Rybelsus and Jardiance: Is It Safe? Label, Studies
Often prescribed together; take extra care with fluids and meals when you are sick or eating little.
- Verdict
- Fine with care
- Label names it
- No
- General caution
- Pills absorbed more slowly
Check a GLP-1 interaction
A quick look at Rybelsus
About 1 week is the half-life: half is gone after 7 d, and five half-lives (35 d) leave about 3% behind.
In PIONEER 1, people with type 2 diabetes lost 3.7 kg over 26 weeks, compared with 1.4 kg on placebo.
The maker's price page supplies monthly price points in US dollars: the list price and self-pay offers.
Sources: FDA label (DailyMed), healthsystemtracker.org, Novo Nordisk pricing, Novo Nordisk.
Rybelsus and Jardiance: the verdict
Fine with care
The drug interactions section of the Rybelsus label, word for word:
“Semaglutide cause a delay of gastric emptying and thereby has the potential to impact the absorption of other oral drugs. Levothyroxine exposure was increased 33%”
Source: The FDA label (DailyMed).
What the Rybelsus label says
The Rybelsus label does not name Jardiance (empagliflozin). Those lines still apply to it.
| Named in the label | The risk | What the label tells doctors |
|---|---|---|
| Insulin or sulfonylureas | Low blood sugar | If you use insulin or a sulfonylurea, including glipizide or glimepiride, with Rybelsus, your risk of low blood sugar goes up. The doctor may lower those doses. |
| Oral medicines | Pills absorbed differently | Because Rybelsus slows stomach emptying, the way your body absorbs other pills may change. |
Source: Rybelsus label (DailyMed).
What the studies show
- clinical trials on use with SGLT2 inhibitors:
- A label warning addresses Acute Kidney Injury Due to Volume Depletion
- reduced caloric intake as a ketoacidosis trigger
- volume depletion as a ketoacidosis trigger
Source: The FDA label (DailyMed).
The practical rule
- If food or fluids will not stay down, contact your doctor that day.
- Let your GLP-1 prescriber know about every pill you take, including this one.
- Ask your pharmacist whether any of your pills need to stay at a steady level in the blood. You may need those checks when you begin or raise the dose.
- After every dose increase, and during the first weeks, check your blood sugar more often.
Source: The FDA label (DailyMed).
Jardiance with other GLP-1s
None of the 10 GLP-1 labels lists Jardiance (empagliflozin) in the drug interaction section. Each one gives the same general caution about the pills you swallow, so the answer stays the same for the whole class.
This question also concerns Ozempic, Mounjaro, Trulicity, Victoza.
Source: The FDA label (DailyMed).