Januvia vs. Jardiance

See how Januvia and Jardiance compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Januvia is a DPP-4 inhibitor and Jardiance is an SGLT2 inhibitor, so despite both being once-daily pills for type 2 diabetes, they lower blood sugar through very different mechanisms.

  • Jardiance carries extra FDA approvals for reducing cardiovascular death, heart failure hospitalization, and chronic kidney disease progression that Januvia does not have.

  • Januvia's most common side effects are respiratory infections and swelling, while Jardiance's are more often urinary and genital infections, hypoglycemia, and volume depletion.

Januvia vs. Jardiance Drug Summary

Januvia

Januvia (sitagliptin) is a DPP-4 inhibitor used to help control blood sugar in adults with type 2 diabetes, taken as a single tablet once a day alongside diet and exercise. It works by boosting incretin hormones that prompt the pancreas to release insulin after meals.

Jardiance

Jardiance (empagliflozin) is an SGLT2 inhibitor that lowers blood sugar in adults and children 10 and older with type 2 diabetes by causing the kidneys to remove excess glucose through urine. It also carries approvals for reducing cardiovascular death, heart failure hospitalization, and chronic kidney disease progression.

Januvia vs. Jardiance Side Effects

Januvia

Most common
Upper respiratory tract infection (up to 15.5%)
Nasopharyngitis (up to 11.0%)
Peripheral edema (up to 8.3%)
Headache (up to 5.5%)

Jardiance

Most common
Hypoglycemia (up to 41.3%)
Volume depletion related reactions (up to 11.4%)
Urinary tract infection (up to 9.3%)
Female genital mycotic infection (up to 5.4%)

Januvia vs. Jardiance Dosage

Januvia

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 100 mg once daily At the start
Maximum dose 25 mg once daily If needed
Dose changes 2 increases As tolerated

Jardiance

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 10 mg once daily At the start
Maximum dose 25 mg once daily If needed
Dose changes 1 increase As tolerated

Januvia vs. Jardiance Indications

Januvia

Januvia is FDA-approved to improve blood sugar control in adults with type 2 diabetes when used alongside diet and exercise. It is not approved for type 1 diabetes or for treating diabetic ketoacidosis.

  • Blood sugar control in type 2 diabetes

  • Used as an adjunct to diet and exercise

  • Not approved for type 1 diabetes

  • Not approved for diabetic ketoacidosis

Jardiance

Jardiance is FDA-approved for blood sugar control in adults and children 10 and older with type 2 diabetes. It also carries approvals for reducing cardiovascular death in patients with heart disease, reducing heart failure hospitalization regardless of ejection fraction, and slowing chronic kidney disease progression.

  • Blood sugar control in type 2 diabetes

  • Reduces cardiovascular death risk in heart disease

  • Reduces heart failure hospitalization risk

  • Slows chronic kidney disease progression

Januvia vs. Jardiance Pros and Cons

Januvia

Januvia has a long safety track record since 2006 and is generally weight-neutral, with no boxed warning on its label. It does not carry the added heart failure or kidney disease indications that newer diabetes drugs have earned.

Pros

  • Weight-neutral, unlike some other diabetes drugs

  • No boxed warning on the label

  • Long safety track record since 2006

  • Simple once-daily dosing without titration

Cons

  • No cardiovascular or kidney protection indication

  • Postmarketing reports of severe pancreatitis

  • Can cause severe, disabling joint pain

  • Bullous pemphigoid reported, requiring hospitalization

Jardiance

Jardiance carries added FDA approvals for heart failure and chronic kidney disease, making it a common choice for patients managing those conditions alongside diabetes. It requires more caution around dehydration, genital infections, and diabetic ketoacidosis risk.

Pros

  • Approved to reduce heart failure hospitalization

  • Approved to slow chronic kidney disease progression

  • Approved for cardiovascular death risk reduction

  • Approved for children 10 and older

Cons

  • Risk of diabetic ketoacidosis even with normal glucose

  • Serious genital and urinary infections possible

  • Not recommended in second or third trimester pregnancy

  • Higher hypoglycemia risk with insulin or sulfonylureas

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