Recommended Dosing for Jardiance (Empagliflozin) in Type 2 Diabetes
The recommended dose of Jardiance (empagliflozin) for adults with type 2 diabetes is 10 mg once daily taken in the morning, with or without food, with the option to increase to 25 mg once daily if additional glycemic control is needed. 1, 2
Dosing Guidelines
- Starting dose: 10 mg once daily in the morning
- Dose titration: May increase to 25 mg once daily if additional glycemic control is needed
- Administration: Can be taken with or without food
Renal Function Considerations
- eGFR ≥45 mL/min/1.73 m²: No dose adjustment required 2
- eGFR <45 mL/min/1.73 m²: Not recommended for initiation for glycemic control 2, 1
- eGFR <30 mL/min/1.73 m²: Contraindicated 2, 1
- Dialysis patients: Contraindicated 2
Special Considerations for Specific Indications
- For cardiovascular risk reduction: 10 mg daily is sufficient for patients with established cardiovascular disease or heart failure with reduced or preserved ejection fraction 2
- For glycemic control: Start with 10 mg, may increase to 25 mg if needed 2, 1
Monitoring Recommendations
Before initiation:
- Assess renal function
- Evaluate volume status, especially in patients with renal impairment, the elderly, those with low systolic blood pressure, or patients on diuretics 1
After initiation:
- Monitor for signs of hypotension
- Watch for genital mycotic infections (more common side effect)
- If patient is on insulin or sulfonylureas, consider reducing doses of these agents to minimize hypoglycemia risk 2
Clinical Efficacy
Common Side Effects
- Urinary tract infections
- Female genital mycotic infections 1
- Risk of hypotension (generally low but should be monitored)
Important Warnings
- Ketoacidosis: Assess patients who present with signs of metabolic acidosis regardless of blood glucose level 1
- Acute kidney injury: Consider temporarily discontinuing in settings of reduced oral intake or fluid losses 1
- Surgery: Discontinue at least 3 days before planned surgery to prevent postoperative ketoacidosis 2
Empagliflozin's unique mechanism of inhibiting glucose reabsorption in renal tubules provides an insulin-independent approach to lowering blood glucose, making it a valuable addition to the therapeutic options for type 2 diabetes management 5.