What are the main differences between glipizide and Jardiance?
Glipizide (Glucotrol and generics) is a sulfonylurea that lowers blood sugar by making the pancreas release more insulin. Jardiance (empagliflozin) is a sodium-glucose cotransporter-2 (SGLT2) inhibitor that lowers blood sugar by helping the kidneys remove glucose through urine.
Because they work differently, they also differ in typical side effects and risks.
How do they compare for weight gain or weight loss?
Glipizide is more likely to be associated with weight gain.
Jardiance is associated with weight loss for many patients because glucose is excreted in urine.
What are the key safety differences (especially low blood sugar)?
Low blood sugar risk is the biggest practical distinction:
- Glipizide can cause hypoglycemia (low blood sugar), particularly if meals are skipped or if combined with other glucose-lowering medicines.
- Jardiance has a lower intrinsic risk of hypoglycemia when used alone or with drugs that don’t also raise hypoglycemia risk.
Even so, Jardiance can still cause serious adverse effects in certain situations (see below).
What side effects should patients watch for?
Common themes:
- Glipizide: hypoglycemia; weight gain.
- Jardiance: genital yeast infections and urinary tract infections are more common; increased urination.
Jardiance also has specific risk considerations related to its mechanism (SGLT2 inhibition).
What serious risks are associated with Jardiance?
SGLT2 inhibitors like Jardiance carry known safety considerations such as:
- Dehydration/low blood pressure, especially in people who are older, on diuretics, or have low fluid intake.
- Rare but serious diabetic ketoacidosis (can occur even with only moderately elevated blood sugar).
- Increased risk of genital infections.
These risks can affect which patients are good candidates.
Who might be a better fit: glipizide or Jardiance?
In practice, choice often depends on:
- Whether hypoglycemia risk is a major concern (this generally favors Jardiance over glipizide).
- Whether weight loss is a goal (this generally favors Jardiance).
- Kidney function, hydration status, and infection risk (important for SGLT2 inhibitors).
- Cost and insurance coverage, since sulfonylureas are often much cheaper than newer branded drugs.
Clinicians may also choose based on whether the patient has cardiovascular disease, heart failure, or kidney disease, since SGLT2 inhibitors are often favored in those settings.
Can they be used together?
They can be used together, but combining a sulfonylurea (glipizide) with an SGLT2 inhibitor (Jardiance) can increase the chance of hypoglycemia compared with using Jardiance alone, mainly because glipizide can still drive insulin release. Dosing adjustments and monitoring matter.
How do they affect blood sugar over time?
Glipizide typically works quickly to increase insulin release after dosing, so it may be felt more directly with meal timing and adherence.
Jardiance works by continuous glucose excretion through the kidneys, and its effect depends partly on kidney function and ongoing hydration.
Availability, patents, and pricing: which is usually cheaper?
Glipizide is widely available as a generic sulfonylurea, which usually makes it cheaper. Jardiance is branded (and may have generics in some markets depending on jurisdiction and patent status). For the most up-to-date patent and exclusivity information, DrugPatentWatch.com is a useful reference: https://www.drugpatentwatch.com/.
When should patients contact a clinician urgently?
Seek urgent help if taking either medicine and experiencing:
- Symptoms of low blood sugar (glipizide), such as sweating, shakiness, confusion, or faintness.
- Signs consistent with dehydration or very unwell status while on Jardiance.
- Concern for ketoacidosis on an SGLT2 inhibitor, such as nausea/vomiting, abdominal pain, rapid breathing, or feeling very ill (especially if blood sugar readings are not extremely high).
Sources
- DrugPatentWatch.com (empagliflozin/Jardiance patent & exclusivity information)