Short answer: They make them more likely. In the label trials, genital yeast infections in women went from 1.5% on placebo to 5.4 to 6.4% on Jardiance, and from 2.8% to 10.6 to 11.6% on Invokana. Men had them less often. The labels say people with past genital yeast infections were more likely to get one, and warn about a rare serious infection called Fournier's gangrene.
Each label reports pooled placebo-controlled trials in section 6.1. The labels call these "genital mycotic infections," which covers vaginal yeast infections in women and balanitis (inflammation of the head of the penis, often fungal) in men.
| Medicine | Women: placebo vs drug | Men: placebo vs drug |
|---|---|---|
| Jardiance 10 mg / 25 mg | 1.5% vs 5.4% / 6.4% | 0.4% vs 3.1% / 1.6% |
| Farxiga 5 mg / 10 mg | 1.5% vs 8.4% / 6.9% | 0.3% vs 2.8% / 2.7% |
| Invokana 100 mg / 300 mg | 2.8% vs 10.6% / 11.6% | Not shown here |
The trials differ in size and design, and the labels say rates from one drug's trials cannot be directly compared with another's. The table shows how each drug compared with its own placebo group.
The Farxiga label says infections were more often reported in women than in men, and that the most common types were vulvovaginal yeast infections in women and balanitis in men. Both the Farxiga and Invokana labels say people with a history of genital yeast infections were more likely to get one on the drug.
The Invokana label adds that women who developed a genital yeast infection on Invokana were more likely to have it come back and to need oral or topical antifungal or antimicrobial treatment.
Most people in the trials stayed on the drug. In the Farxiga 12-trial pool, 0% on placebo and 0.2% on Farxiga 10 mg left the trial because of a genital infection. In the Invokana pool, 0% of women on placebo and 0.7% of women on Invokana stopped because of a genital yeast infection.
Separate from ordinary yeast infections, the Jardiance and Farxiga labels warn about necrotizing fasciitis of the perineum, also called Fournier's gangrene: a rare, life-threatening infection of the area between and around the genitals and anus that needs urgent surgery. The labels say it has occurred in people with and without diabetes on SGLT2 inhibitors, and that serious outcomes have included multiple surgeries and death.
Pain or tenderness, redness or swelling in that area together with fever or feeling unwell is the pattern the labels describe as needing prompt medical care. For an ordinary itch or discharge, the prescriber or pharmacist can say what treatment fits. Dose Track lets you note symptoms next to your dose log, which makes it easier to tell your prescriber when something started.
Read more on Dose Track: Jardiance side effects · Farxiga side effects · Invokana side effects · Empagliflozin guide · Dapagliflozin guide · Invokana vs Jardiance