From the Guidelines
Jardiance (empagliflozin) is contraindicated in patients with severe renal impairment (eGFR less than 45 mL/min/1.73 m²), end-stage renal disease, or those on dialysis, as well as in patients with a history of serious hypersensitivity reactions to the drug 1. The contraindications for Jardiance are primarily focused on patients with severe kidney disease or those undergoing dialysis.
- Severe renal impairment (eGFR less than 45 mL/min/1.73 m²) is a contraindication due to the increased risk of adverse effects and reduced efficacy of the medication in this population 1.
- End-stage renal disease and dialysis are also contraindications, as the medication's efficacy and safety have not been established in these settings 1.
- A history of serious hypersensitivity reactions to empagliflozin is another contraindication, as it may indicate an increased risk of allergic reactions to the medication 1. It is essential to carefully evaluate the patient's kidney function and medical history before initiating Jardiance therapy to minimize the risk of adverse effects and ensure the safe use of the medication.
- Patients with a history of genital mycotic infections may be at higher risk for recurrence, but this is not an absolute contraindication 1.
- Jardiance should be used cautiously in patients with volume depletion, hypotension, or electrolyte imbalances, and temporary discontinuation is recommended during periods of reduced oral intake or fluid losses 1.
From the FDA Drug Label
4 CONTRAINDICATIONS
History of serious hypersensitivity reaction to empagliflozin or any of the excipients in JARDIANCE [see Warnings and Precautions (5.7)]. Severe renal impairment, end-stage renal disease, or dialysis [see Use in Specific Populations (8.6)]. Use of JARDIANCE is not recommended when eGFR is persistently less than 45 mL/min/1.73 m2 and is contraindicated in patients with an eGFR less than 30 mL/min/1. 73 m2
The contraindications for Jardiance (empagliflozin) are:
- History of serious hypersensitivity reaction to empagliflozin or any of the excipients in JARDIANCE
- Severe renal impairment, end-stage renal disease, or dialysis
- eGFR less than 30 mL/min/1.73 m2 2
From the Research
Jardiance Contraindications
The provided studies do not directly address the contraindications of Jardiance (empagliflozin). However, we can look at the potential risks and side effects associated with empagliflozin:
- Diabetic Ketoacidosis: Empagliflozin has been associated with an increased risk of diabetic ketoacidosis, a serious condition that can be life-threatening if not treated promptly 3.
- Acute Kidney Injury: While empagliflozin has been shown to have beneficial effects on kidney outcomes, it can also increase the risk of acute kidney injury, particularly in patients with pre-existing kidney disease 4, 3.
- Hypotension: Empagliflozin can cause symptomatic hypotension, particularly when used in combination with other medications that lower blood pressure 5.
- Hyperkalemia: Empagliflozin can also increase the risk of hyperkalemia, particularly in patients with pre-existing kidney disease or those taking other medications that increase potassium levels 5.
Special Considerations
When considering the use of Jardiance, the following special considerations should be taken into account:
- Kidney Function: Empagliflozin is not recommended for patients with severe kidney impairment or those on dialysis 6, 4.
- Pregnancy and Lactation: The safety of empagliflozin in pregnant or breastfeeding women has not been established, and its use should be avoided in these populations unless the benefits outweigh the risks.
- Drug Interactions: Empagliflozin can interact with other medications, including diuretics, ACE inhibitors, and angiotensin receptor blockers, which can increase the risk of side effects such as hypotension and hyperkalemia 3, 5.