Diabetes:
Indications for JARDIANCE:
Adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus (T2DM). To reduce the risk of cardiovascular (CV) death in adults with T2DM and established CV disease.
Limitations of Use:
Not for treating type 1 diabetes or diabetic ketoacidosis.
Adult Dosage:
Take in the AM. Initially 10mg once daily; may increase to 25mg, if tolerated. Renal impairment: do not initiate if eGFR <45mL/min/1.73m2; discontinue if eGFR falls persistently <45mL/min/1.73m2.
Children Dosage:
<18yrs: not established.
JARDIANCE Contraindications:
Severe renal impairment, ESRD, or dialysis.
JARDIANCE Warnings/Precautions:
Correct volume depletion and assess for volume contraction before initiating. Monitor for symptomatic hypotension after starting therapy (esp. elderly, renal impairment or low systolic BP, or on diuretics); more frequently if volume contraction expected. Assess for ketoacidosis in presence of signs/symptoms of metabolic acidosis, regardless of blood glucose levels; discontinue if suspected, evaluate and treat; consider risk factors before initiation (eg, pancreatic insulin deficiency, caloric restriction, alcohol abuse). Consider temporarily discontinuing prior to scheduled surgery (for ≥3 days) or other clinical situations (eg, prolonged fasting due to illness or post-surgery). Evaluate renal function prior to starting and monitor periodically thereafter; more frequently if eGFR <60mL/min/1.73m2. Risk of acute kidney injury in hypovolemia, chronic renal insufficiency, CHF, and concomitant drugs (eg, diuretics, ACEIs, ARBs, NSAIDs). Consider temporarily discontinuing in reduced oral intake or fluid losses; monitor for acute kidney injury; discontinue and treat if occurs. Necrotizing fasciitis of the perineum (Fournier's gangrene); discontinue and treat immediately if suspected; use alternative antidiabetic. Increased risk of genital mycotic infections, UTIs, or elevated LDL-C; monitor and treat as appropriate. Discontinue if hypersensitivity reaction occurs; treat promptly and monitor until resolve. Elderly. Pregnancy (avoid during 2nd & 3rd trimesters). Nursing mothers: not recommended.
JARDIANCE Classification:
Sodium-glucose co-transporter 2 (SGLT2) inhibitor.
JARDIANCE Interactions:
Consider a lower dose of concomitant insulin or insulin secretagogue (eg, sulfonylurea) to reduce risk of hypoglycemia. Hypotension with concomitant diuretics. May result in false (+) urine glucose tests or unreliable measurements of 1,5-AG assay; use alternative methods to monitor glycemic control.
Adverse Reactions:
UTIs, female genital mycotic infections, increased urination; hypotension, ketoacidosis, renal impairment, urosepsis, pyelonephritis, angioedema; rare: Fournier's gangrene.
Drug Elimination:
Renal (54.4%). Fecal (41.2%). Half-life: 12.4 hours.
Generic Drug Availability:
NO
How Supplied:
Tabs—30, 90