Jardiance vs. Januvia: 6 Differences Between These Diabetes Medications

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There are many oral medications available to treat Type 2 diabetes. Each class of medications has its distinctions. And this allows for flexibility when it comes to tailoring a medication regimen to your needs. But it can be tricky to remember these differences, especially when two medications have similar names.

Jardiance (empagliflozin) and Januvia (sitagliptin) are two diabetes pills whose names sound a bit alike. It's common for people to confuse them, especially if they're taking both. But these medications have several things that set them apart. Below, we detail six differences to keep in mind when comparing Jardiance versus Januvia.

1. Jardiance and Januvia work differently in the body

One of the major differences between Jardiance and Januvia is how they work. While both help lower blood glucose (sugar), they do this in different ways.

Jardiance is a sodium-glucose cotransporter 2 (SGLT2) inhibitor. It mainly works in your kidneys to remove excess glucose from your bloodstream. This extra glucose then exits your body through urine when you pee. Because of this, it can cause you to urinate more than usual.

Januvia is a dipeptidyl peptidase-4 (DPP-4) inhibitor, or "gliptin" for short. It works by blocking an enzyme (protein) called DPP-4. This enzyme's job in the body is to break down a hormone called glucagon-like peptide-1 (GLP-1). GLP-1 helps regulate blood glucose, digestion, and appetite. By blocking DPP-4, Januvia raises your natural levels of GLP-1, which helps lower blood glucose.

Good to know: Jardiance also works in other ways to treat heart failure and chronic kidney disease (CKD). Some of these actions include taking stress off the kidneys, lowering blood pressure, and reducing inflammation. Januvia doesn't have these additional effects.

2. Jardiance and Januvia are approved for different uses

Jardiance and Januvia also have differences when it comes to their FDA-approved uses. Jardiance has more uses than Januvia.

Jardiance is FDA-approved to:

• Lower blood glucose for adults and children ages 10 and older living with Type 2 diabetes, when paired with a diabetes-friendly diet and regular exercise

• Lower the risk of cardiovascular death for adults with Type 2 diabetes and established heart disease

• Lower the risk of hospitalizations and cardiovascular death due to heart failure in adults

• Lower the risk of worsening kidney function, end-stage kidney disease, hospitalizations, and cardiovascular death in adults with CKD that's likely to get worse

Januvia is only approved to lower blood glucose for adults living with Type 2 diabetes. Like Jardiance, it should be combined with dietary changes and routine exercise. But unlike Jardiance, Januvia isn't approved for children. And it doesn't have additional FDA-approved uses for heart- and kidney-related benefits.

3. Jardiance can be a first-choice option for certain people with Type 2 diabetes

The American Diabetes Association regularly updates its recommendations for managing diabetes. These guidelines include a recommended order for trying certain medications.

For many people, the first-choice medication for managing Type 2 diabetes is metformin. But in certain cases, an SGLT2 inhibitor, such as Jardiance, can be a first-choice option. In particular, Jardiance may be recommended if you have heart failure or cardiovascular or kidney disease (or risks for developing them). That's because it can lower blood glucose and offers heart and kidney protection.

Januvia on its own isn't usually a first-choice medication for treating Type 2 diabetes. It's typically prescribed in combination with other medications to help you reach your target hemoglobin A1C (HbA1c or A1C). Your A1C is a blood test that represents your average glucose level over the past 2 to 3 months. Januvia can offer additional A1C reduction to help you meet your goal.

4. Jardiance may lead to weight loss, while Januvia doesn't usually impact body weight

Some diabetes medications can impact body weight, while others don't typically have much of an effect.

Jardiance can lead to modest weight loss for some people taking it. In studies, people lost about 4 to 6 lbs after taking it for 6 months. But not all people who take Jardiance will lose weight.

Januvia is considered a "weight-neutral" medication. This means it shouldn't cause significant body weight changes. So while you likely won't lose weight taking Januvia, you shouldn't gain any, either.

Many things can contribute to weight changes, including genetics, lifestyle changes, and other medications you take. If weight loss is a health goal for you, it's a good idea to work with your prescriber. Together, you can develop a plan to help you lose or maintain weight.

5. The dosage instructions are slightly different with Jardiance and Januvia

Jardiance and Januvia are both oral tablets that you take once a day. But the instructions for taking them are slightly different.

Jardiance comes as either a 10 mg or 25 mg tablet. It's recommended to take 1 tablet once a day in the morning, with or without food. As we discuss more below, Jardiance makes you pee more often than usual. Taking it in the morning lowers the chance of you waking up to use the bathroom while you sleep.

Januvia comes as 25 mg, 50 mg, or 100 mg tablets. You can take Januvia once a day at any time of day, with or without food. Just make sure you take it at about the same time every day. Januvia doesn't affect how often you urinate. So you can take it in the evening if it's easier to remember it that way.

Another dosage difference comes into play if you have kidney problems. Jardiance doesn't require dosage adjustments if you have kidney problems. But your prescriber may ask you to stop taking it if you have severe CKD or receive dialysis.

On the other hand, Januvia does require dosage changes for people with kidney issues. Depending on your kidney function, your prescriber may lower your dosage. But unlike Jardiance, you can continue taking Januvia if you receive dialysis.

6. Jardiance and Januvia have different side effects

Jardiance's and Januvia's side effects are also different. In some cases, you may tolerate one medication better than the other. The side effects for each medication are outlined in the table below.

These aren't the only possible side effects of Jardiance or Januvia. It's a good idea to discuss their potential risks with your prescriber, along with ways you can manage side effects should they happen.

Can you take Jardiance and Januvia together?

Yes. You can take Jardiance and Januvia together if needed. These medications don't interact with each other. In some cases, a person may need both medications in order to meet their A1C goals. Your prescriber can tell you if this combination may be right for you.

How much do Jardiance and Januvia cost?

Jardiance and Januvia are both brand-name medications. They're covered by most insurance plans, including most Medicare plans. But they may have higher copays than generic medications.

The average cash price for 30 tablets of Jardiance 10 mg is $743.53. The average cash price for 30 tablets of Januvia 100 mg is $705.77.

There is a generic form of sitagliptin available. But this isn't a generic for Januvia. It's an authorized generic of a medication called Zituvio. Both Januvia and Zituvio contain the same active ingredient. Your prescriber may suggest taking Zituvio so you can get a generic medication. The average cash price for 30 tablets of generic sitagliptin 100 mg is $590.90.

How to save on Jardiance and Januvia

There are ways to save on Jardiance and Januvia, which are only available as brand-name medications. GoodRx can help you navigate patient assistance programs and copay savings cards.

• Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $10 for Jardiance or $5 for Januvia using a savings card from the manufacturer.

• Save with patient assistance programs. If you're uninsured or underinsured, you may be eligible for Jardiance's and Januvia's patient assistance programs, which offer the medications free of cost.

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