and maintaining long-term glycemic stability. However, it's often linked with weight gain due to fluid retention and an increased risk of bone fractures especially among women. Nonetheless, because it works by increasing sensitivity to insulin rather than stimulating its secretion like many other antidiabetic drugs do, Actos can be advantageous for those who are particularly prone to hypoglycemia or have already experienced beta-cell burnout.
At what dose is Jardiance typically prescribed?
Oral dosages of Jardiance typically start at 10 mg once daily, with the potential to increase to 25 mg based on glycemic response and tolerance. It is used for treating type 2 diabetes in adults but not recommended for children due to lack of studies in this age group. On the other hand, Actos dosage usually starts at 15-30 mg per day and can be increased up to a maximum of 45 mg/day based on individual effectiveness and tolerability. Like Jardiance, Actos is also primarily used for adult patients with type 2 diabetes. Neither medication should exceed their respective maximum dosages under any circumstance.
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At what dose is Actos typically prescribed?
Actos treatment for type 2 diabetes is generally initiated at a dosage of 15 to 30 mg per day, taken orally once daily. Depending on your body's response and tolerance, the dose can be increased up to a maximum of 45 mg per day if needed. The effects can take from two weeks to three months to become apparent, so patients are often advised not to increase their dosage until this period has elapsed. Always consult with your healthcare provider before changing any medication dosages.
What are the most common side effects for Jardiance?
Common side effects that you might experience while taking Jardiance include:
- Urinary tract infections
- Yeast infections in women
- Increased urination
- Kidney problems
- Increased cholesterol levels
On the other hand, Actos may cause:
- Weight gain
- Fluid retention leading to swelling and heart failure
- An increased risk of fractures, particularly in women
- An increased risk of bladder cancer if used for more than one year.
Always consult your healthcare provider for a complete understanding of potential risks and benefits before starting any medication.
Are there any potential serious side effects for Jardiance?
Comparing Jardiance to Actos, they are both used for managing type 2 diabetes but can cause different side effects. For Jardiance, some of the severe adverse reactions include:
- Signs of an allergic reaction: difficulty breathing; swelling in your face or throat; hives
- Symptoms of dehydration - feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin
- Serious urinary tract infections - burning sensation while you urinate, pain in the pelvic area
- Ketoacidosis (increased ketones in the blood or urine) symptoms such as nausea, vomiting, stomach pain followed by confusion or unusual drowsiness
- Severe infections on legs and feet (Necrotizing fasciitis), causing fever alongside increasing redness/swelling under your skin
On the other hand, serious side effects with Actos may include:
- Congestive heart failure signs: shortness of breath (especially when lying down), unusually rapid increase in weight due to fluid retention.
- Liver problems: jaundice-like symptoms-yellowing eyes/skin-, dark urine-color change-, persistent nausea/vomiting/loss of appetite.
If you experience any serious symptoms from either drug immediately seek medical attention.
What are the most common side effects for Actos?
Actos, a widely used medication for controlling blood sugar levels in type 2 diabetes, can have some side effects that patients should be aware of. The most common ones include:
- Headaches and muscle pain
- Upper respiratory tract infection symptoms such as stuffy or runny nose, sore throat
- Sinusitis causing facial discomfort or pressure and a blocked nose
- Fluid retention leading to weight gain and possibly heart failure in more severe cases
- Tooth problems
- Hypoglycemia when used with other diabetic medications In rare instances, Actos may cause blurry vision due to macular edema. Moreover, it has been associated with an increased risk of bladder cancer over prolonged usage. Always consult your doctor if you experience unexplained nausea, vomiting, loss of appetite accompanied by stomach pain or changes in urination patterns while on this medication.
Are there any potential serious side effects for Actos?
Actos, like any medication, can have potential side effects. Some of the more serious ones to watch out for include:
- Allergic reactions such as itching, hives or a rash, swelling in your face or throat and difficulty breathing.
- Vision changes including blurred vision or seeing halos around lights; these could be signs of macular edema (fluid build-up in the eye).
- Signs indicative of congestive heart failure like rapid weight gain, shortness of breath especially when lying down and unusual tiredness.
- Symptoms associated with bladder cancer: blood or red color in urine, painful urination accompanied by lower backside pain
- Liver problems signaled by symptoms such as nausea/vomiting that doesn't stop, loss of appetite leading to extreme fatigue/weakness and dark urine.
If you experience any of these symptoms while taking Actos it's important to seek medical attention immediately.
Contraindications for Jardiance and Actos?
Both Jardiance and Actos, along with other diabetes medications, may cause hypoglycemia (low blood sugar) in some people. If you notice symptoms such as sudden sweating, shaking, fast heartbeat, hunger, blurred vision or tingling hands/feet it is important to consume a quick source of sugar and seek medical attention.
Neither Jardiance nor Actos should be taken if you are suffering from serious kidney problems or if your kidneys are not functioning normally. Always inform your physician about any underlying health conditions and the medications you are taking; both these drugs require careful monitoring for potential impacts on kidney function.
In addition to this, there is a risk of developing heart failure when using Actos especially in patients who already have heart disease or at risk for heart disease. Likewise, Jardiance has been associated with dehydration leading to low blood pressure which can exacerbate existing kidney problems. Therefore it's crucial that you maintain good hydration levels while being treated with these drugs.
It’s also worth noting that both these drugs might interact negatively with certain other medications including insulin or sulfonylureas causing severe drop in blood glucose levels.
How much do Jardiance and Actos cost?
For the brand name versions of these drugs:
- The cost for 30 tablets of Jardiance (10 mg) averages around $600, which works out to about $20/day.
- The price for 30 tablets of Actos (15 mg) averages about $500, working out to approximately $16.67/day.
Thus, if you are on a standard dosage for both medication i.e., 10mg/day for Jardiance and 15mg/day for Actos), then brand-name Actos is less expensive on a per-day treatment basis. However, it's important to note that cost should not be the primary consideration in determining which drug is right for you.
In terms of generic versions:
- Empagliflozin (generic version of Jardiance), is currently unavailable in most countries including the U.S as its patent has not yet expired.
- Pioglitazone (generic version of Actos), costs significantly less than its branded counterpart with approximate costs ranging from $0.20 to $0.60 per day depending on your dose. This makes pioglitazone an affordable alternative if prescribed by your healthcare provider.
Popularity of Jardiance and Actos
Empagliflozin, sold under the brand name Jardiance, was prescribed to approximately 1.5 million people in the United States in 2020. This medication is generally used to manage type-2 diabetes and has been increasingly popular since its introduction due to its additional cardiovascular benefits. It is classified as a SGLT2 inhibitor and accounts for around 20% of all prescriptions within this class of drugs.
Pioglitazone, also known by its brand name Actos, was prescribed to about 3.7 million patients in the USA during the same year. Pioglitazone belongs to a different class of drugs – thiazolidinediones (TZDs) – and represents nearly half of all TZD prescriptions given out in U.S pharmacies. Despite concerns over possible side effects such as weight gain and increased risk of bone fractures, pioglitazone remains an effective treatment option for controlling blood sugar levels in type-2 diabetes patients.
Conclusion
Both Jardiance (empagliflozin) and Actos (pioglitazone) are effective in managing Type 2 diabetes, and their efficacy has been substantiated by numerous clinical trials showing that they can help control blood sugar levels better than placebo treatments. In some cases, these drugs may be used together, but this is subject to careful consideration by a physician due to potential drug interactions. Their mechanisms of action differ significantly: Jardiance works primarily on the kidneys by blocking glucose reabsorption thereby increasing its excretion in urine while Actos increases insulin sensitivity at the cellular level.
Jardiance is often considered as an add-on treatment when first-line oral antidiabetic agents such as metformin fail or are contraindicated. On the other hand, Actos can be used as monotherapy or combined with other diabetic medications including insulin.
Both drugs come in generic form which represents significant cost savings for patients who pay out-of-pocket. Both Jardiance and Actos require time for their effects to become noticeable since they work gradually over time rather than producing immediate results.
The side effect profile differs between the two drugs: both are generally well-tolerated but Jardiance may lead to urinary tract infections due to increased glucose excretion via urine whereas Actos carries a risk of weight gain and edema. For both medications, close monitoring of blood sugar levels is crucial when starting treatment; medical attention should be sought immediately if there's any symptom indicating hypoglycemia or hyperglycemia.