Empagliflozin is a sodium-glucose cotransporter 2 (SGLT2) inhibitor that has demonstrated favorable efficacy in the management of diabetes mellitus, treatment of heart failure, and intervention for chronic kidney disease.

How to Use Empagliflozin

Dosage and Administration

The standard recommended dose of empagliflozin is 10 mg orally once daily, which can be taken in the morning with food or on an empty stomach.

If the patient tolerates the 10 mg dose well and requires further enhancement of blood glucose control, the dose may be increased to 25 mg once daily.

It is important to note that if the patient has concurrent renal impairment, the estimated glomerular filtration rate (eGFR) must be evaluated before medication use. When the eGFR is below 30 mL/min/1.73 m², empagliflozin is not recommended for blood glucose control.

Dosage Adjustment of Empagliflozin

Adjustment Based on Treatment Response

During the initial treatment phase, the 10 mg dose should be maintained for at least 4 weeks. The therapeutic effect is determined by monitoring glycated hemoglobin (HbA1c) and fasting plasma glucose (FPG) levels.

If blood glucose control does not meet the target, the dose may be increased to 25 mg.

If a dose is missed, it should be taken as soon as the patient remembers. However, a double dose should not be taken when it is time for the next scheduled dose.

Dosage Adjustment in Patients with Renal Impairment

For patients with moderate renal impairment (eGFR between 30–60 mL/min/1.73 m²), the benefits and risks of medication use must be carefully evaluated.

There is a lack of relevant study data to support the use of empagliflozin in patients with a persistent eGFR below 20 mL/min/1.73 m² or those who have undergone dialysis.

Medication Use in Special Populations for Empagliflozin

Use in Elderly Patients

Elderly patients (≥75 years old) are more prone to adverse reactions related to hypovolemia and urinary tract infections.

Use in Patients with Chronic Kidney Disease

Empagliflozin is indicated for adult patients with chronic kidney disease at risk of progression. It can significantly reduce the risk of persistent eGFR decline, end-stage renal disease, cardiovascular death, and hospitalization.

However, it is not recommended for patients with polycystic kidney disease, those requiring intravenous immunosuppressive therapy, or those who have recently used a prednisone equivalent dose >45 mg.