Jardiance (Empagliflozin) Dosage for Type 2 Diabetes
The recommended dosage of Jardiance (empagliflozin) for type 2 diabetes is 10 mg once daily in the morning, taken with or without food, with the option to increase to 25 mg daily if tolerated. 1
Standard Dosing Guidelines
- Initial dose is 10 mg once daily in the morning, with or without food 1
- Dose may be increased to 25 mg once daily in patients who tolerate the medication well and need additional glycemic control 1
- No dose adjustment is needed for patients with eGFR ≥45 mL/min/1.73 m² 1
Renal Function Considerations
- Assessment of renal function is recommended before starting Jardiance and periodically thereafter 1
- Jardiance should not be initiated in patients with eGFR <45 mL/min/1.73 m² 1, 2
- Discontinue Jardiance if eGFR persistently falls below 45 mL/min/1.73 m² 1
- Contraindicated in patients with severe renal impairment, end-stage renal disease, or those on dialysis 1
Special Considerations
- For patients with volume depletion, correct this condition prior to initiation of Jardiance 1
- Monitor for signs and symptoms of hypotension after initiating therapy, especially in patients with renal impairment, elderly patients, those with low systolic blood pressure, or patients on diuretics 1
- Discontinue Jardiance at least 3 days before planned surgery to prevent postoperative ketoacidosis 3
Adverse Effects to Monitor
- Genital mycotic infections (more common in women) occur in approximately 6% of patients taking SGLT2 inhibitors compared to 1% on placebo 2
- Urinary tract infections 3
- Risk of euglycemic ketoacidosis, especially in patients with type 2 diabetes requiring insulin 2
- Hypotension due to intravascular volume contraction 1
Clinical Benefits Beyond Glycemic Control
- Empagliflozin has demonstrated cardiovascular benefits in the EMPA-REG OUTCOME trial, showing reduced risk of cardiovascular death, hospitalization for heart failure, and death from any cause 4
- The glucose-lowering efficacy is reduced with declining eGFR, but kidney and cardiovascular benefits are preserved 2
Common Pitfalls and Caveats
- Do not use for treatment of type 1 diabetes or diabetic ketoacidosis 1
- Ketoacidosis may occur with minimal to no elevation in blood glucose; consider pausing treatment during periods of acute illness or stressors 2
- For patients on insulin, maintain at least low-dose insulin when starting Jardiance to reduce ketoacidosis risk 2
- Daily hygienic measures may reduce the risk of genital mycotic infections 2
Jardiance is available as 10 mg and 25 mg film-coated tablets 1, with the 10 mg dose being sufficient for most patients while offering significant cardiovascular and renal protection.