Synjardy Dosage

 Recommended Adult Dosing

Dosage forms:  TAB: 5 mg/500 mg, 5 mg/1000 mg, 12.5 mg/500 mg, 12.5 mg/1000 mg

Diabetes mellitus, type 2

[conversion from metformin]

Dose: 1-2 tabs PO bid; Start: empagliflozin 5 mg PO bid plus current daily metformin dose PO divided bid; Max: 25 mg/2000 mg/day; Info: give w/ meals; hold tx for surgery if restricting food/fluid; consider holding tx at least 3 days before surgery; D/C for iodinated contrast study if eGFR <60, hepatic dz hx, alcoholism hx, heart failure hx, or receiving contrast intra-arterially; restart after 48h if stable renal fxn; see empagliflozin for cardiovascular event risk reduction use

[conversion from empagliflozin]

Dose: 1-2 tabs PO bid; Start: metformin 500 mg PO bid plus current daily empagliflozin dose PO divided bid; Max: 25 mg/2000 mg/day; Info: give w/ meals; hold tx for surgery if restricting food/fluid; consider holding tx at least 3 days before surgery; D/C for iodinated contrast study if eGFR <60, hepatic dz hx, alcoholism hx, heart failure hx, or receiving contrast intra-arterially; restart after 48h if stable renal fxn; see empagliflozin for cardiovascular event risk reduction use

[conversion from empagliflozin plus metformin]

Dose: 1-2 tabs PO bid; Start: equivalent dose of each component in current regimen; Max: 25 mg/2000 mg/day; Info: give w/ meals; hold tx for surgery if restricting food/fluid; consider holding tx at least 3 days before surgery; D/C for iodinated contrast study if eGFR <60, hepatic dz hx, alcoholism hx, heart failure hx, or receiving contrast intra-arterially; restart after 48h if stable renal fxn; see empagliflozin for cardiovascular event risk reduction use

Renal dosing

[see below]

eGFR 30-44: avoid tx initiation; eGFR <30: contraindicated; Info: weigh risk/benefit if eGFR 30-44 during tx

HD/PD: contraindicated

Hepatic dosing

hepatic impairment: avoid use