Maximum Dose of Jardiance (Empagliflozin)

The maximum recommended dose of Jardiance (empagliflozin) is 25 mg once daily. 1

Dosing Guidelines

The recommended starting dose of Jardiance is 10 mg once daily in the morning, taken with or without food 1
In patients tolerating the initial dose, the dose may be increased to the maximum of 25 mg once daily 1
No dose adjustment is needed for patients with an estimated glomerular filtration rate (eGFR) greater than or equal to 45 mL/min/1.73 m² 1
Jardiance should not be initiated in patients with an eGFR less than 45 mL/min/1.73 m² 1
Jardiance should be discontinued if eGFR is persistently less than 45 mL/min/1.73 m² 1

Assessment of renal function is recommended prior to initiation of Jardiance and periodically thereafter 1
Jardiance is contraindicated in patients with severe renal impairment, end-stage renal disease, or those on dialysis 1
The glucose-lowering efficacy of empagliflozin decreases with declining renal function 2

Jardiance causes intravascular volume contraction which may lead to symptomatic hypotension 1
It is recommended to correct volume depletion prior to initiation of Jardiance 1
Patients at higher risk of hypotension include those with renal impairment, elderly patients, patients with low systolic blood pressure, and patients on diuretics 1

Jardiance may cause genital mycotic infections, particularly in women 2
Risk of euglycemic diabetic ketoacidosis should be monitored, especially in patients undergoing surgery or fasting 2
Patients should be monitored for signs and symptoms of hypotension after initiating therapy 1
Jardiance should be discontinued at least 3 days before planned surgery to prevent postoperative ketoacidosis 2

At the maximum dose of 25 mg daily, empagliflozin has demonstrated:
- Reduction in cardiovascular death by 38% in patients with type 2 diabetes and established cardiovascular disease 3
- Reduction in hospitalization for heart failure by 35% 3
- Reduction in all-cause mortality by 32% 3
- Reduction in incident or worsening nephropathy by 39% 3

Do not initiate Jardiance in patients with eGFR less than 45 mL/min/1.73 m² as it will be ineffective for glycemic control 1
Do not use Jardiance for treatment of type 1 diabetes or diabetic ketoacidosis 1
Be cautious when using Jardiance in patients already on diuretics due to increased risk of volume depletion 1
Monitor for genital mycotic infections, which occur in approximately 6% of patients taking SGLT2 inhibitors compared to 1% on placebo 2