Rybelsus and Jardiance are brand names for prescription drugs used to help control blood sugar in adults with type 2 diabetes. The American Diabetes Association (ADA) guidelines recommend using these medications in combination with diet and exercise.
Here we will explain how they work, their similarities and differences, their side effects, and more. This should provide you with the basics to better understand your options.
What is Rybelsus?
Rybelsus (oral semaglutide) is an FDA (U.S. Food and Drug Administration) approved medication manufactured by Novo Nordisk Inc. It is given to adults with type 2 diabetes to help lower their blood sugar (glucose) when used with exercise and diet changes. It is a non-insulin medication that causes your pancreas to produce more insulin, helping to lower your blood glucose levels. You take Rybelsus in tablet form, usually once a day when you first wake up but make sure you always use your Rybelsus as directed by your doctor or pharmacist.
The active ingredient in Rybelsus is called semaglutide. It’s a non-insulin drug that can help lower your blood glucose levels by stimulating the cells in your pancreas that produce insulin (called beta cells). When you take Rybelsus, semaglutide molecules attach to beta cells in your pancreas at sites called glucagon-like peptide-1 receptors (it is classed as a GLP-1 receptor agonist). The semaglutide stimulates these receptors, which makes the beta cells produce more insulin, helping to lower your blood sugar after you’ve eaten.
Semaglutide also encourages the growth of more beta cells in your pancreas, allowing your pancreas to produce higher levels of insulin, reversing any declines in your body’s insulin production.
Rybelsus dosage
Rybelsus is available in tablet form, in the following doses: 3 mg, 7 mg, and 14 mg.
Take Rybelsus at least 30 minutes before your first food, beverage, or other oral medications of the day with not more than 4 ounces of water only. Swallow the tablets whole. Do not cut, crush, or chew the tablets. The starting dosage is 3 mg once daily for 30 days, followed after 30 days by an increase to 7 mg once daily. The dose may be increased to 14 mg once daily after another 30 days if needed.
What is Jardiance?
Jardiance is an FDA (U.S. Food and Drug Administration) approved medication manufactured by Boehringer Ingelheim Pharmaceuticals, Inc. It is prescribed to adults with type 2 diabetes to lower blood sugar levels and reduce the risk of heart attacks and death due to cardiovascular disease.
The medication can help you lower your blood sugar levels when taken alongside dietary and lifestyle changes. It causes you to excrete more sugar in your urine than you would normally. This lowers your blood sugar and helps to reduce your risk of health conditions like cardiovascular disease. Jardiance comes as a tablet you swallow with water.
The active ingredient in Jardiance is called empagliflozin. It is classed as a sodium-glucose co-transporter 2/SGLT-2 inhibitor. It lowers your blood sugar levels by causing you to lose more sugar in your urine than you usually would. Empagliflozin is also available in combination with metformin as Synjardy, Synjardy XR, and Glyxambi.
Your kidneys help recycle sugar back into your blood from your urine, with the help of a protein called SGLT-2. Empagliflozin blocks this protein from working, reducing how much sugar your kidneys recycle. This makes you lose more sugar in your urine, rather than it being excreted back into your blood.
Jardiance dosage
Jardiance is available in tablet form, in the following doses: 10 mg, and 25 mg. The recommended dose is 10 mg once daily, in the morning, with or without food. The dose may be increased to 25 mg once daily.
Common side effects of Rybelsus and Jardiance
The most common side effects of Rybelsus in clinical trials compared to placebo include:
- Nausea, vomiting
- Stomach (abdominal) pain
- Constipation
- Diarrhea
- Decreased appetite
- Weight loss
More serious side effects of Rybelsus include:
- An increased risk of thyroid tumors, including cancerous tumors
- Inflammation of your pancreas (pancreatitis)
- Diabetic retinopathy and other vision problems
- Very low blood sugar (hypoglycemia)
- Severe allergic reactions to the medication that can cause itching, rashes, swelling, and difficulties breathing
The most common side effects of Jardiance in clinical trials include:
- Genital yeast infections (thrush) in both men and women
- Needing to urinate more often and urinating more than usual
- Feeling more thirsty than usual
- Itching
- A skin rash – this may be itchy and include raised bumps and blisters that leak fluid, and may cause your skin to redden
- An increase in cholesterol levels (this may show up in blood tests)
More serious side effects of Jardiance include
- Severe allergic reactions to the medication
- A rare but serious bacterial infection that damages tissue under the skin (necrotizing fasciitis) in the area between the anus and genitals (perineum)
- Diabetic ketoacidosis, is a potentially life-threatening condition where your body breaks down too much fat too quickly, causing you to produce high levels of blood acids called ketones
- Hypoglycemia – your blood sugar falling too low – particularly when used with other medications like insulin or sulfonylurea
- An increased risk of serious urinary tract infections
- A high and potentially harmful increase in your cholesterol levels
- Dehydration
These aren’t all the side effects Rybelsus or Jardiance can cause. You can find more details in the patient leaflet that comes with your medication. If you have any concerns about side effects, talk to your physician or a pharmacist.
Rybelsus and Jardiance drug interactions
Rybelsus can interact with other medications. These include:
- Insulin – Rybelsus can be used alongside insulin, but your doctor may change the dose of insulin you take and/or how often you take insulin
- Any other medications taken to treat type 2 diabetes, like sulfonylureas
- Any medications you take by mouth to reduce the risk of blood clots (oral anticoagulants) like warfarin
- Diuretics, taken to make you lose water and salt, usually to treat high blood pressure – bumetanide, furosemide
- Corticosteroids such as cortisone and prednisolone
- Beta 2-stimulants, taken to treat asthma – salmeterol
- Antipsychotics – clozapine
- Estrogen-containing drugs including birth control and hormone replacements
Jardiance can interact with other medications. These include:
- Any other diabetes medications, like insulin or sulfonylureas
- Beta-blockers
- Calcium channel blockers
- Diuretics
- ACE inhibitors
- Corticosteroids
- Anticonvulsants
Rybelsus and Jardiance can interact with other medications. This can change how Rybelsus and Jardiance and other medications work and can make side effects more likely. Tell your prescribing physician about all your drugs, including vitamins and dietary supplements.
Rybelsus and Jardiance contraindications
Don’t take Rybelsus if you:
- Are allergic to the active ingredient semaglutide
- Are allergic to any of the other ingredients in Rybelsus
- Have had a type of thyroid cancer called medullary thyroid carcinoma (MTC)
- Have an endocrine system condition called multiple endocrine neoplasia syndrome type 2 (MEN 2)
- Have pancreatitis (inflammation of your pancreas)
- Have type 1 diabetes (Rybelsus is for type 2 diabetes only)
- Are under 18 years of age
Talk to your doctor before taking Rybelsus if you:
- Are taking any of the medications that could interact with Rybelsus
- Have had any problems with your pancreas
- Have kidney disease
- Have or have ever had any problems with your eyes, including cataracts or glaucoma
- Are pregnant or are planning to become pregnant
- Are breastfeeding or are planning to breastfeed
Don’t take Jardiance if you:
- Are allergic to the active ingredient empagliflozin
- Are allergic to any of the other ingredients in Jardiance
- Have type 1 diabetes (Jardiance is for type 2 diabetes only)
- Are under 18 years of age
Talk to your doctor before taking Jardiance if you:
- Have any liver or kidney problems
- Have or have ever had problems with your pancreas, like pancreatitis or surgery on your pancreas
- Have a history of urinary tract infections or any problems with urination
- Often drink alcohol, or drink a lot of alcohol in a short period of time (“binge” drinking)
- Are going to have surgery in the near future
- Are eating less than usual or have changed your diet
- Are pregnant or are planning to become pregnant
- Are breastfeeding or are planning to breastfeed
Other treatments for type 2 diabetes
If you have any concerns about Rybelsus or Jardiance side effects, talk to your physician, or pharmacist for medical advice. Also inform your healthcare provider about any medical conditions, supplements, and over-the-counter meds you are taking. You are also encouraged to report side effects to the FDA: visit http://www.fda.gov/medwatch or call 1-800-FDA-1088.
