From the Guidelines
Jardiance (empagliflozin) is a highly recommended medication for patients with type 2 diabetes, particularly those with established cardiovascular disease or at high risk of heart failure, due to its proven benefits in reducing hospitalization for heart failure and progression of kidney disease, as demonstrated in the EMPA-REG OUTCOME trial 1. The standard dose of Jardiance is 10mg once daily, taken in the morning with or without food, which can be increased to 25mg daily if needed for better glycemic control. Key benefits of Jardiance include:
- Reduced risk of hospitalization for heart failure by 35% compared to placebo, as shown in the EMPA-REG OUTCOME trial 1
- Reduced risk of cardiovascular death by 38% compared to placebo, as shown in the EMPA-REG OUTCOME trial 1
- Improved renal outcomes, including a reduced risk of end-stage kidney disease and doubling of serum creatinine, as demonstrated in the CANVAS and DAPA-CKD trials 1 Common side effects of Jardiance include genital yeast infections, urinary tract infections, and increased urination. Patients should maintain adequate hydration while taking this medication and temporarily stop it during severe illness, surgery, or if unable to eat or drink normally. Jardiance should not be used by patients with type 1 diabetes or diabetic ketoacidosis. Regular monitoring of kidney function is important, especially when starting treatment. The medication has demonstrated ability to reduce hospitalization for heart failure and progression of kidney disease, making it valuable beyond just blood sugar control, as supported by recent studies, including the EMPEROR-Reduced and DAPA-HF trials 1.
From the FDA Drug Label
1 INDICATIONS AND USAGE JARDIANCE is indicated: as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus, to reduce the risk of cardiovascular death in adult patients with type 2 diabetes mellitus and established cardiovascular disease.
Limitations of Use JARDIANCE is not recommended for patients with type 1 diabetes or for the treatment of diabetic ketoacidosis.
- Indications for Jardiance:
- Improve glycemic control in adults with type 2 diabetes mellitus
- Reduce the risk of cardiovascular death in adult patients with type 2 diabetes mellitus and established cardiovascular disease
- Limitations of Use: Not recommended for patients with type 1 diabetes or for the treatment of diabetic ketoacidosis 2
From the Research
Overview of Jardiance
- Jardiance, also known as empagliflozin, is a sodium glucose cotransporter-2 (SGLT2) inhibitor used in the treatment of type 2 diabetes mellitus 3, 4.
- It works by inhibiting the reabsorption of glucose from the proximal tubules in the kidney, providing a novel insulin-independent mechanism of lowering blood glucose 4.
Efficacy and Safety
- Empagliflozin has been shown to be effective in improving glycaemic control, promoting weight loss, and lowering blood pressure in patients with type 2 diabetes 3, 5, 4.
- It has a low inherent risk of hypoglycaemia due to its insulin-independent mechanism of action, making it a useful addition to the therapeutic options for the management of type 2 diabetes 3, 4.
- However, empagliflozin may have adverse effects such as genital infections, kidney failure, and diabetic ketoacidosis, and may also be hepatotoxic 6.
Dosage and Administration
- The dosage and administration of empagliflozin are still controversial clinically, but a network meta-analysis suggests that 25mg may be the most appropriate dose for patients with type 2 diabetes mellitus 7.
- High-daily doses (10,25, 50mg) have been shown to be more effective than low doses (1,2.5, 5mg) in improving glycaemic control, but may also have a higher risk of adverse effects 7.
Cardiovascular Benefits
- Empagliflozin has been shown to have cardioprotective and renoprotective properties, largely independent of glycaemic control, in patients with type 2 diabetes and established cardiovascular disease 3, 6.
- It has been demonstrated to reduce mortality, particularly due to heart failure, in patients with type 2 diabetes and significant cardiovascular risk factors 6.