From the Guidelines
Jardiance (empagliflozin) should be held at least 3 days before surgery, as recommended by the most recent guidelines 1. This recommendation is based on the medication's mechanism of action as an SGLT2 inhibitor, which increases glucose excretion through the kidneys and can potentially lead to volume depletion and electrolyte imbalances. During surgery, these effects could increase the risk of complications like hypotension or acute kidney injury. The medication has a half-life of approximately 12 hours, so stopping 3-4 days before surgery allows adequate time for the drug to be cleared from your system. Some key points to consider when holding Jardiance before surgery include:
- The risk of diabetic and euglycemic ketoacidosis in the perioperative period, which can be mitigated by stopping the medication at least 3 days prior to surgery 1
- The importance of consulting with both your surgeon and the doctor who prescribed Jardiance before making any changes to your medication regimen, as they may have specific instructions based on your individual health situation, the type of surgery you're having, and your diabetes control 1
- The need to receive clear instructions about when to resume taking Jardiance after surgery, which typically occurs once you're eating and drinking normally and your kidney function has been assessed 1 It's also important to note that the blood glucose goal in the perioperative period should be 100–180 mg/dL (5.6–10.0 mmol/L) within 4 h of the surgery, and that stricter perioperative glycemic goals are not advised, as they may not improve outcomes and are associated with more hypoglycemia 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Preoperative Management of Jardiance
- The studies provided do not directly address when to hold Jardiance before surgery 2, 3, 4, 5.
- However, one study discusses pre-operative fasting practices in adult patients having elective surgery, which may be relevant to managing medications like Jardiance before surgery 6.
- According to this study, patients are typically advised to fast from midnight before surgery, but new guidelines recommend fasting from clear fluids for 2 hours and from solids for 6 hours before surgery 6.
- It is essential to note that Jardiance is an oral medication, and its management before surgery should be guided by the healthcare provider's instructions and the hospital's policies.
- The decision to hold Jardiance before surgery may depend on various factors, including the type of surgery, the patient's medical condition, and the anesthesiologist's preferences.
- There is no specific information available in the provided studies on the optimal timing for holding Jardiance before surgery 2, 3, 4, 5.