Empagliflozin Brand Name and Preoperative Holding Period
Empagliflozin is marketed under the brand name Jardiance, and should be discontinued at least 3 days before scheduled surgery requiring general anesthesia to prevent perioperative ketoacidosis. 1
Brand Name
- Empagliflozin is commercially available as Jardiance 2, 3, 4, 5
- Available in 10 mg and 25 mg once-daily oral formulations 1, 4
Preoperative Holding Period
Recommended Timing
- Discontinue empagliflozin at least 3 days (≥72 hours) before scheduled surgery including procedures requiring general anesthesia 1
- This 3-day holding period applies specifically to canagliflozin, dapagliflozin, and empagliflozin 1
- Ertugliflozin requires a longer 4-day holding period 1
Rationale for Holding
- Primary concern is prevention of perioperative ketoacidosis, including both diabetic and euglycemic ketoacidosis 1
- SGLT2 inhibitors increase the risk of metabolic acidosis in the surgical setting 1
- The American College of Cardiology specifically cautions about temporary discontinuation before scheduled surgery to avoid potential ketoacidosis risk 1
Clinical Context
- This recommendation applies to patients with heart failure, type 2 diabetes, or both conditions 1
- The holding period should be implemented "when feasible" for elective procedures 1
- For patients with diabetes, consultation with an endocrinologist regarding bridging diabetic therapy may be necessary if empagliflozin is held longer than the next scheduled dosing time 1
Important Caveats
- Do not confuse SGLT2 inhibitor holding periods with standard preoperative fasting guidelines 1
- Standard fasting for clear liquids (2 hours), light meals (6 hours), and fatty meals (8 hours) remain unchanged 1
- The 3-day holding period for empagliflozin is specifically for the medication itself, not related to food/fluid fasting 1