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Jardiance vs Onglyza
Introduction
For patients with type 2 diabetes, certain medications that manage the levels of blood glucose can help prevent complications associated with high sugar levels and effectively control symptoms. Jardiance and Onglyza are two such drugs that are prescribed for this condition. They each function differently in the body but both aim to maintain balanced blood sugar levels in patients with diabetes.
Jardiance is a sodium-glucose co-transporter 2 (SGLT2) inhibitor, which works by blocking the reabsorption of glucose in the kidneys, promoting its excretion through urine and thereby reducing blood glucose levels. On the other hand, Onglyza belongs to a class of medicines known as dipeptidyl peptidase-4 (DPP-4) inhibitors; it primarily functions by increasing insulin production after meals while also decreasing the amount of glucose produced by your liver.
What is Jardiance?
Empagliflozin (the generic name for Jardiance) is a newer class of medication known as SGLT2 inhibitors, which plays an instrumental role in managing Type 2 diabetes by helping kidneys get rid of glucose from the bloodstream. Empagliflozin was first approved by the FDA in 2014. Jardiance functions by preventing blood sugar levels from rising too high, effectively reducing them to healthier limits. It is prescribed predominantly for adults with type 2 diabetes to improve glycemic control and reduce cardiovascular death risk.
In contrast, Saxagliptin (the generic name for Onglyza), belongs to another class of drug called DPP-4 inhibitors that works differently but also aids in controlling blood sugar levels. It increases insulin production and reduces glucagon secretion after meals resulting in lesser spikes in post-meal blood glucose levels.
Both drugs have different side effect profiles due to their distinct mechanisms of action. While empagliflozin may cause urinary tract infections or dehydration due to its mode of action on the kidneys, saxagliptin can lead to joint pain or even heart failure in some rare cases.
What conditions is Jardiance approved to treat?
Jardiance and Onglyza are both approved for the treatment of type 2 diabetes. They offer different benefits:
- Jardiance (empagliflozin) is known to reduce the risk of cardiovascular death in patients with type 2 diabetes who have known heart disease, and it can also help with weight loss and blood pressure control.
- Onglyza (saxagliptin) does not directly contribute to weight loss or blood pressure control, but it can be used together with a diet and exercise program to control high blood sugar in adults with type 2 diabetes.
How does Jardiance help with these illnesses?
Jardiance helps to manage type 2 diabetes by reducing the amount of glucose reabsorbed by the kidneys. It does this by inhibiting a protein called sodium-glucose co-transporter 2 (SGLT2), which is responsible for transporting glucose from the kidney back into the bloodstream. When SGLT2 function is blocked, more glucose can be expelled in urine, thus lowering blood sugar levels. Glucose is a simple sugar that provides energy to all parts of the body and plays an important role in metabolism, brain function, physical performance and overall health. It's thought that individuals with type 2 diabetes have higher than normal levels of glucose due to either insulin resistance or insufficient insulin production. Therefore, by decreasing glucose reabsorption via Jardiance use, patients can better manage their condition and stabilize their blood sugar levels.
What is Onglyza?
Onglyza is a brand name for saxagliptin, which is an oral diabetes medicine that aids in controlling blood sugar levels. It works by adjusting the levels of insulin your body produces after eating. Saxagliptin was first approved by the FDA in 2009 and belongs to a class of drugs known as dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors). Unlike empagliflozin found in Jardiance, which works by assisting the kidneys get rid of glucose from your bloodstream, Onglyza does not work this way.
Its effect on insulin means that its side-effect profile differs from sodium-glucose co-transporter 2 (SGLT2) inhibitors like Jardiance. One primary difference is that it doesn’t cause weight loss and isn't as likely to induce urinary tract infections or yeast infections – common side effects associated with SGLT2 inhibitors such as Jardiance. The role Onglyza plays on insulin can be beneficial for managing type 2 diabetes, particularly in patients who do not respond well to "typical" SGLT2 inhibitor drugs such as Jardiance.
What conditions is Onglyza approved to treat?
Onglyza has been approved by the Food and Drug Administration for the treatment of:
- Type 2 diabetes mellitus, as an adjunct to diet and exercise
- It can be used alone or in combination with other drugs such as metformin, pioglitazone, or glimepiride.
How does Onglyza help with these illnesses?
Onglyza is a medication that functions by inhibiting the action of an enzyme known as DPP-4. This enzyme breakdowns incretins, hormones in the body that stimulate the release of insulin after meals. By blocking this enzyme, Onglyza allows for higher levels of incretins to remain active in the body and thus more insulin can be released. The end result being better control over blood glucose levels, helping manage symptoms of type 2 diabetes effectively. While Jardiance works differently to reduce glucose reabsorption from kidneys back into the bloodstream, Onglyza's approach focuses on enhancing your body’s natural ability to lower blood sugar when it is elevated. It does not cause weight gain and has been associated with a lower risk of hypoglycemia than some other antidiabetic medications making it a good option for patients who have trouble maintaining stable glucose levels or are concerned about weight changes.
How effective are both Jardiance and Onglyza?
Both empagliflozin (Jardiance) and saxagliptin (Onglyza) are effective oral medications for managing type 2 diabetes, with Jardiance being approved by the FDA in 2014 and Onglyza in 2009. They function through different mechanisms, which can guide their prescription based on individualized patient needs. Empagliflozin works by inhibiting sodium-glucose co-transporter-2 (SGLT2), leading to increased glucose excretion via urine, while saxagliptin functions as a dipeptidyl peptidase-4 inhibitor, increasing insulin levels and decreasing glucagon levels.
A direct comparison study conducted in 2017 showed that patients receiving empagliflozin had similar glycemic control to those taking saxagliptin but exhibited significant weight loss—an often desirable side effect given the association of obesity with type 2 diabetes. However, it's important to note that increased urination is a common side effect of SGLT2 inhibitors like empagliflozin.
Reviews of various studies have shown both drugs effectively reducing HbA1c levels—a key measure for long-term blood sugar control—with minimal risk of hypoglycemia when used alone or alongside metformin. Additionally, cardiovascular benefits were observed for patients treated with empagliflozin in EMPA-REG OUTCOME trial which was not noted among those treated with saxagliptin.
While both medications play an important role in treating type 2 diabetes, they may be chosen over one another depending on specific patient characteristics or concerns such as kidney function and heart disease history due to their distinct mechanism of action.
At what dose is Jardiance typically prescribed?
Oral dosages of Jardiance typically start at 10 mg/day, and it has been shown to be effective for managing type 2 diabetes in most adults. If necessary, the dosage can be increased to a maximum of 25 mg/day after a few weeks if there is no response or improvement in blood glucose control. On the other hand, Onglyza is also administered orally with an initial typical dose of 2.5-5 mg per day. In all cases, patients should not exceed the prescribed dose unless advised by their healthcare provider.
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At what dose is Onglyza typically prescribed?
Onglyza treatment is typically initiated at a dosage of 2.5-5 mg/day, taken once daily without regard to meals. The dose can remain at this level for the entirety of the treatment, as adjustment based on efficacy and tolerance isn't usually required. In patients with moderate or severe renal impairment, or end-stage renal disease (ESRD) requiring hemodialysis, the recommended starting dose is 2.5 mg once daily. It's important to note that Onglyza should not be used in patients with type 1 diabetes mellitus or for the treatment of diabetic ketoacidosis.
What are the most common side effects for Jardiance?
Potential side effects of Jardiance can include:
- Urinary tract infections (UTIs)
- Increased urination
- Yeast infections in both men and women
- Thirst resulting from dehydration due to increased urination
- Nausea, vomiting or diarrhea
- Weight loss
Whereas Onglyza may cause some different adverse reactions such as:
- Upper respiratory tract infection
- Urinary tract infection
- Headache -Nausea, abdominal pain and indigestion.
It's important to discuss these potential side effects with your healthcare provider when making a decision about which medication is right for you.
Are there any potential serious side effects for Jardiance?
While both Jardiance and Onglyza are medications used to manage type 2 diabetes, they might present different side effects in certain cases. For Jardiance, potential severe side effects may include:
- Signs of a serious allergic reaction such as hives, difficulty breathing or swallowing, swelling in your face or throat.
- Symptoms associated with ketoacidosis: excessive thirst, frequent urination, nausea or vomiting, stomach pain, tiredness or fatigue.
- Dehydration symptoms - dizziness/lightheadedness especially on standing up from a sitting position due to low blood pressure; dry mouth; dark yellow urine.
With Onglyza the severe side-effects could be:
- Pancreatitis (inflammation of the pancreas)–severe abdominal pain that may spread to your back and cause nausea/vomiting
- Heart failure – shortness of breath even while resting; swelling feet/ankles/hands; rapid weight gain due to fluid retention -Joint pain could also occur which can become severe at times
If you experience any of these symptoms for either medication it is critical that you seek immediate medical attention.
What are the most common side effects for Onglyza?
While comparing Jardiance to Onglyza, it is important to consider the potential side effects of each. Some common side effects associated with Onglyza include:
- Headache or dizziness
- Upper respiratory tract infections, such as a stuffy or runny nose and sore throat
- Urinary tract infections
- Joint pain
- Nausea, vomiting, abdominal pain
- Hypoglycemia (low blood sugar) which may cause tremors, sweating and anxiety.
It's notable that Onglyza doesn't typically result in weight loss but could potentially lead to slight weight gain. Also unlike some other medications for type 2 diabetes, it does not tend to increase urination. Always consult your healthcare provider about any symptoms you experience while taking medication.
Are there any potential serious side effects for Onglyza?
While Onglyza is generally considered safe, it can sometimes cause severe side effects. These include:
- Signs of an allergic reaction such as hives, difficulty breathing, or swelling in your face or throat
- Symptoms of heart failure: shortness of breath (especially when lying down), unusual tiredness, sudden weight gain and swelling in the feet/legs
- Painful or difficult urination
- Severe stomach pain that may spread to your back with nausea and vomiting
- High blood sugar levels which might cause symptoms like dry mouth, increased thirst and urination, fruity breath odor
- Low blood sugar levels (hypoglycemia) causing symptoms like dizziness, hunger pangs
If any of these symptoms occur after taking Onglyza you should seek immediate medical attention.
Contraindications for Jardiance and Onglyza?
Both Jardiance and Onglyza, like most diabetes medications, may cause adverse effects in some individuals. If you notice symptoms such as unusual fatigue, rapid heart rate, or persistent nausea, please seek immediate medical attention.
Neither Jardiance nor Onglyza should be taken if you are using or have used within the last two weeks any medications that interfere with kidney function (such as NSAIDs) or certain antibiotics. Always inform your physician about all medications you are taking; these drugs might require a period of clearance from your system to prevent harmful interactions with either Jardiance or Onglyza.
It is also important to note that both drugs can increase the risk of hypoglycemia (low blood sugar), especially when used alongside other glucose-lowering medications. Symptoms include shakiness, sweating, fast heartbeat, and blurred vision which need immediate attention.
Lastly remember that maintaining good control over diet and regular exercise routines remain crucial even while on medication for managing diabetes.
How much do Jardiance and Onglyza cost?
For the brand name versions of these drugs:
- The price of 30 tablets of Jardiance (10 mg) averages around $540, which works out to about $18/day.
- The price of 30 tablets of Onglyza (5 mg) averages around $470, working out to approximately $15.70 per day.
Thus, on a per-day treatment basis, brand-name Onglyza is less expensive than Jardiance. However, cost should not be a primary consideration in determining which drug is right for you.
Currently there are no generic equivalents available for either Jardiance or Onglyza in the United States:
- Empagliflozin (Jardiance's active ingredient) and Saxagliptin (Onglyza's active ingredient) are still under patent protection and therefore no approved generic versions exist yet.
Please remember that prices can differ significantly depending on your insurance coverage and local pharmacy pricing policies. It’s also important to note that although one medication may be cheaper than the other, this does not mean it is more effective or safer - always consult with your healthcare provider when making decisions about medication.
Popularity of Jardiance and Onglyza
Empagliflozin, also known by the brand name Jardiance, was estimated to have been prescribed to about 2.7 million people in the US in 2020. Empagliflozin accounted for approximately 14% of SGLT2 inhibitor prescriptions in the US. It is used along with diet and exercise to improve blood sugar control in adults with type 2 diabetes, and can be used whether or not they use insulin.
Saxagliptin, which includes brand versions such as Onglyza, was prescribed to roughly 1.5 million people in the USA during that same year. In America, saxagliptin accounts for just under 20% of DPP-4 inhibitor prescriptions - a different class of medication but similarly used for type-2 diabetes management. The prescription trends for saxagliptin has remained fairly steady over recent years without significant increases or decreases noted.
Conclusion
Both Jardiance (empagliflozin) and Onglyza (saxagliptin) are used in the management of type 2 diabetes, with numerous clinical studies supporting their effectiveness over placebo treatments. In some instances, these drugs may be combined to achieve better blood glucose control, but this would require careful consideration by a healthcare provider due to possible contraindications or drug interactions.
Jardiance works by blocking the reabsorption of glucose in the kidneys leading to excretion of excess glucose through urine whereas Onglyza increases insulin production after meals and decreases the amount of sugar made by your body. This difference in mechanisms often determines when they are prescribed; Jardiance could be considered as an initial therapy especially for patients needing weight loss or having heart disease while Onglyza is usually added if metformin alone doesn’t provide adequate control or not well-tolerated.
While both medicines have generic versions which can offer cost savings especially for those paying out-of-pocket, it's important to note that effects might not be noticeable right away as adjustments in dosage may be required based on individual response.
The side effect profiles between both drugs differ somewhat; both generally being well-tolerated but urinary tract infections and genital fungal infections tend to occur more frequently with Jardiance due its mechanism of action while upper respiratory tract infection is more common with Onglyza. Regular monitoring is crucial particularly looking at kidney function and signs/symptoms related to low blood sugars. Immediate medical attention should be sought if there’s unexpected rapid weight loss, persistent nausea/vomiting or difficulty breathing.