adults with type 2 diabetes.
It is indicated as an adjunct to diet and exercise to improve glycemic control in
adults with type 2 diabetes mellitus.
MECHANISM OF ACTION: It is a sodium glucose co-transporter-2 (SGLT2) inhibitor. Empagliflozin works by blocking the reabsorption of glucose in the kidney, increasing glucose excretion and lowering blood glucose levels in adults with type 2 diabetes who have elevated blood glucose levels.
DOSAGE AND ADMINISTRATION: The recommended dose of empagliflozin is 10 mg once daily in the morning, taken with or without food. In patients tolerating empagliflozin, the dose may be increased to 25mg
Patients with Renal Impairment: Assessment of renal function is recommended prior to initiation of empagliflozin and periodically thereafter. It should not be initiated in patients with an eGFR less than 45 mL/min/1.73 m2
No dose adjustment is needed in patients with an eGFR greater than or equal to 45 mL/min/1.73 m2. It should be discontinued if eGFR is persistently less than 45 mL/min/1.73m2
CONTRAINDICATIONS : History of serious hypersensitivity reaction to empagliflozin.
Severe renal impairment, end-stage renal disease, or
ADVERSE REACTIONS : The package insert lists following important adverse reactions
- Impairment in renal function
- Hypoglycemia with concomitant use with Insulin and insulin secretagogues.
- Genital mycotic infections.
- Urinary tract infections.
- Increased low-density lipoprotein cholesterol (LDL-C).
- Jardiance is the third drug to be approved in a novel class of anti-diabetic
drugs called SGLT-2 inhibitors. The other two being Invokanna and Farxiga.
- Other than its glucose lowering effects, one can expect weight loss and decrease in systolic blood pressure with this drug.
- All the other drugs in its class along with Jardiance, have unique side effect to increase the risk of male and female genital mycotic infection and UTIs, because of high glucose concentration of urine.
- Its HbA1c lowering effects are from 0.7-0.9 % as monotherapy, which is comparable to Meglitinides, alpha-glucosidase ibhibitors and DPP-4 inhibitors.
- Even though approved by FDA as adjunct to diet and exercise to reduce HbA1C, it has also been studied in combination with other diabetes drugs.
- Its place in therapy is debatable, but one can safely say that it is a reasonable choice as a second line or third line agent in right kind of patients.
- Its use in special population like geriatric, pediatric and pregnant patients has not been studied.
- There is no data that lowering the HbA1C with Jardiance prevents one from micro or macro vascular damage resulting from diabetes at later stages.
Posted by : Rahul Patel, PharmD. Candidate 2015.