Jardiance (Empagliflozin)
Also sold as: Jardiance, Empa, Glyxambi (with linagliptin)
Pregnancy
Cat C
Lactation
Avoid
Schedule
H
Forms
Tablet 10/25mg
Indications
- Type 2 DM (with established CVD or high CV risk)
- Heart failure (HFrEF and HFpEF) — even non-diabetics
- CKD (slowing progression in diabetic and non-diabetic CKD)
Adult Dosing
T2DM/HF/CKD
10 mg PO OD; may increase to 25 mg for additional glycemic effect
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| eGFR > 30 | Initiate; continue until eGFR persistently <20 |
| eGFR < 20 | Discontinue (insufficient glycemic effect) |
| For HF/CKD only | Continue down to eGFR 20 (newer evidence) |
Pregnancy & Lactation
Pregnancy: Category C
Avoid in pregnancy; switch to insulin
Lactation: Avoid
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Insulin/sulfonylureas | Hypoglycemia — reduce dose of other agent | Moderate |
| Diuretics | Volume depletion, hypotension | Moderate |
| Lithium | Reduced lithium levels | Moderate |
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Side Effects
Common
- Genital mycotic infections (10% women, 4% men)
- UTI
- Polyuria
- Volume depletion
Serious / Discontinue If
- Diabetic ketoacidosis (euglycemic DKA — rare but serious)
- Necrotizing fasciitis of perineum (Fournier gangrene)
- AKI (volume depletion)
- Lower limb amputation (canagliflozin > empa)
- Bone fractures
Contraindications
- Type 1 DM, recurrent DKA
- eGFR <20 (for diabetes indication)
- Hypersensitivity
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Jardiance 10 | Boehringer | 14 tab ₹680 |
| Empa 10 | Mankind | 10 tab ₹385 |
Monitoring Required
- eGFR, volume status, BP, ketones if symptomatic
Patient Counseling Points
- Drink adequate fluids
- Stop and seek care if severe abdominal pain, breathlessness, or perineal pain
- Stop temporarily if NPO/dehydrated/sick day rules
- Maintain genital hygiene
- Continue even when not feeling diabetic — proven kidney/heart benefit
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References
- BNF
- Lexicomp Drug Information
- Indian National Formulary
- Specialty society guidelines (RSSDI/CSI/IAP)
Disclaimer: This information is for clinical reference only. It is not exhaustive and does not substitute clinical judgement. Always verify current dosing against the manufacturer's prescribing information and current treatment guidelines. Drug prices are approximate and may vary.