Adults

The recommended initial dose is 10 mg once daily in the morning, with or without food. The dose may be increased to 25 mg once daily based on glycemic response and tolerability. For heart failure and chronic kidney disease, the recommended dose is 10 mg once daily.

Elderly

No dose adjustment is required based on age alone. Renal function should be assessed before initiation and periodically thereafter.

Renal_impairment

No dose adjustment is needed for patients with an eGFR ≥30 mL/min/1.73 m². Initiation is not recommended in patients with an eGFR <20 mL/min/1.73 m².

Onset

Glycemic effect typically starts within hours of administration.

Excretion

Approximately 50% of the dose is excreted unchanged in urine, and approximately 50% is excreted in feces (mostly as metabolites).

Half life

The mean terminal elimination half-life is approximately 12.4 hours.

Absorption

Rapidly absorbed after oral administration, with peak plasma concentrations (Cmax) typically reached 1.5 hours post-dose. Absolute bioavailability is approximately 78%.

Metabolism

Primarily metabolized via glucuronidation by uridine 5'-diphospho-glucuronosyltransferases UGT1A8, UGT1A3, UGT1A9, and UGT2B7.

Diuretics

Co-administration with diuretics may increase the risk of dehydration and hypotension.

UGT Inducers (e.g., Rifampicin, Phenytoin)

May lead to decreased empagliflozin exposure and reduced efficacy.

Insulin and Insulin Secretagogues (e.g., Sulfonylureas)

Increased risk of hypoglycemia when used in combination; a lower dose of insulin or insulin secretagogue may be required.