From the Guidelines
The starting dose of Jardiance (empagliflozin) should be 10 mg once daily, as this is the lowest dose tested in CV and renal outcomes trials, and no further dose titration is needed for CV or renal risk reduction. According to the 2020 expert consensus decision pathway on novel therapies for cardiovascular risk reduction in patients with type 2 diabetes 1, the recommended dose of empagliflozin is 10 mg PO daily. The key indications for empagliflozin include improving glycemic control in adults with type 2 diabetes as an adjunct to diet and exercise, reducing the risk of cardiovascular death in adults with type 2 diabetes and established cardiovascular disease, and reducing the risk of hospitalization for heart failure in adults with type 2 diabetes and established cardiovascular disease or multiple cardiovascular risk factors.
Some important considerations when initiating Jardiance include:
- Assessing kidney function before starting the medication, as it is not recommended for patients with an eGFR less than 45 mL/min/1.73m² for glycemic control 1
- Advising patients to stay well hydrated while taking Jardiance and to monitor for symptoms of volume depletion, particularly during the initial weeks of therapy
- Informing patients about potential side effects, including genital mycotic infections, urinary tract infections, and euglycemic diabetic ketoacidosis 1
- Considering the potential benefits of Jardiance in reducing cardiovascular and renal risk, as well as its role in improving glycemic control, when determining the optimal treatment plan for patients with type 2 diabetes.
It is also worth noting that while dose increases may provide further glucose reduction benefits if indicated, the initial dose of 10 mg once daily is the recommended starting point, and titration should be based on individual patient response and tolerability. As stated in the evidence, because there is no evidence of a graded dose response regarding CV and renal effects, SGLT2 inhibitors with CV benefit should be initiated at the lowest dose tested in CV and renal outcomes trials 1.
From the FDA Drug Label
The recommended dose of JARDIANCE is 10 mg once daily in the morning, taken with or without food. In patients tolerating JARDIANCE, the dose may be increased to 25 mg [see Clinical Studies (14)]. The starting dose for a patient starting Jardiance is 10 mg once daily. The dose may be increased to 25 mg once daily in patients who tolerate the initial dose.
- The dose should be taken in the morning, with or without food.
- Patients with volume depletion should have their condition corrected prior to initiation of JARDIANCE.
- Assessment of renal function is recommended prior to initiation of JARDIANCE and periodically thereafter 2, 2, 2.
From the Research
Dosing Information for Jardiance (Empagliflozin)
- The starting dose and titration schedule for Jardiance are not explicitly stated in the provided studies 3, 4, 5, 6, 7.
- However, it is known that Jardiance is administered orally, once daily, and is available in 10mg and 25mg tablets 3, 4.
- The studies provided focus on the efficacy, safety, and mechanisms of action of empagliflozin, but do not provide specific dosing instructions 3, 4, 5, 6.
- One study discusses the addition of empagliflozin to metformin and sulfonylurea therapy in patients with sub-optimally controlled type 2 diabetes mellitus, but does not specify the starting dose or titration schedule 6.
- Another study evaluates the safety of empagliflozin, but also does not provide dosing information 4.