Jardiance vs. Actos
See how Jardiance and Actos compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Jardiance is an SGLT2 inhibitor with added FDA approvals for heart failure and chronic kidney disease, while Actos is a thiazolidinedione approved only for blood sugar control.
Actos carries a boxed warning for causing or worsening heart failure and is contraindicated in advanced heart failure, while Jardiance has no such warning and is actually approved to treat heart failure.
Jardiance can occasionally cause diabetic ketoacidosis or genital infections, while Actos is more often linked to fluid retention, bone fractures in women, and a small increase in bladder cancer risk.
Jardiance vs. Actos Drug Summary
Jardiance
Jardiance (empagliflozin) is an SGLT2 inhibitor that lowers blood sugar by causing the kidneys to remove excess glucose through urine. It is taken as one oral tablet daily and also carries FDA approvals for reducing cardiovascular death, treating heart failure, and slowing chronic kidney disease.
Actos
Actos (pioglitazone) is a thiazolidinedione that improves the body's response to insulin, helping muscle and fat cells use blood sugar more effectively. It is taken as one oral tablet daily and is FDA-approved only for blood sugar control in type 2 diabetes, alone or with other diabetes drugs.
Jardiance vs. Actos Side Effects
Jardiance
Actos
Jardiance vs. Actos Dosage
Jardiance
Actos
| 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 |
| STAGE | DOSE | WHEN |
| Starting dose | 15 mg once daily | At the start |
| Maximum dose | 45 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 |
Actos
| STAGE | DOSE | WHEN |
| Starting dose | 15 mg once daily | At the start |
| Maximum dose | 45 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
Jardiance vs. Actos Indications
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 people with heart disease, treating heart failure regardless of ejection fraction, and slowing chronic kidney disease progression.
Type 2 diabetes blood sugar control (adults and children 10+)
Reduce cardiovascular death risk in adults with heart disease
Heart failure: reduce CV death and hospitalization risk
Actos
Actos is FDA-approved only for blood sugar control in adults with type 2 diabetes, used alone or combined with other diabetes medications. It is sometimes prescribed off-label for nonalcoholic fatty liver disease, though this use is not FDA-approved.
Type 2 diabetes blood sugar control as monotherapy
Type 2 diabetes blood sugar control combined with other drugs
Off-label: nonalcoholic fatty liver disease/NASH (not FDA-approved)
Jardiance vs. Actos Pros and Cons
Jardiance
Jardiance's clinical profile extends beyond diabetes into heart failure and kidney protection, which most oral diabetes drugs cannot claim. It does not typically cause hypoglycemia on its own, though the risk rises when combined with insulin or sulfonylureas.
Pros
FDA-approved for heart failure and chronic kidney disease, not just diabetes
Approved for cardiovascular death risk reduction in heart disease
No boxed warning for heart failure
Cons
Can cause genital yeast infections and urinary tract infections
Risk of diabetic ketoacidosis, even with normal blood sugar
Rare risk of serious genital infection (Fournier's gangrene)
Not recommended in later pregnancy due to fetal kidney risk
Actos
Actos improves insulin sensitivity without directly triggering the pancreas, so it doesn't cause hypoglycemia on its own. Its long-term risks, including fluid retention, fractures, and bladder cancer, make it a less common first choice than newer diabetes drugs like Jardiance.
Pros
Does not cause hypoglycemia when used alone
Available as a low-cost generic (pioglitazone)
Long track record of use since 1999
Cons
Boxed warning for causing or worsening heart failure
Contraindicated in NYHA Class III or IV heart failure
Increased risk of bladder cancer with long-term use
Increased fracture risk in women
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