Generic Name and Formulations:
Empagliflozin 10mg, 25mg; tabs.
Boehringer Ingelheim and Lilly
Indications for JARDIANCE:
Adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus (T2DM). To reduce the risk of cardiovascular (CV) death in adults with T2DM and established CV disease.
Limitations Of use:
Not for treating type 1 diabetes or diabetic ketoacidosis.
Take in the AM. Initially 10mg once daily; may increase to 25mg, if tolerated. Renal impairment: do not initiate if eGFR <45mL/min/1.73m2; discontinue if eGFR falls persistently <45mL/min/1.73m2.
<18yrs: not established.
Severe renal impairment, ESRD, or dialysis.
Correct volume depletion and assess for volume contraction before initiating. Monitor for symptomatic hypotension after starting therapy (esp. elderly, renal impairment or low systolic BP, or on diuretics); more frequently if volume contraction expected. Assess for ketoacidosis in presence of signs/symptoms of metabolic acidosis, regardless of blood glucose levels; discontinue if suspected, evaluate and treat; consider risk factors before initiation (eg, pancreatic insulin deficiency, caloric restriction, alcohol abuse). Evaluate renal function prior to starting and monitor periodically thereafter; more frequently if eGFR <60mL/min/1.73m2. Risk of acute kidney injury in hypovolemia, chronic renal insufficiency, CHF, and concomitant drugs (eg, diuretics, ACEIs, ARBs, NSAIDs). Consider temporarily discontinuing in reduced oral intake or fluid losses; monitor for acute kidney injury; discontinue and treat if occurs. Increased risk of genital mycotic infections, UTIs, or elevated LDL-C; monitor and treat as appropriate. Discontinue if hypersensitivity reaction occurs; treat promptly and monitor until resolve. Elderly. Pregnancy (avoid during 2nd & 3rd trimesters). Nursing mothers: not recommended.
Consider a lower dose of concomitant insulin or insulin secretagogue (eg, sulfonylurea) to reduce risk of hypoglycemia. Hypotension with concomitant diuretics. May result in false (+) urine glucose tests or unreliable measurements of 1,5-AG assay; use alternative methods to monitor glycemic control.
Sodium-glucose co-transporter 2 (SGLT2) inhibitor.
UTIs, female genital mycotic infections, increased urination; hypotension, ketoacidosis, renal impairment, urosepsis, pyelonephritis, angioedema.
Neurology Advisor Articles
- Clarifying Cardiovascular Risk in Migraine
- Parkinson Disease Symptom Fluctuations Well-Managed With Adaptive Deep Brain Stimulation
- More Evidence Supports Benefits of Cannabidiol for Treatment-Resistant Epilepsy
- Monthly Erenumab Reduces Frequency of Episodic Migraine
- Reduced Risk for Multiple Sclerosis Linked to Greater Sun Exposure
- Tamsulosin Associated With Dementia Risk in Older Patients With BPH
- FDA Approves Blood Test to Assess Concussion
- Gait Difficulty in Parkinson Disease May Be Associated With More Progressive Disease Course
- Tau PET a Useful Biomarker for Alzheimer Disease Risk and Progression
- Multiple Sclerosis Drug Zinbryta Withdrawn From the Market
- Incidence of Delayed Traumatic Intracranial Hemorrhage Low in Older Adults With Blunt Head Trauma
- Older Epilepsy Patients More Likely to Experience AED, Non-AED Drug Interaction
- Female Gender, Natalizumab Exposure Associated With Increased Lymphopenia Risk in FNG-Treated MS
- Accelerated Cognitive Decline Associated With Retinopathy
- Treatment Effects Often Exaggerated in Early Clinical Studies