Jardiance for congestive heart failure: pros and cons?

My cardiologist put me on Jardiance with my Entresto as Jardiance was seen to help improve cardiac health. I was, but not now, a type 2 diabetic (from high steroids for asthma). Since decreasing my steroids, type 2 DM has gone away. However, he still stresses the positive effects of Jardiance on cardiac health. He also prescribed Spironolactone at a low dose, as it preserves potassium while having diuretic properties. Thankfully, the Entresto and combination of lifestyle change, along with decreased steroids, have helped bring up my EF.
Good luck.

@bettycll
Jardiance has helped me (I think). I have HFpEF and Congestive Heart Failure II/C. Jardiance caused me to lose weight really fast (and maybe too much). I was a little bit overweight but I had a lot of muscles and am broad shouldered. It caused me to lose weight every day all the way to my lowest dry weight but I also lost all my muscles and strength. Jardiance also did not lower my diastolic blood pressure. It took a low dose of a beta blocker(metoprolol) to do that.

I just came on this thread again, and wanted to add a caution about paying attention to side effects that have been reported for the SGLT-2 inhibitor drugs like Jardiance. It looks as though from reading this thread Jardiance has been a godsend to quite a number of patients, as it effectively treats the condition for which it was prescribed, and thank goodness for that.

But some serious side effects for these drugs are listed in the literature, and while these are hopefully rare, I can attest that they can happen. My brother (age 73) was on one of the SGLT-2 inhibitor drugs for treatment of type 2 diabetes, and possibly to treat heart failure, since he had that too. I don't know which drug it was. He developed a perianal abscess attributed to the drug, waited too long to get medical help ( he thought he had hemorrhoids), developed necrotizing fasciitis in the area ( Fournier's gangrene), and passed away from sepsis from this condition. He was in immense pain throughout this ordeal, and it was too late to do much for him when he got to the hospital. I'm still in shock over what happened to him.
I'd hope this is rare enough that most people on these drugs would not have this or any of the other serious side effects listed in the literature or package inserts happen to them. But it's a good idea to be aware that it could happen, and in the event it does, getting medical help early on is the key to recovering from these conditions.

Thank you to both mikeydc2008 and to marybird. I still have not taken Jardiance. All of your comments are very helpful. My nephrologist has now decided that Jardiance would not be a good option for me because I was on another (less expensive) SGLT-2 inhibitor drug, and my creatinine level increased. She had me discontinue it, and my creatinine level decreased. So, she is no longer recommending a SGLT-2 inhibitor drug, due to my kidney issues. However, I see my cardiologist this week. Since I have HFpEF, he wants me on an SGLT-2. Reading the side effects mentioned here, I may err on the side of caution and not take it. By the way, I asked my primary his opinion, he has a relative who also passed away due to necrotizing fasciitis, described by Marybird. Without another echo, I don't have any idea how bad my diastolic dysfunction is (a few months ago it was diagnosed as Grade 3 Severe. So, I am still in a bit of a quandary - I highly appreciate everyone who has responded with their experiences.

I am so thankful for all the comments Re: Jardiance in the past year. I started on it Jan of 2025 and it's been going very well along with the Entresto. My SOB
has improved greatly and I feel so much better overall. I have not experienced any side effects to the Jardiance as of now, thankfully. Lightheadedness, SOB with exertion (climbing steps) and bendopnea are my biggest challenges with HF, but all and all, I'm most grateful for my life.
Wishing the best of Holidays to everyone and a great and healthy New Year!!

@bettycll in your shoes I'd probably not want to take another SGLT-2 drug either, with the evidence you have of the drug adversely affecting your kidney function, so much that your nephrologist took you off the drug. It's hard to imagine your cardiologist wanting you to take a drug that affects your kidney that way, if he/she knew of the effects of the drug on your kidney. You might have that talk with your cardiologist, and see what he/she says.

Are you taking other drugs for your heart failure?

@joyh That's great to hear!!! Wishing you a Merry Christmas and Happy healthy New Year too!

@marybird
No, I am not taking any other drugs for heart failure. I take Metoprolol, but I have been taking that prior to knowing about the HF. My cardiologist added Lasix - but I only take it every other day, due to balancing kidney issues with cardiac issues. I had been on multiple meds for my AFib (nothing worked). After an AV Node Ablation, I am now off those. I do plan to talk with my cardiologist. My nephrologist wants to wait for 3 months to see how things progress; then she may update her decision about the SGLT-2 because they ARE supposed to be helpful to the kidneys. It is difficult balancing multiple health issues and multiple specialists! As you can probably tell from my 'name', I am also seeing an oncologist! Thanks for sharing your time and experience.

@joyh
Great to know that your SOB has improved with Jardiance. My SOB with exertion is my biggest issue. Thanks for sharing! Wishing you - and all - the best of Holidays and a Healthy New Year!

@bettycll

It's a new drug, so no one knows what the long-term consequences are. It initially was for the kind of heart failure with low and lowering ejection fraction and was not recommended for heart failure with PRESERVED ejection fraction (HFpEF). Fairly recently, "they" have decided that those of us who have HFpEF should take it, too, and say that it is helping significantly.

Nonetheless, my cardiologist with 30 years experience will not prescribe it, because she has concerns about the side effects and long-term effects. I think she's right.

Most important, though, is your kidneys, and it seems clearly contraindicated in your case, as your doctor says. Maybe ask what you can do to slow the progression or whether there's any way to reduce the severity?