Jardiance dosage, forms, and strengths

Jardiance forms and strengths

Jardiance tablets come in two different dose strengths:

• Tablets: 10 milligrams (mg), 25 mg

Jardiance dosage for adults

Jardiance is used along with diet and exercise to reduce blood sugar in people with Type 2 diabetes. Because it reduces sodium levels in the blood, Jardiance is also prescribed to reduce the risk of cardiovascular death in people with both Type 2 diabetes and cardiovascular disease. It reduces the risk of hospitalization and death in people who have congestive heart failure with reduced ejection fraction, congestive heart failure in which the heart does not pump enough blood to the rest of the body. Jardiance is not used to control high blood sugar in people with Type 1 diabetes because of the risk for diabetic ketoacidosis. This is a potentially life-threatening condition in which the blood fills with ketones. Jardiance may also need to be discontinued a few days before surgery in order to reduce the risk of ketoacidosis

Sources: Epocrates, PDR

Jardiance dosage for Type 2 diabetes mellitus

The U.S. Food and Drug Administration (FDA) has approved Jardiance as an adjunct to diet and exercise in order to reduce blood sugar in people with Type 2 diabetes mellitus. Empagliflozin, the active ingredient in Jardiance, belongs to a class of drugs called sodium-glucose co-transporter 2 (SGLT2) inhibitors. These drugs specifically prevent the kidneys from reabsorbing glucose and sodium back into the blood from the urine as it passes through tiny filtration tubes in the kidneys. Because the kidneys do not reabsorb glucose at normal levels from the urine, blood glucose levels go down, helping to keep blood sugar levels under control. 

• Standard dosage for Type 2 diabetes in adults: 10–25 mg taken once daily in the morning

• Maximum dosage for Type 2 diabetes in adults: 25 mg per day

Jardiance dosage to reduce cardiovascular risk in people with Type 2 diabetes and cardiovascular disease

SGLT2 inhibitors like Jardiance decrease both glucose and sodium levels in the body. By reducing sodium, empagliflozin also reduces the amount of work the heart needs to do to pump blood. In medical terms, it reduces the “load” on the heart. The heart then has an easier time pumping blood and becomes less vulnerable to serious or life-threatening cardiovascular events, such as a heart attack. Other positive effects of Jardiance include weight loss and lower blood pressure. For this reason, Jardiance is FDA-approved to treat people with both Type 2 diabetes and cardiovascular disease. The drug helps to restore glycemic control while reducing the incidence of serious cardiovascular events or death. Dosing is the same as Type 2 diabetes dosing for those without cardiovascular disease. 

• Standard dosage to reduce cardiovascular risk in adults with Type 2 diabetes and cardiovascular disease: 10–25 mg taken once daily in the morning

• Maximum dosage to reduce cardiovascular risk in adults with Type 2 diabetes and cardiovascular disease: 25 mg per day

Jardiance dosage for congestive heart failure

Empagliflozin is FDA-approved to treat people with congestive heart failure with reduced ejection fraction, which is when the heart fails to pump out enough blood to rest of the body. By reducing the load on the heart, empagliflozin makes it easier for the heart to pump blood. In addition, Jardiance contributes to weight loss by reducing glucose in the body, another positive effect for a failing heart. However, because of the increased risk of blood sugar falling too low, Jardiance is prescribed at a lower dose for people who have congestive heart failure with normal blood sugar levels. 

• Standard dosage for congestive heart failure with reduced ejection fraction in adults: 10 mg taken once daily in the morning

Jardiance dosage for children

Jardiance is not approved for use in children.

Jardiance dosage restrictions

Jardiance is a powerful and effective drug, but it may cause problems in people with certain physical problems or conditions. 

Some conditions are contraindications, making it too risky to prescribe Jardiance if they are present. These include Type 1 diabetes, diabetic ketoacidosis, or any allergic reaction to Jardiance. Because of the effects of empagliflozin on sodium levels, Jardiance cannot be given to people with volume depletion, or low fluid levels in the body. Volume depletion is frequently caused by low sodium, so empagliflozin will only worsen the condition. Body fluid levels have to be restored to normal before Jardiance can be taken.

Because Jardiance works through the kidneys, it may be ineffective in those with reduced kidney function. Healthcare providers measure the stages of kidney disease or “impaired renal function” by the kidney’s estimated glomerular filtration rate(eGFR). In the end stages of kidney disease, people will need to have their blood filtered by a mechanical device, or dialysis machine. Dosage restrictions for people with kidney problems are as follows:

Renally impaired patients (kidney disease) 

Treatment of Type 2 diabetes mellitus:

• Mild to moderate renal impairment (eGFR > 30): no dose adjustment

• Moderate to severe renal impairment (eGFR < 30): Jardiance is not used

• Dialysis: Jardiance is not used

Treatment of congestive heart failure:

• Mild to moderate renal impairment (GFR > 20): no dose adjustment

• Severe renal impairment (eGFR < 20): Jardiance is not used

• Dialysis: Jardiance is not used

How to take Jardiance

Each dose of Jardiance is taken by mouth with or without food once per day in the morning. 

• Take Jardiance as directed by a healthcare provider. The dose should stay the same, but the prescribing healthcare provider may change the dose depending on blood glucose levels and side effects.

• Jardiance should come with a medication guide. Please read the entire medication guide each time a prescription is filled or refilled. If the medication guide is missing, a pharmacist can provide a free copy.

• Jardiance may be prescribed with other diabetes medications. Take those medications as directed.

• Take Jardiance only one time each day in the morning.

• Store Jardiance at room temperature (68°F to 77°F) in a closed container.

Jardiance dosage FAQs

What happens if I miss a dose of Jardiance?

If a dose is missed, take the missed dose when it’s remembered. However, if it is almost time for the next dose, skip the missed dose. Return to the regular schedule and take the next dose at its normal scheduled time. Never take extra medicine to make up for a missed dose.

How do I stop taking Jardiance?

Jardiance can be discontinued without causing withdrawal symptoms or other problems. However, if other diabetes medications are not being taken, quitting Jardiance may cause blood sugar to quickly rise to unhealthy levels.

There are many reasons why people may need to stop taking Jardiance. It may not work for some. Others may need to quit the drug immediately because of serious side effects, such as hypersensitivity reactions, ketoacidosis, severe urinary tract infections (urosepsis), severe kidney infections (pyelonephritis), or Fournier’s gangrene, a painful, severe, and rapidly progressing infection of the scrotum, penis, or lower abdomen. Of course, some people may quit Jardiance because of common side effects such as urinary tract infections or genital yeast infections. These infections are not minor inconveniences. People taking Jardiance who notice any sign of a genital or urinary tract infection should immediately talk to a healthcare professional. These infections can quickly get worse.

If Jardiance can’t be taken, healthcare providers have a wide spectrum of diabetes medications to prescribe. These include biguanides (such as metformin), sulfonylureas, meglitinides, glitazones, DPP-4 inhibitors, alpha-glucosidase inhibitors, dopamine-2 agonists, bile acid sequestrants, insulin, GLP-1 agonists, thiazolidinediones, and other SGLT2 inhibitors like empagliflozin. Combination therapy using two or more drugs of these types may be needed to achieve adequate glycemic control.

Can you overdose on Jardiance?

Taking too much Jardiance will cause blood sugar to drop too low. Symptoms of low blood sugar include headache, drowsiness, weakness, dizziness, sweating, confusion, or fast heartbeat. Low blood sugar could also result when Jardiance is taken with other diabetes medications, particularly sulfonylurea drugs or insulin. If you suspect too much Jardiance has been taken or you believe a drug interaction may have caused hypoglycemia, get medical attention. In some cases, however, a healthcare professional may already have prescribed a glucagon injection kit to use in the case of severe hypoglycemia.

What interacts with Jardiance?

Jardiance can cause problems when taken with certain prescription drugs, over-the-counter medications, or dietary supplements. Be sure to tell the healthcare professional prescribing Jardiance about all the drugs and supplements being taken, even if they don’t seem important. 

Drugs that could cause serious problems include:

• Diabetes medications: Jardiance is often prescribed with diabetes medications, but the combination could cause a serious drop in blood sugar, particularly when Jardiance is combined with insulin, insulin secretagogues (sulfonylureas and meglitinides), and other SGLT2 inhibitors similar to empagliflozin.

• Diuretics: Jardiance reduces sodium and, therefore, fluids in the body. Diuretics also excrete fluids and electrolytes. The combination of Jardiance and diuretics could produce volume depletion (hypovolemia), low blood pressure (hypotension), and electrolyte problems.

What happens when you mix Jardiance and alcohol?

As a general rule, it is not a good idea for anyone taking any kind of diabetes medication to drink alcohol. First, combining alcohol with diabetes medication raises the risk of low blood sugar. Second, many alcoholic drinks are high in carbohydrates. These drinks will defeat the benefits of taking diabetes medications. If alcohol is ingested, it is best to drink it moderately on a full stomach to reduce the risk of hypoglycemia.

Is it safe to take Jardiance during pregnancy?

Healthcare professionals do not recommend Jardiance be taken in the second and third trimesters of pregnancy. Taking empagliflozin during this time could compromise the development of the fetus’ kidneys. In general, healthcare professionals will also want to switch to another diabetes drug even in the first trimester.

While there is no research on whether empagliflozin is present in human breast milk or presents a danger to a nursing infant, breastfeeding mothers are encouraged to switch to a different diabetes medication or stop breastfeeding. There is a potential risk that empagliflozin could cause adverse reactions in a nursing infant and possibly interfere with the baby’s kidney function or development.

Related resources for Jardiance dosages:

• Empagliflozin drug summary, Prescriber’s Digital Reference

• Jardiance, Epocrates

• Jardiance prescribing information, U.S. National Library of Medicine

• Jardiance, Boehringer Ingelheim.