IMPORTANT SAFETY
INFORMATION AND INDICATIONS
CONTRAINDICATIONS: Hypersensitivity to empagliflozin
or any of the excipients in JARDIANCE, reactions such as angioedema have occurred; patients
on dialysis.
WARNINGS AND PRECAUTIONS
Ketoacidosis: Ketoacidosis, a serious life-threatening condition
requiring urgent hospitalization, has been identified in patients with type 1 and
type 2 diabetes mellitus receiving SGLT2 inhibitors, including empagliflozin. Fatal
cases of ketoacidosis have been reported in patients taking empagliflozin. Patients who
present with signs and symptoms of metabolic acidosis should be assessed for ketoacidosis,
even if blood glucose levels are less than 250 mg/dL. If suspected, discontinue
JARDIANCE, evaluate, and treat promptly. Before initiating JARDIANCE, consider risk factors
for ketoacidosis. Patients may require monitoring and temporary discontinuation in
situations known to predispose to ketoacidosis. For patients who undergo scheduled surgery,
consider temporarily discontinuing JARDIANCE for at least 3 days prior to surgery.
Volume Depletion: Empagliflozin can cause intravascular volume
depletion which may manifest as symptomatic hypotension or acute transient changes in
creatinine. Acute kidney injury requiring hospitalization and dialysis has been reported in
patients with type 2 diabetes receiving SGLT2 inhibitors, including empagliflozin. Before
initiating, assess volume status and renal function in patients with impaired renal function
(eGFR <60 mL/min/1.73 m2), elderly patients or patients on loop diuretics. In
patients with volume depletion, correct this condition. After initiating, monitor for signs
and symptoms of volume depletion and renal function.
Urosepsis and Pyelonephritis: Serious urinary tract infections
including urosepsis and pyelonephritis requiring hospitalization have been identified in
patients receiving SGLT2 inhibitors, including empagliflozin. Treatment with SGLT2
inhibitors increases the risk for urinary tract infections. Evaluate for signs and symptoms
of urinary tract infections and treat promptly.
Hypoglycemia: The use of JARDIANCE in combination with insulin or insulin
secretagogues can increase the risk of hypoglycemia. A lower dose of insulin or
the insulin secretagogue may be required.
Necrotizing Fasciitis of the Perineum (Fournier’s Gangrene):
Serious, life-threatening cases requiring urgent surgical intervention have occurred in both
females and males. Serious outcomes have included hospitalization, multiple surgeries and
death. Assess patients presenting with pain or tenderness, erythema, or swelling in the
genital or perineal area, along with fever or malaise. If suspected, institute prompt
treatment and discontinue JARDIANCE.
Genital Mycotic Infections: Empagliflozin increases the risk for
genital mycotic infections, especially in patients with prior infections. Monitor and treat
as appropriate.
Hypersensitivity Reactions: Serious hypersensitivity reactions
have occurred with JARDIANCE (angioedema). If hypersensitivity reactions occur, discontinue
JARDIANCE, treat promptly, and monitor until signs and symptoms resolve.
MOST COMMON ADVERSE REACTIONS (≥5%): Urinary tract
infections and female genital mycotic infections.
DRUG INTERACTIONS:
Diuretics: Coadministration with diuretics may enhance the potential for volume depletion. Monitor for signs and symptoms.
Lithium: Concomitant use with lithium may decrease serum lithium concentrations. Monitor more frequently during JARDIANCE initiation and dosage changes.
USE IN SPECIAL POPULATIONS
Pregnancy: JARDIANCE is not recommended during the second and
third trimesters.
Lactation: JARDIANCE is not recommended while
breastfeeding.
Geriatric Use: JARDIANCE is expected to have diminished glycemic
efficacy in elderly patients with renal impairment. Assess renal function more
frequently in elderly patients. The incidence of volume depletion-related adverse
reactions and urinary tract infections increased in T2D patients ≥75 years treated with
empagliflozin.
INDICATIONS AND LIMITATIONS OF USE
JARDIANCE is indicated:
-
to reduce the risk of cardiovascular death and hospitalization for heart failure in
adults with heart failure.
-
to reduce the risk of cardiovascular death in adults with type 2 diabetes mellitus
and established cardiovascular disease.
-
as an adjunct to diet and exercise to improve glycemic control in adults with
type 2 diabetes mellitus.
JARDIANCE is not recommended in patients with type 1 diabetes mellitus. It may increase
their risk of diabetic ketoacidosis.
JARDIANCE is not recommended for use to improve glycemic control in adults with type 2
diabetes mellitus with an eGFR <30 mL/min/1.73 m2. JARDIANCE is likely to
be ineffective in this setting based upon its mechanism of action.
CL‑JAR‑100130 10.17.2022
Please see JARDIANCE Prescribing Information and
Medication Guide.
†Add-on to
metformin: A Phase III, randomized, double-blind, placebo-controlled,
parallel-group, efficacy and safety study of JARDIANCE (10 mg, 25 mg) administered
orally once daily over 24 weeks in patients with type 2 diabetes mellitus with
insufficient glycemic control despite treatment with metformin ≥1500 mg alone. Six
hundred thirty-seven treated patients received placebo + metformin (n=207), JARDIANCE
10 mg + metformin (n=217), or JARDIANCE 25 mg + metformin (n=213). The primary
endpoint was A1C change from baseline. Weight change and blood pressure change from baseline
were secondary endpoints.¹
‡Source:
Based on Fingertip Formulary and/or data on file, Boehringer Ingelheim Pharmaceuticals,
Inc., as of 3/13/22.
§Percentage of covered lives represent a weighted average of both commercial and
Part D availability. "Patients" consists of commercially and Medicare Part D
insured lives.
T2D=Type 2 Diabetes
mm Hg=millimeter of mercury
References: 1. American Diabetes Association. Standards of
medical care in diabetes-2021. Diabetes Care. 2021;44 (suppl 1):
S1-S232. 2. Das SR, Everett BM, Birtcher KK, et al. J
Am Coll Cardiol. 2018;72(24):3200-3223. 3. Roden M,
Weng J, Eilbracht J, et al; EMPA-REG MONO Trial Investigators. Lancet Diabetes
Endocrinol. 2013;1(3):208-219. 4. Data on file.
Boehringer Ingelheim Pharmaceuticals, Inc. 5. Häring HU,
Merker L, Seewaldt-Becker E, et al; EMPA-REG MET Trial Investigators. Diabetes Care.
2014;37(6):1650-1659.
Copyright © 2022 Boehringer
Ingelheim Pharmaceuticals, Inc.
All rights
reserved.
(12/22) PC-US-130759-C