empagliflozin (Rx)

Brand and Other Names:Jardiance
  • Print

Dosing & Uses


Dosage Forms & Strengths


  • 10mg
  • 25mg

Type 2 Diabetes Mellitus

Indicated as an addition to diet and exercise to improve glycemic control in adults with type 2 diabetes

Also indicated to reduce the risk of cardiovascular death in adults with type 2 diabetes mellitus and cardiovascular disease (based on results from the EMPA-REG trial [n>7000]; N Engl J Med 2015 Nov 26;373(22):2117-28)

10 mg PO qDay in the morning, taken with or without food

May increase to 25 mg/day if needed and tolerated

Dosage Modifications

Hepatic impairment: No dosage adjustment required

Renal Impairment

  • eGFR <45 mL/min/1.73 m²: Do not initiatee
  • GFR ≥45 mL/min/1.73 m²: No dosage adjustment required
  • Discontinue if eGFR persistently falls below 45 mL/min/1.73 m²

Dosing Considerations

Not indicated for treatment of type 1 diabetes or diabetic ketoacidosis

Assess renal function before initiating and periodically thereafter

<18 years: Safety and efficacy not established

No dosage change is recommended based on age; see Adult Dosing

Risk of volume depletion-related adverse reactions increased in patients who were ≥75 yr to 2.1%, 2.3%, and 4.4% for placebo, 10 mg, and 25 mg, respectively

Risk of urinary tract infections increased in patients who were ≥75 yr to 10.5%, 15.7%, and 15.1% in patients randomized to placebo, 10 mg, and 25 mg, respectively



Interaction Checker

and empagliflozin

No Results

     activity indicator 
    No Interactions Found
    Interactions Found


      Serious - Use Alternative

        Significant - Monitor Closely


            All Interactions Sort By:
             activity indicator 

            Adverse Effects


            Urinary tract infection (7.6-9.3%)

            Female genital mycotic infections (5.4-6.4%)

            Upper respiratory tract infection (3.1-4%)

            Increased urination (3.2-3.4%)

            Dyslipidemia (2.3-2.4%)

            Male genital mycotic infections (1.6-3.1%)

            Nausea (1.1-2.3%)

            Polydipsia (1.5-1.7%)

            Postmarketing reports

            Severe and disabling arthralgia

            Hypersensitivity reactions


            Skin reactions (e.g., rash, urticaria)




            History of serious hypersensitivity reaction to drug or any of excipients formulation

            Severe renal impairment, end-stage renal disease, or dialysis


            Causes intravascular volume contraction; symptomatic hypotension may occur after initiating, particularly in patients with renal impairment, low systolic blood pressure, on diuretics, or in the elderly

            Acute kidney injury reported; consider risk factors, including hypovolemia, heart failure, and chronic renal insufficiency or use of medications, including diuretics, ACE inhibitors, NSAIDs, or angiotensin receptor blockers, prior to initiating therapy; correct volume status before initiating if needed and monitor renal function periodically thereafter

            Increases serum creatinine and decreases eGFR; risk increased in elderly or those with moderate renal impairment

            Increased incidence of bone fractures reported; American Diabetes Association recommends avoiding sodium glucose cotransporter-2 inhibitors in patients with fracture risk factors

            May increase low density lipoprotein levels; monitor and treat as necessary

            Hypoglycemia risk increased with insulin and insulin secretagogues (eg, sulfonylureas); a lower dose of insulin or the insulin secretagogue may be required

            Genital mycotic infections may occur; patients with history of genital mycotic infections and uncircumcised males are more susceptible

            Increases risk of urinary tract infections (UTIs), including life-threatening urospesis and pyelonephritis that started as UTIs

            Necrotizing fasciitis of the perineum (Fournier gangrene) reported with SGLT2 inhibitors; signs and symptoms include tenderness, redness, or swelling of the genitals or the area from the genitals back to the rectum, and have a fever above 100.4 F or a general feeling of being unwell; if suspected, discontinue SGLT2 inhibitor and start treatment immediately with broad-spectrum antibiotics and surgical debridement if necessary

            Dose-related increases in LDL-C reported

            GLT2 inhibitors increase urinary glucose excretion and will lead to positive urine glucose tests; use alternative methods to monitor glycemic control

            Monitoring glycemic control with 1,5-AG assay is not recommended; this test is unreliable in assessing glycemic control in patients taking SGLT2 inhibitors

            Fatal cases of ketoacidosis associated with SGLT2 inhibitors reported; monitor for signs of ketoacidosis and advise patients to seek immediate medical attention for symptoms (eg, difficulty breathing, nausea, vomiting, abdominal pain, confusion, unusual fatigue or sleepiness); assess patients who present with signs and symptoms of metabolic acidosis for ketoacidosis, regardless of blood glucose level; consider risk factors for ketoacidosis prior to initiating therapy; patients may require temporary discontinuation of therapy in clinical situation that may predispose to ketoacidosis

            No conclusive evidence of macrovascular risk reduction with empagliflozin or any other antidiabetic agent


            Pregnancy & Lactation


            Limited data available in pregnant women not sufficient to determine a drug-associated risk for major birth defects and miscarriage; there are risks to mother and fetus associated with poorly controlled diabetes in pregnancy; based on animal data showing adverse renal effects, not recommended during second and third trimesters of pregnancy

            Poorly controlled diabetes in pregnancy increases maternal risk for diabetic ketoacidosis, pre-eclampsia, spontaneous abortions, preterm delivery, stillbirth, and delivery complications; poorly controlled diabetes increases fetal risk for major birth defects, still birth, and macrosomia related morbidity


            There is no information regarding presence in human milk, the effects on breastfed infant or on milk production; because of potential for serious adverse reactions in a breastfed infant, advise women that it is not recommended while breastfeeding

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.



            Mechanism of Action

            Selective sodium-glucose transporter-2 (SGLT2) inhibitor

            SGLT2 is expressed in the proximal renal tubules and is responsible for the majority of the reabsorption of filtered glucose from the tubular lumen; SGLT2 inhibitors reduce glucose reabsorption and lower the renal threshold for glucose, thereby increasing urinary glucose excretion


            Peak plasma time: 1.5 hr

            Peak plasma concentration: 259 nmol/L (10 mg/day); 687 nmol/L (25 mg/day)

            AUC: 1870 nmol•h/L (10 mg/day); 4740 nmol•h/L (25 mg/day)


            Protein bound: 86.2%

            Red blood cell partitioning: 36.8%

            Vd: 73.8 L


            Primary route of metabolism is glucuronidation by the uridine 5'-diphospho-glucuronosyltransferases UGT2B7, UGT1A3, UGT1A8, and UGT1A9

            No major metabolites were detected and the most abundant metabolites were 3 glucuronide conjugates (2-O-, 3-O-, and 6-O-glucuronide)

            Systemic exposure of each metabolite was <10%


            Half-life: 12.4 hr

            Clearance: 10.6 L/hr

            Excretion: 54.4% urine; 41.2% feces



            Oral Administration

            May take with or without food

            Advise patient to have adequate fluid intake to decreased risk of hypotension





            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Additional Offers
            Email to Patient



            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient



            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.