Names and pronunciation
(em-pa-gli-floe′zin) Jardiance
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Individual generic drug information
Extracted information for empagliflozin only.
(em-pa-gli-floe′zin) Jardiance
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Func. class.: Antidiabetic
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Chem. class.: Sodium-glucose cotransporter 2 (SGLT2) inhibitor
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ACTION: An inhibitor of sodium- glucose cotransporter 2 (SGLT2), the transporter responsible for reabsorbing the majority of glucose filtered by the tubular lumen in the kidney
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USES: Type 2 diabetes mellitus with diet and exercise to reduce CV death in diabetes mellitus
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Extracted information for empagliflozin only.
CONTRAINDICATIONS: Hyper- sensitivity, dialysis, renal failure Precautions: Adrenal insufficiency, breastfeeding, children, dehydration, dia- betic ketoacidosis, fever, geriatric patients, hypercholesterolemia, hypercortisolism, hyperglycemia, hyperthyroidism, hypogly- cemia, hypotension, hypothyroidism, hypovolemia, malnutrition, pituitary insuf- ficiency, pregnancy, renal impairment, type 1 diabetes mellitus, vaginitis
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SIDE EFFECTS MS: Arthralgia ENDO: Hypercholesterolemia, hyperlip- idemia, hypoglycemia (in combination) CV: Hypotension, orthostatic hypotension GU: Increased urinary frequency, nocturia, polyuria, cystitis, dehydration, diuresis, UTI GI: Nausea CNS: Syncope MISC: Infection, ketoacidosis, URI
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INTERACTIONS Increase: hypoglycemic effect—angio- tensin II receptor antagonists, angioten- sin-converting enzyme (ACE) inhibitors, loop diuretics, thiazide diuretics, fluox- etine, olanzapine, beta-blockers, other antidiabetics, octreotide, fibric acid de- rivatives, MAOIs type A Increase/Decrease: hypoglycemic effect—clonidine, androgens, bortezo- mib, lithium, alcohol, sulfonamides Decrease: hypoglycemic effect— phenothiazines, typical antipsychotics, baclofen, carbonic anhydrase inhibitors, estrogens, progestins, oral contracep- tives, dextrothyroxine, glucagon, cortico- steroids, fenfluramine, dexfenfluramine, phenytoin, fosphenytoin, ethotoin, salicy- lates, cycloSPORINE, tacrolimus, tobacco Drug/Herb/Supplements Increase: hypoglycemia—chromium, horse chestnut Increase/Decrease: hypoglycemia— niacin Decrease: hypoglycemia—green tea Drug/Lab Test Increase: HCT, creatinine Decrease: GFR
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Extracted information for empagliflozin only.
DOSAGE AND ROUTES • Adult: PO 10 mg daily, may increase to 25 mg daily
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Available forms: Tablets 10, 25 mg
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Administer: • Give every day without regard to food in the AM • Store at room temperature, protect from moisture
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Extracted information for empagliflozin only.
Assess: • Diabetes: monitor blood glucose, glyco- sylated hemoglobin A1c (HbA1c), serum cholesterol profile, serum creatinine/BUN, assess for polydipsia, other products taken by patient; assess for hypoglycemia, head- ache, drowsiness, hunger, weakness, sweat- ing; have sugar source available • Ketoacidosis: if patient has volume depletion, dehydration, discontinue, give insulin, glucose source • Renal studies: monitor serum creati- nine eGFR baseline and periodically avoid in those with eGFR <45 mL/min/1.73 m2 • UTI: treat with anti-infective • Pregnancy/breastfeeding: use if bene- fits outweigh risk to fetus; no well-controlled studies; do not breastfeed
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Evaluate: • Therapeutic response: decreasing blood glucose, A1c
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • How to check blood glucose; to con- tinue with diet and exercise changes; to avoid smoking, alcohol • That frequent blood glucose, HbA1c, BUN/creatinine will be needed • To avoid other products unless ap- proved by prescriber • To take in the AM, without regard to food; that if dose is missed, to take when remem- bered, do not double dose; to read “medica- tion guide” provided; that product controls symptoms but does not cure diabetes • To follow medical regimen including diet, exercise, and weight loss • Teach how to take blood glucose, urine ketones readings and how often • Hypoglycemia: to report rapid heartbeat, dizziness, weakness; that lab testing will be needed, including blood glucose monitoring, and that a dosage change may be needed; to carry a sugar source at all times; review signs and symptoms of hypoglycemia and hyper- glycemia and what to do about each • Hypotension: to report vision changes, dizziness, fatigue; B/P should be checked regularly, stress adequate hydration • Ketoacidosis: to report nausea, vomiting, abdominal pain, confusion, sleepiness • Infections: (usually UTIs) to report burning, cloudy, foul-smelling urine, fever, back pain; antibiotics will be needed; and to report symptoms of mycotic infections, including foul-smelling vaginal discharge or penile discharge and redness; UTI: burning/stinging on urination, frequency • Pregnancy/breastfeeding: to report if pregnancy is planned or suspected; not to breastfeed
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Extracted information for empagliflozin only.
PHARMACOKINETICS Protein binding 82.6%, terminal elimina- tion half-life 12.4 hr, peak 1.5 hr
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Filter the extracted dose blocks for this individual drug.
• Adult: PO 10 mg daily, may increase to 25 mg daily
Candidate age grouping · source page 460