Managing both heart failure and diabetes means dealing with two serious conditions that demand careful attention. If your doctor recently mentioned Jardiance or Entresto, you’re probably trying to understand which medication addresses which problem and whether you might need one or both.
Here’s what matters most: these medications serve different primary purposes even though they sometimes overlap.
Jardiance was originally developed for diabetes but turned out to have powerful effects on heart failure. Entresto was specifically designed to treat heart failure and has become a cornerstone of modern treatment for this condition.
The decision between them isn’t always either/or. Some people take both because they target heart failure through different mechanisms. Understanding what each medication does, who benefits most from which one, and how they might work together helps you make sense of your treatment plan.
What Jardiance Does
Jardiance belongs to a class called SGLT2 inhibitors, which were initially developed to lower blood sugar in people with type 2 diabetes. The medication works by blocking a protein in your kidneys that reabsorbs glucose from urine back into your bloodstream. When this protein is blocked, excess glucose leaves your body when you urinate.
That was the original purpose.
What researchers discovered through large trials is that Jardiance also significantly reduces hospitalizations for heart failure, even in people who don’t have diabetes. The mechanism isn’t completely understood, but the medication appears to reduce fluid retention, improve how efficiently your heart pumps blood, and decrease strain on your cardiovascular system.
This dual benefit makes Jardiance particularly valuable if you’re dealing with both diabetes and heart failure.
You address two conditions with one medication, which simplifies your treatment regimen and potentially reduces costs compared to taking separate drugs for each problem.
What Entresto Does
Entresto takes a different approach to treating heart failure. It combines two medications in one pill: sacubitril and valsartan. Valsartan blocks a hormone that causes blood vessels to constrict, allowing them to relax and making it easier for your heart to pump blood. Sacubitril prevents the breakdown of beneficial proteins that help your blood vessels stay relaxed and reduce the strain on your heart.
This combination has been shown to reduce hospitalizations for heart failure and decrease the risk of cardiovascular death more effectively than older heart failure medications like enalapril.
Entresto is specifically designed for heart failure with reduced ejection fraction, which means your heart isn’t pumping as much blood with each beat as it should.
If your ejection fraction is low, Entresto can help your heart work more efficiently and reduce symptoms like shortness of breath, fatigue, and swelling in your legs.
When Jardiance Makes More Sense
If you have type 2 diabetes along with heart failure, Jardiance offers the advantage of treating both conditions. Your blood sugar improves while your heart failure symptoms get better.
This dual action means fewer medications to manage and potentially better overall control of your health.
According to the Centers for Disease Control and Prevention (CDC), a staggering 38 million Americans struggle with diabetes, and many of them also develop cardiovascular complications including heart failure. Having one medication that addresses both problems simplifies treatment considerably.
Jardiance also causes modest weight loss, typically four to seven pounds over several months, because you’re losing calories when glucose leaves your body in urine. If you’re carrying extra weight that puts additional strain on your heart, this weight loss provides another benefit.
The medication comes as a once-daily pill, which many people find easier to manage than multiple doses throughout the day.
You take it in the morning with or without food.
When Entresto Makes More Sense
If your primary concern is heart failure rather than diabetes, Entresto has stronger evidence specifically for this condition. The medication was purpose-built to treat heart failure with reduced ejection fraction, and the research supporting its use for this purpose is extensive.
Entresto is particularly important if you’ve been hospitalized for heart failure recently or if your symptoms are getting worse despite other treatments.
The medication can significantly reduce your risk of being hospitalized again and improve your quality of life by reducing symptoms like breathlessness and fatigue.
You take Entresto twice daily rather than once, which requires more attention to timing but ensures consistent medication levels in your system throughout the day.
Using Both Medications Together
Some people take both Jardiance and Entresto because they work through different mechanisms to protect your heart. Entresto helps your heart pump more efficiently by affecting hormones and blood vessel function. Jardiance reduces fluid retention and improves metabolic factors that stress your cardiovascular system.
Combining these medications can provide better results than either one alone, particularly if you have both diabetes and heart failure with reduced ejection fraction.
Your cardiologist will determine whether this combination approach makes sense based on your specific situation, other medications you’re taking, and how well each medication controls your symptoms.
The combination does mean taking more medications and managing more potential side effects, but for people with severe heart failure or poorly controlled diabetes, the benefits often outweigh these inconveniences.
Side Effects to Consider
Jardiance side effects relate primarily to having extra glucose in your urine:
- Genital yeast infections, especially in women
- Urinary tract infections
- Increased urination that can lead to dehydration
- Dizziness when standing up
A rare but serious risk is diabetic ketoacidosis, which can occur even when blood sugar isn’t extremely high.
Symptoms include severe nausea, vomiting, abdominal pain, and confusion requiring immediate medical attention.
Entresto side effects stem from how it affects blood pressure and kidney function:
- Low blood pressure causing dizziness or lightheadedness
- Cough
- Elevated potassium levels
- Worsening kidney function in some people
Entresto can also cause angioedema, which is swelling of the face, lips, tongue, or throat. This is rare but requires immediate medical attention if it occurs.
People who’ve had angioedema with ACE inhibitors shouldn’t take Entresto.
Kidney Function Matters
Your kidney function plays a role in whether you can take these medications and how well they work. Jardiance requires reasonably good kidney function to be effective at lowering blood sugar, though it may still provide heart failure benefits even with reduced kidney function.
Your doctor monitors your kidney function regularly when you take Jardiance.
Entresto can affect kidney function, particularly when combined with other medications that stress the kidneys. People with severe kidney disease may need dose adjustments or might not be candidates for Entresto. Regular blood tests check both kidney function and potassium levels to ensure the medication remains safe.
If your kidney function is declining, your doctor will carefully weigh the benefits of these medications against the risks and may adjust doses or recommend alternatives.
Blood Pressure Considerations
Both medications can lower blood pressure, which is generally beneficial for heart failure but can cause problems if your blood pressure drops too low.
When starting either medication, your doctor monitors your blood pressure closely to ensure it doesn’t fall to levels that cause dizziness, fainting, or inadequate blood flow to vital organs.
If you’re already taking other blood pressure medications, adding Jardiance or Entresto might require adjusting those doses to prevent excessive blood pressure lowering. Some people actually feel better when their blood pressure comes down to healthier levels, experiencing less strain on their heart and improved energy. Others struggle with low blood pressure symptoms and need careful dose management.
Cost Considerations
Both medications are expensive without insurance coverage. On average, Jardiance typically costs $600 to $700 per month. Entresto runs $600 to $650 per month. However, it’s important to note that it could be much more, depending on location.
If you’re taking both, you’re looking at substantial monthly costs unless you have good insurance coverage.
Insurance coverage varies considerably. Some plans place these medications on favorable tiers because they reduce hospitalizations and potentially save the insurance company money long-term. Other plans require extensive prior authorization or make these medications financially difficult to access.
Generic versions aren’t available for either medication, which keeps costs high.
Patient assistance programs from the manufacturers can provide medications at reduced cost or no cost to people meeting income and insurance requirements.
Monitoring Your Treatment
Whichever medication you take, regular monitoring ensures it’s working safely and effectively. For Jardiance, your doctor checks blood sugar levels, kidney function, and watches for signs of infections or dehydration.
For Entresto, blood pressure, kidney function, and potassium levels need regular monitoring.
If you’re taking both medications, the monitoring becomes more comprehensive but follows the same general principles. Your doctor wants to see that your heart failure symptoms are improving, your blood sugar is controlled if you have diabetes, and you’re not developing problematic side effects.
Keep track of symptoms like shortness of breath, swelling in your legs, and how much activity you can manage without feeling exhausted.
These symptom changes tell your doctor whether your heart failure treatment is working effectively.
Your Treatment Decision
The choice between Jardiance and Entresto depends on whether you’re primarily treating diabetes, heart failure, or both conditions. Jardiance excels when you need to address both problems simultaneously.
Entresto is the stronger choice when heart failure with reduced ejection fraction is your main concern.
Many people end up taking both because they provide complementary benefits that together offer better control than either medication alone. Work closely with your cardiologist and endocrinologist if you have both specialists involved in your care. They can coordinate your treatment plan to ensure all your medications work together effectively without creating unnecessary complications or drug interactions.
Managing multiple serious health conditions is challenging. If affording your medications creates additional stress, you don’t have to navigate that alone. The Rx Advocates specializes in connecting people with patient assistance programs for medications like Jardiance and Entresto. We handle the paperwork, work with your doctors to provide necessary documentation, and manage renewals so you maintain continuous access to your medications.
Our service fee starts at $80 monthly for one medication and $90 monthly for two. Contact us online or call us at (844) 559-8331 to learn whether you qualify for programs that can make these essential medications affordable.