Empagliflozin Dosage

Medically reviewed by Drugs.com. Last updated on Aug 28, 2023.

Usual Adult Dose for Diabetes Type 2

10 mg orally once a day in the morning

• For additional glycemic control in patients tolerating this drug: May increase to 25 mg orally once a day

Comments:

• Assess renal function before starting this drug and as clinically indicated.
• Correct volume depletion before starting this drug.
• Consider using a lower dose of insulin or insulin secretagogue when used in combination this drug.
• Do not use for glycemic control in patients with estimated GFR less than 30 mL/min/1.73 m2.

Uses:

• To reduce the risk of cardiovascular death in patients with type 2 diabetes mellitus and established cardiovascular disease (CVD)
• As an adjunct to diet and exercise, to improve glycemic control in patients with type 2 diabetes mellitus

Usual Adult Dose for Cardiovascular Risk Reduction

10 mg orally once a day in the morning

• For additional glycemic control in patients tolerating this drug: May increase to 25 mg orally once a day

Comments:

• Assess renal function before starting this drug and as clinically indicated.
• Correct volume depletion before starting this drug.
• Consider using a lower dose of insulin or insulin secretagogue when used in combination this drug.
• Do not use for glycemic control in patients with estimated GFR less than 30 mL/min/1.73 m2.

Uses:

• To reduce the risk of cardiovascular death in patients with type 2 diabetes mellitus and established cardiovascular disease (CVD)
• As an adjunct to diet and exercise, to improve glycemic control in patients with type 2 diabetes mellitus

Usual Adult Dose for Heart Failure

10 mg orally once a day in the morning

Comments:

• The risk of volume depletion is higher in patients with heart failure; assess volume status and correct volume depletion if indicated before therapy initiation.

Use: To reduce the risk of cardiovascular death and hospitalization for heart failure in patients with heart failure

Usual Pediatric Dose for Diabetes Type 2

10 mg orally once a day in the morning

• For additional glycemic control in patients tolerating this drug: May increase to 25 mg orally once a day

Comments:

• The risk of hypoglycemia is higher in pediatric patients regardless of concomitant insulin use.
• Consider using a lower dose of insulin or insulin secretagogue when used in combination this drug.

Use: As an adjunct to diet and exercise to improve glycemic control in pediatric patients aged 10 years and older with type 2 diabetes mellitus.

Renal Dose Adjustments

Estimated GFR less than 30 mL/min/1.73 m2:

• For glycemic control in patients without established CVD or cardiovascular risk factors: Not recommended
• In patients with type 2 diabetes and established CVD: Data not available

Estimated GFR less than 20 mL/min/1.73 m2:

• In patients with heart failure: Data not available to support a dosing recommendation

Patients on dialysis: Contraindicated

Pediatric patients with an estimated GFR less than 60 mL/min/1.73 m2: Data not available; this population was not studied

Comments:

• The glucose lowering benefit of empagliflozin 25 mg decreased in adult patients with worsening renal function.
• The risks of renal impairment, volume depletion adverse reactions, and urinary tract infection-related adverse reactions increased with worsening renal function.

Liver Dose Adjustments

Liver dysfunction: No adjustment recommended

Dose Adjustments

Concomitant use of insulin and insulin secretagogues: A lower dose of insulin or an insulin secretagogue may be required to reduce the risk of hypoglycemia.

Precautions

CONTRAINDICATIONS:

• Hypersensitivity to the active component or any of the ingredients; reactions such as angioedema have occurred
• Patients on dialysis

Safety and efficacy have not been established in patients younger than 10 years.

Consult WARNINGS section for additional precautions.

Dialysis

Contraindicated

Other Comments

Administration advice:

• Administer with or without food.
• Missed dose: If a dose is missed, instruct patients to take the dose as soon as possible. Do not double up the next dose.

Storage requirements:

• Store at 20C to 25C (68F to 77F); excursions permitted to 15C to 30C (59F to 86F).

General:

• Limitations of Use:
• This drug is not recommended in patients with type 1 diabetes mellitus; it may increase the risk of diabetic ketoacidosis in these patients.
• This drug is not recommended for use to improve glycemic control in patients with type 2 diabetes mellitus with an estimated GFR less than 30 mL/min/1.73 m2; based on the mechanism of action, it is likely to be ineffective.

Monitoring:

• Infections/Infestations: For signs/symptoms of urinary tract infections (during therapy); patients with history of chronic/recurrent genital mycotic infections
• Metabolic: Volume status (before starting therapy); for signs/symptoms of volume depletion (during therapy); for ketoacidosis (in clinical situations known to predispose ketoacidosis)
• Renal: Renal function (before starting therapy and as clinically indicated)

Patient advice:

• Read the US FDA-approved patient labeling (Medication Guide).
• Check ketones (when possible) if symptoms consistent with ketoacidosis occur, even if blood glucose is not elevated. If symptoms of ketoacidosis (including nausea, vomiting, abdominal pain, tiredness, labored breathing) occur, discontinue this drug and seek medical attention immediately.
• Contact health care provider if symptomatic hypotension occurs. Maintain adequate fluid intake; dehydration may increase the risk for hypotension.
• Seek medical advice if symptoms of urinary tract infection occur.
• Promptly seek medical attention if you develop pain/tenderness, redness, or swelling of the genitals/area from genitals back to rectum, as well as a fever above 100.4F or malaise.
• Immediately report any skin reaction or angioedema and discontinue this drug until you have consulted prescribing health care provider.
• Report pregnancy to health care provider as soon as possible.
• Do not breastfeed during therapy.
• Take this drug only as prescribed. If a dose is missed, take it as soon as you remember; do not double your next dose.

Frequently asked questions

• How long does it take for Jardiance to work?

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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