What are the consequences of incorrect dosing of Jardiance (Empagliflozin) for heart failure?

From the Guidelines

Jardiance (empagliflozin) should be dosed at 10 mg once daily for heart failure treatment, as this dose has been shown to reduce the risk of cardiovascular death and hospitalization in heart failure patients, regardless of whether the patient has diabetes. This medication works by helping the kidneys remove excess glucose from the bloodstream and has been consistently demonstrated to provide benefits in heart failure patients across various studies, including the EMPEROR-Reduced trial 1. The 10 mg dose is the standard recommended dose for heart failure, which differs from diabetes treatment where doses may range from 10-25 mg daily. Patients should take Jardiance in the morning with or without food, and maintain adequate hydration throughout the day. It's essential to monitor kidney function before and during treatment, as the medication is not recommended for patients with severely impaired kidney function (eGFR less than 20 mL/min/1.73m²) 1. Common side effects may include urinary tract infections and genital mycotic infections due to the increased glucose in the urine. Patients should be aware that Jardiance may cause a slight decrease in blood pressure, so monitoring for symptoms of low blood pressure is advisable, especially when starting treatment.

Some key points to consider when prescribing Jardiance for heart failure include:

• The medication has been shown to reduce the risk of hospitalization for heart failure and cardiovascular death in patients with heart failure with reduced ejection fraction (HFrEF) 1.
• The benefits of Jardiance in heart failure patients have been consistently demonstrated across various studies, including the EMPEROR-Reduced and DAPA-HF trials 1.
• Patients with severely impaired kidney function (eGFR less than 20 mL/min/1.73m²) should not be prescribed Jardiance due to the increased risk of adverse effects 1.
• Monitoring of kidney function and blood pressure is essential during treatment with Jardiance 1.

Overall, the use of Jardiance in heart failure treatment has been well-established, and the 10 mg once daily dose is the recommended dose for this indication, as supported by the most recent and highest quality study available 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Failure Dosing of Jardiance for Heart Failure

• Jardiance, also known as empagliflozin, is a medication used to treat heart failure and has been shown to reduce the risk of hospitalization for heart failure and cardiovascular death 2, 3, 4.
• The dosing of Jardiance for heart failure is typically 10 mg once daily, and it has been shown to be effective in reducing the risk of heart failure hospitalization and cardiovascular death in patients with reduced ejection fraction 4, 5.
• The medication has been shown to be effective in patients with and without diabetes, and its effects are consistent across a broad range of baseline kidney function 3, 4.
• Jardiance has also been shown to slow the decline in kidney function and reduce the risk of serious renal outcomes in patients with heart failure 3, 4.

Key Findings

• Empagliflozin reduces the composite end point of hospitalizations for heart failure and mortality, and improves the quality of life irrespective of left ventricular ejection fraction 2.
• The medication has a beneficial effect on cardiovascular and kidney outcomes in patients with heart failure, including those with reduced ejection fraction and chronic kidney disease 3, 4.
• Empagliflozin is well tolerated in patients with heart failure, and its effects are consistent across a broad range of baseline characteristics, including systolic blood pressure 6.

Patient Populations

• Jardiance has been shown to be effective in patients with heart failure with reduced ejection fraction, including those with and without diabetes 4, 5.
• The medication has also been shown to be effective in patients with atrial fibrillation, and its effects are consistent across a broad range of baseline characteristics, including kidney function and systolic blood pressure 5, 6.