When managing Type 2 diabetes, weight management often becomes a crucial concern. Jardiance (empagliflozin) and Ozempic (semaglutide) are two medications that have gained attention for their potential weight loss benefits alongside their primary function of blood sugar control. While both drugs assist patients in shedding pounds, their mechanisms of action, effectiveness, and usage differ significantly. This article provides a detailed comparison to help you make an informed decision in consultation with your healthcare provider.
Understanding Jardiance and Ozempic
Jardiance (Empagliflozin)
Jardiance belongs to a class of drugs known as sodium-glucose cotransporter 2 (SGLT2) inhibitors. It functions by preventing the reabsorption of glucose in the kidneys, which results in excess glucose being excreted through urine. By increasing the amount of glucose excreted in the urine, people can see improved blood glucose, some weight loss, and small decreases in blood pressure.
Ozempic (Semaglutide)
Ozempic, on the other hand, is a glucagon-like peptide-1 (GLP-1) receptor agonist. It mimics the GLP-1 hormone to reduce appetite, slow digestion, and regulate blood sugar. This hormone targets areas of the brain involved in appetite regulation, helping individuals feel full sooner and for a longer duration. This reduction in appetite leads to lower calorie intake, promoting weight loss.
How They Work: Mechanisms of Action
The primary distinction between Ozempic® and Jardiance® lies in their mechanisms of action. While Ozempic® operates by mimicking GLP-1, Jardiance® works by inhibiting SGLT2.
Jardiance's Mechanism
Glucose in the bloodstream passes through the kidneys, where it can either be excreted in the urine or reabsorbed back into the blood. Sodium-glucose cotransporter 2 (SGLT2) works in the kidney to reabsorb glucose. Jardiance® is an SGLT2 inhibitor that has been approved by the Food and Drug Administration (FDA) to treat type 2 diabetes. By hindering this protein’s function, Jardiance® allows for more glucose to be excreted in urine, helping to lower blood glucose levels.
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Ozempic's Mechanism
Ozempic lowers blood sugar levels by mimicking the effects of GLP-1, a naturally occurring hormone that stimulates insulin secretion and lowers glucagon secretion from the liver. GLP-1 is released by special cells in your intestines after you eat. These cells respond to nutrients and send signals that help manage digestion and appetite.
Weight Loss Effectiveness: Comparing Results
Both medications have been shown to aid in weight loss, but the extent of their effectiveness varies.
Weight Loss with Jardiance
Clinical studies indicate that patients taking Jardiance can expect to lose about 2 to 3% of their starting weight over 6 months to a year when combined with healthy eating and physical activity. This translates to approximately 4 to 6 pounds after six months of treatment. The weight‑loss results with Jardiance are steady but limited because its primary function is to control blood sugar levels.
Weight Loss with Ozempic
Studies reveal that patients using Ozempic can lose significantly more weight compared to those on Jardiance. In clinical trials, people taking semaglutide (2.4 mg) lost an average of 15% of their starting weight over about 68 weeks, with some losing even more. For a 200-pound person, that’s around 30 pounds. While Ozempic was also initially developed as a diabetes medication, it has proven to be highly effective at dramatic weight loss.
Additional Health Benefits
While weight loss is a significant concern, both medications offer additional health benefits that might influence your choice.
Read also: Ozempic Meal Plan
Cardiovascular Benefits
Jardiance is particularly noted for its cardiovascular benefits. It has demonstrated a significant reduction in risk of cardiovascular death by approximately 38% when compared to placebo in patients with Type 2 diabetes and established cardiovascular disease. Jardiance has also demonstrated reduced risk of the composite endpoint of cardiovascular death or rate of hospitalization for heart failure in patients with congestive heart failure, and slowed decline in kidney function.
Ozempic also offers cardiovascular benefits, including a reduction in major adverse cardiovascular events like heart attack or stroke. An advantage of both medications is that they have been shown to carry clear benefits beyond glucose control in those with Type 2 diabetes, particularly as it relates to the prevention of major adverse cardiac events and chronic kidney disease.
Glycemic Control and Cholesterol
Ozempic helps with glycemic control and has a favorable impact on cholesterol levels.
Kidney-Related Outcomes
Research suggests that Jardiance® might have a beneficial impact on kidney-related outcomes and is believed to slow the progression of kidney disease in those with type 2 diabetes. Moreover, it is thought to reduce the risk of kidney disease progression, cardiovascular death, and hospitalization for heart failure. Recent studies have also suggested potential renal benefits from Ozempic, such as reducing albuminuria (a marker of kidney disease), although more research is required in this area.
Side Effects: What to Expect
Jardiance Side Effects
Jardiance’s side effects include urinary tract infections and vaginal yeast infections. Common effects include more frequent urination, urinary tract infections, and genital yeast infections. Some patients might also experience dehydration, especially if they do not maintain adequate fluid intake. Serious side effects are possible with either drug, including serious allergic reactions and low blood sugar (hypoglycemia). In addition, Jardiance may interact with diuretics, also known as water pills. Jardiance may interact with lithium, a mood stabilizer used to treat manic episodes of bipolar disorder. The use of Jardiance may increase the risk of a serious condition called diabetic ketoacidosis, especially in those with Type 1 diabetes or who are at risk for ketoacidosis. Before starting Jardiance, hydration levels and kidney function may need to be checked, especially in older adults or those with kidney issues.
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Ozempic Side Effects
Ozempic’s side effects are often related to its impact on the gastrointestinal system. These can include nausea, vomiting, diarrhea, and constipation, especially when starting the treatment. These are often most noticeable when starting or increasing the dose and usually improve over time. However, these symptoms often decrease over time. Given the nature of its route of administration, Ozempic may also cause some minor injection site reactions.
Administration and Dosage
Jardiance Administration
Jardiance is taken as an oral tablet, usually once daily in the morning, with or without food. This convenience can be a significant factor for many patients. It comes in two strengths, 10 mg or 25 mg, and the doctor will typically start the patient on the lower strength before adjusting as required.
Ozempic Administration
Ozempic is administered via a weekly subcutaneous injection, usually injected into the abdomen, thighs, or upper arms. Ozempic® is prescribed as a once-weekly injection and is usually started at a lower dose of 0.25mg for four weeks, followed by an increase to 0.5mg. Optionally, the dosage can increase to 1mg if additional blood sugar control is needed. While the idea of self-injecting can be scary, the once-weekly schedule is often more convenient than daily medications.
Drug Interactions
Ozempic Interactions
Ozempic and Jardiance can interact with similar classes of drugs. They can both interact with insulin and medications that increase insulin release, such as sulfonylureas. Because Ozempic slows the emptying of the stomach, it may affect the absorption of oral medications. Therefore, it’s recommended to use caution when using Ozempic alongside medications taken by mouth. Alcohol may affect blood glucose levels in patients with diabetes. Food may affect the absorption of semaglutide when taken orally.
Jardiance Interactions
Unlike Ozempic, Jardiance may interact with diuretics, also known as water pills. In addition, Jardiance may interact with lithium, a mood stabilizer used to treat manic episodes of bipolar disorder.
Potential Risks and Warnings
Ozempic Warnings
Ozempic, in particular, carries a boxed warning (also called a black box warning) for an increased risk of thyroid cancer. This risk is increased in people with a personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2).
Jardiance Warnings
The use of Jardiance may increase the risk of a serious condition called diabetic ketoacidosis, especially in those with Type 1 diabetes or who are at risk for ketoacidosis. Before starting Jardiance, hydration levels and kidney function may need to be checked, especially in older adults or those with kidney issues.
General Warnings
Ozempic and Jardiance are not recommended during pregnancy due to the risk of birth defects.
Cost and Availability
Both Ozempic and Jardiance are only available as brand-name medications at this time.
Jardiance Cost
Jardiance has a list price of about $630 per month. On average, the out-of-pocket cost of Jardiance® without insurance is generally lower, averaging around $600 to $700 for a one-month supply without insurance.
Ozempic Cost
Ozempic averages around $997 per month without insurance, regardless of the dosage strength. On average, the out-of-pocket cost of Ozempic® without insurance can range from $800 to $900 for a one-month supply.
Insurance Coverage
Most Medicare and insurance plans cover these medications when prescribed to treat Type 2 diabetes. Coverage is possible for type 2 diabetes, but rare for weight loss. However, without insurance coverage, the retail or cash price of these medications may be high for some people. You can save on the cash price of these medications through savings options, such as the SingleCare prescription discount card.
Combining Ozempic and Jardiance
Typically, Ozempic® and Jardiance® can be taken together to manage blood sugar levels if monotherapy does not yield the desired results. As they have different mechanisms of action, they can act on various aspects of glucose regulation and possibly offer a more comprehensive approach to blood sugar control. Adding a medication like Jardiance® to Ozempic® therapy could provide additional cardiovascular benefits, particularly in those with heart failure or a high risk of cardiovascular disease. However, this combination therapy may increase the risk of potential side effects. It’s important that this decision should be based on careful evaluation of multiple factors including individual response, tolerance, adherence to therapy, cost considerations, and most importantly, the patient’s overall safety.
Who Should Not Take These Medications?
Choosing a medication should always be individualized, considering a person’s health history, current conditions, and their lifestyle.
When to Avoid Ozempic
Ozempic is not recommended for individuals with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 (genetic disorders that increase the risk of certain tumours). It is also not advised for those with severe gastrointestinal disease or with hypersensitivity to semaglutide or any of its components.
When to Avoid Jardiance
Jardiance, on the other hand, should not be used in individuals with severe kidney disease or dialysis-dependent kidney failure, severe urinary tract infections or a history of ketoacidosis. It is also not for people with hypersensitivity to empagliflozin. Pregnant women or those planning to become pregnant should discuss with their health care provider before starting either of these medications.
Unique Benefits of Each Medication
While both Ozempic® and Jardiance® aim to control blood sugars in those with type-2 diabetes, they offer unique benefits.
Ozempic's Unique Benefits
Ozempic has been highlighted for its robust impact on blood sugar control and promoting weight loss. Its once-weekly dosing can also be convenient for those who struggle to remember daily medication doses. Besides, it has shown potential cardiovascular benefits in reducing the risk of major cardiovascular events such as heart attack, stroke, and cardiovascular death.
Jardiance's Unique Benefits
Jardiance is known for its cardiovascular benefits - particularly for reducing the likelihood of hospitalizations due to heart failure. It can also confer kidney-protective benefits and slow the progression of kidney disease in those with type 2 diabetes, a welcome benefit as kidney disease is a common complication of the condition. As an oral medication, it might be more appealing to those wary of injections.
Making the Right Choice
When it comes to weight loss, both Jardiance and Ozempic offer results, but they serve different needs and preferences. Jardiance only offers mild weight loss because its primary function is to control blood sugar levels. Meanwhile, while Ozempic was also initially developed as a diabetes medication, it has proven to be highly effective at dramatic weight loss.
Ultimately, the decision should be made in consultation with your healthcare provider, who can help you weigh the benefits and drawbacks based on your specific health profile and treatment goals. Before starting either Jardiance® or Ozempic®, your provider will review your health history, current conditions, and personal goals.