Does a patient need to taper off Jardiance (Empagliflozin)?

Jardiance Does Not Require Tapering and Can Be Stopped Abruptly

No, patients do not need to wean off Jardiance (empagliflozin)—the medication can be discontinued abruptly without a tapering schedule. 1

Key Points About Stopping Jardiance

Abrupt Discontinuation is Safe

• Unlike medications such as proton pump inhibitors, corticosteroids, or lithium, SGLT2 inhibitors like Jardiance do not cause withdrawal symptoms or rebound effects when stopped suddenly 1
• The FDA label for Jardiance contains no warnings or recommendations about gradual dose reduction prior to discontinuation 1
• The mechanism of action (blocking glucose reabsorption in the kidney) does not create physiologic dependence that would require tapering 2, 3

When to Stop Jardiance Immediately

Discontinue Jardiance promptly if any of the following occur: 1

• Acute kidney injury develops - some cases have required hospitalization and dialysis 1
• Serious hypersensitivity reactions occur, including angioedema 1
• Diabetic ketoacidosis is suspected, even with normal blood glucose (euglycemic DKA) 1, 4
• Serious urinary tract infections develop, including urosepsis or pyelonephritis requiring hospitalization 1

Temporary Discontinuation Scenarios

Consider temporarily stopping Jardiance in these situations: 1

• Acute illness with reduced oral intake or fasting states 1
• Gastrointestinal illness causing fluid losses 1
• Excessive heat exposure leading to dehydration 1
• Any setting where the patient is at risk for volume depletion 1

Monitor patients for signs and symptoms of acute kidney injury during these periods, and restart only when the patient is adequately hydrated and stable 1

Important Clinical Considerations

Renal Function Monitoring

• Jardiance is contraindicated when eGFR is less than 30 mL/min/1.73 m² 1
• Use is not recommended when eGFR is persistently less than 45 mL/min/1.73 m² 1
• More frequent monitoring is needed in patients with eGFR below 60 mL/min/1.73 m² 1

Managing Diabetes After Discontinuation

• When stopping Jardiance, ensure alternative glucose-lowering therapy is in place to maintain glycemic control 2, 3
• The glucose-lowering effect of Jardiance is moderate (HbA1c reduction of approximately 0.5-0.8%), so blood glucose will rise after discontinuation 2, 5
• Adjust other diabetes medications accordingly to prevent hyperglycemia 3

Common Pitfall to Avoid

• Do not continue Jardiance during acute illness or dehydration thinking gradual tapering is needed—this increases the risk of acute kidney injury and should be stopped immediately in these circumstances 1
• The cardiovascular and renal protective benefits demonstrated in clinical trials are lost upon discontinuation, so stopping should only occur when medically necessary or when risks outweigh benefits 3