Is it safe to skip Jardiance on days when I'm fasting or sick with a stomach bug?

Is It Safe to Skip Jardiance on Days You’re Fasting or Have a Stomach Bug?

If you take Jardiance (empagliflozin) to help manage type 2 diabetes, you may wonder whether it’s okay to miss a dose when you’re fasting or dealing with a stomach virus. Skipping medication can affect your blood sugar control, but so can low fluid intake and illness. Below, we’ll review what’s known about Jardiance, its side effects, and practical guidelines for “sick days” and fasting days. Always work with your health care team to build a personalized plan.

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1. What Is Jardiance and Why It Matters
Jardiance is part of a group of drugs called SGLT2 inhibitors. It helps lower blood sugar by causing the kidneys to remove excess glucose through urine. In large clinical trials, Jardiance has also been shown to reduce the risk of heart failure and kidney complications in people with type 2 diabetes.

Key points:

• Jardiance lowers blood sugar by blocking glucose reabsorption in the kidney.
• It’s proven to improve heart and kidney outcomes in people with diabetes.
• Missing doses can lead to higher blood sugar levels and may reduce these protective effects.

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2. Common Jardiance Side Effects
Like any medication, Jardiance can cause side effects. Knowing these helps you weigh the risks of continuing versus pausing treatment:

• Genital and urinary tract infections: Increased sugar in urine can feed bacteria and yeast.
• Dehydration: Increased urination may lead to low fluid volume, especially if you’re not drinking enough.
• Low blood pressure: Losing water can lower blood pressure, causing dizziness or fainting.
• Euglycemic diabetic ketoacidosis (DKA): A rare but serious state where you produce acid even with near-normal glucose levels—more likely during illness, fasting, or dehydration.
• Increased urination: You may need to go more often, which can compound dehydration if you’re unwell.

Being aware of these helps you spot problems early and decide whether to continue or pause your dose on challenging days.

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3. Fasting and Jardiance—What You Should Know
People fast for various reasons—religious, medical, or weight management. By reducing or eliminating caloric intake, fasting can change how your body processes glucose and fluids.

Potential concerns:

• Hypoglycemia risk: Fasting lowers blood sugar; combining that with a glucose-lowering drug can increase the risk of low blood sugar.
• Dehydration risk: Many fasts limit fluids, which adds to Jardiance’s diuretic effect.
• Ketoacidosis risk: With low insulin levels and reduced carbs, your body may produce ketones. Jardiance can increase this risk even if blood sugar isn’t very high.

General guidance (but check with your doctor):

• If your fasting plan allows fluids, keep drinking water to reduce dehydration.
• Monitor your blood sugar more often—aim for at least before meals and bedtime.
• If you experience dizziness, lightheadedness, or blood sugar below 70 mg/dL, treat per your hypoglycemia plan, and consider pausing Jardiance.
• Discuss planned fasts with your provider beforehand; you may need to adjust the dose or timing.

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4. Sick Days and Stomach Bugs
A stomach flu—vomiting, diarrhea, poor appetite—can disrupt your diabetes care routine:

Why you might pause Jardiance:

• Fluid losses: Vomiting and diarrhea strip your body of water and electrolytes. Jardiance can make this worse.
• Low food intake: Not eating means less glucose entering your system; adding a blood-glucose–lowering drug can lead to hypoglycemia.
• Increased DKA risk: Illness is a known trigger for ketoacidosis when on SGLT2 inhibitors.

When to consider holding Jardiance on a sick day:

• You can’t keep down at least 1–2 cups of fluid per hour.
• You’re eating very little to no solid food for more than 12–24 hours.
• You develop signs of dehydration (dizziness, extreme thirst, dark urine).
• Blood sugar falls below your target range (often < 80 mg/dL) or spikes (often > 300 mg/dL) despite usual measures.

If you pause, resume once you can tolerate fluids, are eating normally, and your blood sugar and kidney function are stable.

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5. Balancing Risks and Benefits
Stopping Jardiance without a plan can lead to higher blood sugar. However, continuing during severe dehydration or fasting may lead to dangerous complications.

Consider these steps:

1. Talk with your provider before any extended fast or if you develop a stomach bug.
2. Have a sick-day plan: Include when to check blood sugar, ketone testing (if advised), and when to hold medications.
3. Stay hydrated: Sip clear fluids (water, broth, electrolyte drinks) regularly.
4. Monitor closely:
   • Blood sugar at least every 4–6 hours.
   • Ketones if you feel unwell and blood sugar is > 250 mg/dL or as your doctor recommends.
5. Know your thresholds: Clear rules for when to treat hypoglycemia, when to call your provider, and when to seek emergency care.

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6. Signs You Need Medical Attention
Whether you’re fasting or fighting a bug, watch for serious warning signs. Contact your doctor or go to the emergency department if you experience:

• Persistent vomiting or diarrhea (> 24 hours).
• Inability to drink fluids without vomiting.
• Symptoms of DKA: nausea, vomiting, abdominal pain, rapid breathing, confusion.
• Blood sugar consistently > 300 mg/dL or < 70 mg/dL that you cannot manage.
• Dizziness, fainting, or rapid heartbeat despite fluid intake.

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7. Practical Tips for Safe Management
• Prep ahead: Keep your provider’s phone number handy.
• Pack a “sick kit”: Juice boxes, glucose tablets, electrolyte packets, ketone strips.
• Set alarms: Reminders for blood sugar checks and fluid breaks.
• Lean on resources: Consider a free, online symptom check, using the doctor approved Ubie Symptom Checker to guide your next steps if you’re not sure what to do.
• Communicate: Let family or friends know your plan so they can help if you get too sick to manage on your own.

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8. Key Takeaways

• Jardiance has benefits beyond blood sugar control, but its diuretic effect and risk of euglycemic DKA mean extra caution during fasting or illness.
• Skipping a dose temporarily may be safer if you can’t eat or drink enough, but always follow a sick-day plan agreed with your provider.
• Maintain hydration and monitor blood sugar (and ketones if recommended) more frequently on challenging days.
• Know when to seek help: severe dehydration, uncontrolled blood sugar, or DKA symptoms warrant prompt medical care.

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9. When in Doubt, Speak to Your Doctor
This information is based on clinical guidelines and Jardiance’s prescribing information. It’s not a substitute for personalized medical advice. If you experience any life-threatening or serious symptoms, contact your health care provider or go to the nearest emergency department right away. Always consult your doctor before making changes to how you take Jardiance or any other medication.