Can Jardiance Be Taken Twice A Day?

It is normal for patients to want to increase how often they take their medication, especially when they are not getting the results they desire. 

However, there is always a safety concern in doing this. Because side effects are more likely to happen in higher doses or frequent doses than in smaller once-daily doses. 

In this article, the pharmacist will discuss whether Jardiance can be taken twice a day or not. He will also answer if Jardiance can be taken morning and night, as well as explain what happens if you take too much Jardiance.

Jardiance is a medication used to control blood sugar levels in patients with diabetes. It contains the active drug empagliflozin and is available in two strengths – 10 mg and 25 mg.

Manufacturers of Jardiance recommend that it be taken 10 mg once daily in the morning, with or without food. With the potential to be increased to 25 mg if the patient tolerates it [1,2].

Can Jardiance Be Taken Twice A Day?

No, Jardiance should not be taken twice a day because research has shown that it does not provide any significant additional health benefits when compared to taking a single daily dose.

The recommended doses of Jardiance are 10 mg daily in the morning or 25 mg daily in the morning. The drug is not designed to be split or cut, so deciding to take 10 mg or 25 mg twice a day may result in an overdose based on your current sugar level goals.

This can put you at risk of having low blood sugar which can be dangerous. Varying doses of Jardiance other than the recommended 10 mg and 25 mg are only used in products where the drug is combined with another antidiabetic drug. Examples are 

• Synjardy: containing empagliflozin (5 mg) and metformin (1000 mg)
• Jardiance Duo: containing empagliflozin (12.5 mg) and metformin (850 mg)
• Glyxambi: containing Empagliflozin (25 mg) and linagliptin (5 mg)

The doses in these combination products are often arrived at after proper clinical research has shown that it is safe and effective to use the two medications at the chosen doses. 

What Research Says About Twice Daily Dosing Of Jardiance

A study was carried out to ascertain whether taking empagliflozin twice daily works the same as taking the full dose once daily to lower blood sugar (measured by HbA1c) in patients with type 2 diabetes who are already on metformin [3]. 

In the study, 876 patients took empagliflozin split either 12.5 mg morning and night, 5 mg morning and night, 25 mg once daily, or 10 mg once daily, as an add-on to metformin.

After 16 weeks, they compared changes in HbA1c between the twice-daily and full once-daily doses. The results showed the decreases in HbA1c were nearly identical between 12.5 mg twice daily vs 25 mg once daily, as well as between 5mg twice daily and 10 mg once daily. 

All empagliflozin regimens were also well tolerated. It was concluded that in patients already taking metformin, empagliflozin works equivalently to lower blood sugar regardless of whether the daily dose is split across morning/evening or taken fully once a day, providing flexibility in dosing schedules.

Can I Take Jardiance Morning And Night?

No, Jardiance is meant to be taken only once a day and in the morning. It is not recommended to take it twice a day, morning or night. Taking Jardiance at night can disrupt your sleep, as it will make you urinate more frequently [4]. 

The manufacturers of Jardiance state that the pill should be swallowed whole, not split or cut. So, by moving to take it morning and night, you’d have to split the tablet so as to stay within the recommended daily dose. 

This is not advised and should not be done because apart from the fact that the tablet has been coated to either mask taste, make it easier to swallow, or prevent breakdown by stomach acid and enzymes. 

There is also no evidence showing that taking a split Jardiance – 5mg twice daily (for the 10 mg tablet) or 12.5 mg twice daily (for the 25 mg tablet) is safe and effective in controlling blood sugar levels when used alone. 

What Happens If You Take Too Much Jardiance?

If you take more than the recommended doses or Jardiance, you may experience the following side effects:

• Low blood sugar level (hypoglycemia)
• Diabetic ketoacidosis (too much acid in the blood) which can be life-threatening
• Frequent urination
• Dehydration
• Fungal infection affecting the genitals
• Urinary tract infection
• Low blood pressure, etc.

It is highly recommended that you only take the doses of Jardiance advised by your doctor. Do not increase or decrease the dose without informing your healthcare provider.

Final thoughts

The only recommended dosing frequency of Jardiance is once a day and in the morning. Taking it twice a day can lead to overdose which can increase your chances of having side effects like low blood sugar, diabetic ketoacidosis, genital yeast infection, etc. Always take your medications as advised by your healthcare provider.

References

1. Jardiance manufacturer’s official website
2. Sizar O, Podder V, Talati R. Empagliflozin. [Updated 2023 May 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. 
3. Ross S, Thamer C, Cescutti J, Meinicke T, Woerle HJ, Broedl UC. Efficacy and safety of empagliflozin twice daily versus once daily in patients with type 2 diabetes inadequately controlled on metformin: a 16-week, randomized, placebo-controlled trial. Diabetes Obes Metab. 2015 Jul;17(7):699-702. doi: 10.1111/dom.12469. Epub 2015 May 13. PMID: 25827441.
4. ElDash RM, Raslan MA, Shaheen SM, Sabri NA. The effect of morning versus evening administration of empagliflozin on its pharmacokinetics and pharmacodynamics characteristics in healthy adults: a two-way crossover, non-randomised trial. F1000Res. 2021 Apr 26;10:321. doi: 10.12688/f1000research.51114.1. PMID: 34123370; PMCID: PMC8167502.