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
Jardiance
Januvia vs. Jardiance Dosage
Januvia
Jardiance
| 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 |
| 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
| 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
| 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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