Managing diabetes effectively is crucial, but with so many medications available, choosing the right one can be confusing. Rybelsus and Jardiance are two popular options that often come up and understanding their differences can be challenging. 

Trying to balance the effectiveness, side effects, cost, and how a medication fits into your daily routine is frustrating. Every diabetic’s situation is different, and what works well for one person may not be the best for another.

In this article, you will learn about Rybelsus and Jardiance, two leading diabetes medications. We’ll compare their effectiveness, side effects, and how they fit into your diabetes management plan. Understanding these options can empower you to decide whether you are newly diagnosed or considering a change in your treatment.

Key Takeaways

  • Rybelsus (Semaglutide) mimics the GLP-1 hormone, increasing insulin production and decreasing liver sugar production. Jardiance (Empagliflozin) blocks the SGLT2 protein in the kidneys, which helps the body expel excess glucose through urine. Understanding these mechanisms can help patients choose a medication that fits their health profile.
  • Rybelsus is an oral pill taken once a day, which may be an advantage for patients who prefer not injecting insulin or have a fear of needles. Jardiance is also taken orally once daily, offering a similar benefit regarding ease of administration.
  • Both medications have shown benefits beyond lowering blood sugar levels. Rybelsus has been associated with significant weight loss in some patients, while Jardiance has proven cardiovascular benefits, reducing the risk of heart disease deaths in diabetes patients with heart disease.
  • Potential side effects of Rybelsus include nausea, vomiting, diarrhea, stomach pain, and decreased appetite. Jardiance’s side effects may include urinary tract infections, dehydration, and genital infections. Patients should weigh these potential side effects against the benefits of each medication.
  • The cost and insurance coverage for both medications can vary significantly. Jardiance might be covered under certain insurance plans or have a generic version that reduces the cost. In contrast, Rybelsus is relatively new and may be more expensive or less likely to be covered. Patients must consider their insurance coverage and potential out-of-pocket costs when choosing between these options.

Comparing Rybelsus vs Jardiance

RybelsusJardiance
Drug ClassSGLT-2 inhibitorsIncretin Mimetics (GLP-1 Agonists)
Indications and UsesType 2 diabetes mellitusHeart failure, Type 2 diabetes mellitus, Cardiovascular risk
Limitations of UseNot recommended as first-line therapy, Not studied in patients with a history of pancreatitis, Not for treatment of type 1 diabetes mellitusNot recommended for patients with type 1 diabetes mellitus, Not effective in patients with severe kidney impairment
Age Approval18 years of age and older10 years of age and older
Dosage And AdministrationDaily oral medicationDaily oral medication
Forms and StrengthsOral tablets, Available in the strengths of 3 mg, 7 mg, and 14 mgOral tablets, Available in the strengths of 10 mg and 25 mg
Side EffectsNausea, stomach (abdominal) pain, diarrhea, decreased appetite, vomiting, constipation, amylase and lipase, cholelithiasis (Gallstones), and increases in heart rate.Urinary tract infections, female genital mycotic infections (yeast infections), ketoacidosis (increased ketones in your blood or urine), Dehydration leading to low blood pressure, kidney problems, serious urinary tract infections that may lead to hospitalization, low blood sugar when taken with other diabetes medicines, serious allergic reactions, including anaphylaxis, angioedema, or severe skin reactions, necrotizing fasciitis of the perineum (Fournier’s Gangrene)
Warnings and PrecautionsRisk of Thyroid c-cell tumors, pancreatitis, diabetic retinopathy complications, hypoglycemia with concomitant use of insulin, secretagogues or insulin, acute kidney injury, hypersensitivityKetoacidosis, volume depletion, urosepsis and pyelonephritis, hypoglycemia with concomitant use with insulin and insulin secretagogues, necrotizing fasciitis of the perineum (Fournier’s Gangrene), genital mycotic infections, hypersensitivity Reactions
ContraindicationsPersonal or family history of medullary thyroid carcinoma and patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)Allergic to empagliflozin or any of the ingredients in Jardiance and patients on dialysis
CostIn the US, the price for Rybelsus tablets, whether 3 mg, 7 mg, or 14 mg, is $935.77 per package. However, If you purchase it through Buycandianinsulin.com, it is only $297 for a 30-day supply.Jardiance costs in the US are $2.6177 daily, and the yearly cost is $1,139.33 without additional fees or markups. However, a 30-day supply costs only $139 through Buycanadianunsulin.com.

What is Rybelsus?

Rybelsus is a prescription medication used to manage blood sugar levels in adults with type 2 diabetes mellitus. The FDA initially approved it in 2017. Its active ingredient is semaglutide, which belongs to a class of drugs known as glucagon-like peptide-1 (GLP-1) receptor agonists. 

It works by enhancing the release of insulin—a hormone that lowers blood sugar—when glucose levels are elevated. Additionally, Rybelsus slows down gastric emptying, which helps lower glucose levels after meals. It also inhibits the release of glucagon, a hormone that raises blood glucose levels, thereby further aiding in reducing blood sugar.

What is Jardiance?

Jardiance (empagliflozin) is an oral medication used primarily to treat type 2 diabetes. It works by inhibiting the sodium-glucose co-transporter 2 (SGLT2), a protein in the kidneys responsible for reabsorbing glucose from the urine back into the blood. By blocking SGLT2, Jardiance prevents glucose reabsorption, allowing more glucose to be excreted in the urine, thus lowering blood sugar levels. This mechanism also contributes to reduced sodium reabsorption, which can also affect cardiovascular health.

Jardiance was first approved by the FDA in 2014. It is indicated not only to improve glycemic control in adults with type 2 diabetes but also to reduce the risk of cardiovascular death in adults with type 2 diabetes mellitus and established cardiovascular disease, and for the treatment of heart failure in certain cases.

The recommended starting dose of Jardiance is 10 mg once daily, taken in the morning with or without food. For patients who need additional glycemic control and tolerate the medication well, the dose may be increased to 25 mg once daily. It’s important to assess kidney function before starting Jardiance, as its use is less effective in patients with more severe renal impairment and is not recommended when the eGFR is less than 30 mL/min/1.73 m^2.

Dosage And Administration

Rybelsus

Start Rybelsus with 3 mg once daily for 30 days. The 3 mg dose is intended for treatment initiation and is ineffective for glycemic control. After 30 days on the 3 mg dose, increase the dose to 7 mg once daily. The dose may be increased to 14 mg once daily if additional glycemic control is needed after at least 30 days on the 7 mg dose. Taking two 7 mg Rybelsus tablets to achieve a 14 mg dose is not recommended. If a missed dose, it should be skipped, and the next dose should be taken the following day.

Jardiance

Jardiance tablets are available in 10 mg and 25 mg doses. The initial dose may start at 10 mg once daily in the morning, taken with or without food. If the patient tolerates it well, the dose can be increased to 25 mg daily for improved blood sugar control.

How Effective Are the Rybelsus vs Jardiance in Treating Diabetes?

Rybelsus

Rybelsus is an effective medication that has been found to regulate blood sugar levels among individuals diagnosed with type 2 diabetes. The medication has been tested in various clinical trials, and results have indicated that it significantly lowers blood sugar levels. 

In trials where patients were given Rybelsus without any other diabetes medication, 69% of those who took 7 mg daily and 77% of those who took 14 mg daily achieved blood sugar levels below 7% (measured by hemoglobin A1c) after 26 weeks. These numbers demonstrate Rybelsus’s ability to control blood sugar effectively in people with type 2 diabetes. 

These results significantly improved compared to only 31% of patients who achieved this with a placebo. Therefore, Rybelsus has been highly recommended by medical professionals as an effective medication for controlling blood sugar levels in people with type 2 diabetes.

Jardiance

Jardiance has also shown effectiveness in controlling blood sugar levels in adults with type 2 diabetes. Studies such as the EMPA-REGMONO and EMPA-REG MET trials provide evidence of its effectiveness. For example, in the EMPA-REGMONO trial, Jardiance reduced the average blood sugar level, measured by HbA1c, by up to 0.9% compared to a placebo over 24 weeks. 

Additionally, the drug significantly reduced fasting blood sugar and body weight. In the EMPA-REG MET trial, when used with metformin, Jardiance further reduced HbA1c by up to 0.8% compared to placebo over 24 weeks. 

These results show that Jardiance can be an effective part of diabetes treatment, helping lower blood sugar levels and manage the condition more effectively.

Side Effects of Rybelsus and Jardiance

Below are the side effects of Rybelsus vs Jardiance:

Rybelsus Side Effects

Below are some of the commonly observed side effects of Rybelsus according to a study:

  • Nausea: 20.2% of patients given Rybelsus experienced this, compared to 6.7% of those who received a placebo.
  • Stomach (Abdominal) Pain: 6.9% of patients who took Rybelsus reported this side effect, in contrast to 2.8% of those who were on placebo.
  • Diarrhea: This was observed in 10.5% of patients who were given Rybelsus, as compared to 3.7% of those who received placebo.
  • Decreased Appetite: 8.6% of patients who took Rybelsus reported this side effect, while only 2.2% of those on placebo experienced it.
  • Vomiting: This was experienced by 8.1% of patients who were given Rybelsus, compared to 3.1% of those who were on placebo.
  • Constipation: 7.4% of patients who took Rybelsus reported this side effect compared to 2.6% of those who received placebo.

Apart from these, the clinical trials also showed some other significant findings, including:

  • Increases in Amylase and Lipase: Patients who took Rybelsus at different dosages (7 mg and 14 mg) showed mean increases from baseline in amylase of 10% and 13% respectively, and lipase of 30% and 34% respectively.
  • Cholelithiasis (Gallstones): 1% of patients treated with Rybelsus 7 mg reported this condition.
  • Increases in Heart Rate: Rybelsus 7 mg and 14 mg resulted in a mean increase in heart rate of 1 to 3 beats per minute.

Jardiance

Jardiance (empagliflozin) is associated with several side effects, varying from common to rare. Here are the side effects reported in clinical trials:

Common Side Effects

These occur in more than 5% of patients.

  • Urinary tract infections (UTIs): Observed in approximately 9.3% of patients treated with Jardiance 10 mg and 7.6% with Jardiance 25 mg.
  • Female genital mycotic infections: Found in a significant number of female patients.

Other Side Effects

These include:

  • Ketoacidosis: A serious condition that may require hospitalization.
  • Necrotizing Fasciitis of the Perineum (Fournier’s Gangrene): A rare but serious bacterial infection that destroys tissue under the skin of the perineum.
  • Hypersensitivity Reactions: Including angioedema and serious skin reactions such as Stevens-Johnson syndrome.
  • Volume Depletion: This leads to symptoms like dehydration, hypotension, and renal impairment, especially in patients with preexisting kidney issues, elderly patients, or those on diuretics.
  • Hypoglycemia: Especially when used with insulin or insulin secretagogues.
  • Increased Low-Density Lipoprotein (LDL) cholesterol.

Serious Adverse Reactions

  • Acute Kidney Injury
  • Urosepsis and Pyelonephritis: Serious urinary tract infections that may lead to hospitalization.
  • Hypotension: Mainly in patients treated with diuretics or those with renal impairment.
  • Increased Hematocrit: This could lead to an increased risk of thrombosis.

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Final Thoughts

Choosing between Rybelsus and Jardiance for diabetes management depends largely on individual health needs and preferences. Both medications have proven efficacy in managing blood sugar levels in adults with type 2 diabetes. However, their mechanisms of action and side effects differ, which could influence a doctor’s recommendation.

Rybelsus, taken orally, stimulates insulin production and reduces sugar production in the liver. It’s an option for those who prefer oral medication and may also aid in weight loss, which is beneficial for many type 2 diabetes patients. On the other hand, Jardiance, also taken orally, works by helping the kidneys remove sugar from the body through urine. It has the added benefits of reducing heart disease and kidney damage risk, making it a preferable choice for patients with these concerns.

In conclusion, the decision between Rybelsus and Jardiance should be made in consultation with a healthcare provider, considering all aspects of a patient’s health profile and treatment goals. Both medications offer significant benefits for diabetes management, but the best choice will vary based on individual health situations and treatment objectives.

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FAQs About Jardiance vs Rybelsus

Which is better, Rybelsus or Jardiance?

Both are effective in reducing A1C and blood sugar levels. However, if you have a history of heart disease, your doctor might suggest Jardiance instead of Rybelsus.

How do I choose between Rybelsus or Jardiance?

When choosing between Rybelsus and Jardiance, it is important to consider several factors such as your individual health condition, medical history, lifestyle, and preferences.

What alternative medications are available for Rybelsus?

Some alternative medications for Rybelsus include:

What alternative medications are available for Jardiance?

Some alternative medications to Jardiance (empagliflozin) for treating type 2 diabetes include:

Is it safe to take Rybelsus and Jardiance together?

Taking Rybelsus and Jardiance together can be more effective for your condition and cause fewer side effects than taking either drug alone.

Can I take Rybelsus and Jardiance for weight loss?

Yes, Rybelsus and Jardiance may be used for weight loss as they can help reduce body weight in people with type 2 diabetes, but they should only be used under the guidance of a healthcare provider. According to a study, individuals with an average weight of 202 lost approximately 8.4 pounds while taking 14 mg of Rybelsus and 8.1 pounds while taking 25 mg of Jardiance.

What is empagliflozin 25 mg used for?

Empagliflozin (Jardiance) 25 mg is used to reduce the risk of stroke, heart attack, or death in people with type 2 diabetes and heart/blood vessel disease. It is also used in adults with heart failure to reduce the risk of hospitalization and death related to heart/blood vessel disease.

Can you take Metformin Jardiance and Rybelsus together?

No interactions were detected when metformin, Jardiance, and Rybelsus were taken together.

How many calories does Jardiance burn?

Taking Jardiance can lead to burning 300 calories daily, which may result in losing slightly more than one pound each week.

Does Jardiance reduce abdominal fat?

Specifically, Jardiance may decrease visceral adiposity or abdominal fat. This is significant because individuals with higher levels of abdominal fat are at a greater risk of diabetes, heart disease, and arterial plaque buildup, which can lead to heart attacks and strokes.

Are Jardiance and Rybelsus the same?

Rybelsus and Jardiance function differently in managing blood sugar levels. Consequently, your doctor might prescribe both medications for you. Using Rybelsus and Jardiance together can be more effective for your condition and result in fewer side effects than taking either drug alone.

Can Jardiance increase creatinine levels?

Jardiance can elevate serum creatinine and reduce eGFR. Patients with hypovolemia may be more susceptible to these changes.

Which medication is comparable to Rybelsus?

Rybelsus and Ozempic belong to a class of drugs known as glucagon-like peptide-1 (GLP-1) agonists. GLP-1 agonists, such as Rybelsus and Ozempic, are recommended in the American Diabetes Association (ADA) guidelines for treating type 2 diabetes.

How long should you take Rybelsus?

Typically, you will begin with a low dose of Rybelsus and take it for 30 days. Subsequently, your doctor may increase your dosage. After at least another 30 days, they may further adjust your dosage based on your body’s response to the treatment.

Sources

U.S. Food and Drug Administration. (2019, September 20). FDA approves first oral GLP-1 treatment for type 2 diabetes. https://www.fda.gov/news-events/press-announcements/fda-approves-first-oral-glp-1-treatment-type-2-diabetes

Fala, L. (2015, March). Jardiance (Empagliflozin), an SGLT2 Inhibitor, Receives FDA Approval for the Treatment of Patients with Type 2 Diabetes. American Health & Drug Benefits, 8(Spec Feature), 92–95. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4665046/

Novo Nordisk Inc. (2021). Rybelsus (semaglutide) tablets, for oral use [Prescribing Information]. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/213051s006lbl.pdf

Boehringer Ingelheim Pharmaceuticals, Inc. (2022). Jardiance (empagliflozin) tablets, for oral use: Full prescribing information. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/204629s033lbl.pdf

Novo Nordisk. (2023). RYBELSUS® vs Other Diabetes Pills. Retrieved from https://www.rybelsus.com/why-rybelsus/rybelsus-vs-other-diabetes-pills.html