Names and pronunciation
(em′pa-gli-floe′zin/met-for′min) Synjardy, Synjardy XR
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Drug reference
(em′pa-gli-floe′zin/met-for′min) Synjardy, Synjardy XR
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Func. class.: Antidiabetic
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Chem. class.: Biguanide; sodium- glucose cotransporter 2 (SGLT2) inhibitor
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USES: Type 2 diabetes mellitus
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CONTRAINDICATIONS: Hyper- sensitivity, diabetic ketoacidosis, dialysis, metabolic acidosis, radiographic con- trast administration, renal failure
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Black Box Warning: Lactic acidosis Precautions: Pregnancy, geriatric patients, severe renal/hepatic/GI disease, pancreatitis, vitamin D deficiency, acide- mia, acute heart failure, acute myocardial infarction, alcoholism, balanitis, breast- feeding, burns, cardiac disease, children, dehydration, diarrhea, ethanol intoxica- tion, fever, gastroparesis, hypercholester- olemia, hypercortisolism, hyperglycemia, hyperthyroidism, hypoglycemia, hypoten- sion, hypovolemia, hypoxemia, infection, malnutrition, pernicious anemia, pituitary insufficiency, polycystic ovary syndrome, sepsis, surgery, trauma, type 1 diabetes mellitus, vaginitis, vomiting
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DOSAGE AND ROUTES • Adult: PO bid with meals; individual- ize. In geriatric patients, use lowest effec- tive dose. Max in normal renal function is empagliflozin 25 mg/day and metformin 2000 mg/day; correct volume depletion prior to initiation of treatment • Patients currently treated with empa- gliflozin: metformin 500 mg with a similar total daily dose of empagliflozin; increase gradually to reduce the GI side effects • Patients currently treated with met- formin: empagliflozin 5 mg/dose with a E similar total daily dose of metformin. Patients taking an evening dose of met- formin XR should check with their provider about when to take their last dose prior to starting empagliflozin/ metformin • Patients already treated with both em- pagliflozin and metformin: use the same doses of each component per day, then di- vide the daily doses to bid dosing with meals Renal dose: • Adult: PO eGFR ≥45 mL/min/1.73 m2, no change; eGFR <45 mL/min/1.73 m2, do not use
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Available forms: Tablets 5 mg/1000 mg, 12.5 mg/1000 mg; extended-release tablets 5 mg/1000 mg, 12.5 mg/1000 mg
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• Adult: PO bid with meals; individual- ize. In geriatric patients, use lowest effec- tive dose. Max in normal renal function is empagliflozin 25 mg/day and metformin 2000 mg/day; correct volume depletion prior to initiation of treatment
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• Patients currently treated with empa- gliflozin: metformin 500 mg with a similar total daily dose of empagliflozin; increase gradually to reduce the GI side effects
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• Patients currently treated with met- formin: empagliflozin 5 mg/dose with a E similar total daily dose of metformin. Patients taking an evening dose of met- formin XR should check with their provider about when to take their last dose prior to starting empagliflozin/ metformin
PDF page 461
• Patients already treated with both em- pagliflozin and metformin: use the same doses of each component per day, then di- vide the daily doses to bid dosing with meals Renal dose:
PDF page 461
• Adult: PO eGFR ≥45 mL/min/1.73 m2, no change; eGFR <45 mL/min/1.73 m2, do not use
PDF page 461