Adults

Individualized dosage based on efficacy and tolerability. Typically initiated with Empagliflozin 5 mg/Metformin 500 mg orally twice daily with meals. May be titrated up to a maximum of Empagliflozin 25 mg/Metformin 2000 mg daily.

Elderly

No specific dose adjustment for age alone, but renal function should be monitored carefully. Do not initiate if eGFR <45 mL/min/1.73 m².

Renal_impairment

Contraindicated in severe renal impairment (eGFR <30 mL/min/1.73 m²). Dosage adjustment required for eGFR 30-45 mL/min/1.73 m² (max Empagliflozin 10 mg/day, Metformin 1000 mg/day).

Onset

Within hours for blood glucose reduction.

Excretion

Both empagliflozin and metformin are primarily excreted renally.

Half life

Empagliflozin: Approximately 10-13 hours. Metformin: Approximately 4-9 hours.

Absorption

Empagliflozin is well absorbed orally, with peak plasma concentrations occurring within 1.5 hours. Metformin is slowly and incompletely absorbed, with peak concentrations reached in 2-3 hours.

Metabolism

Empagliflozin is primarily metabolized via glucuronidation. Metformin is not metabolized in the liver.

Alcohol

Increases the risk of lactic acidosis with metformin.

Diuretics

May increase the risk of dehydration and hypotension with empagliflozin.

Iodinated contrast agents

Metformin should be withheld before or at the time of the imaging procedure and for at least 48 hours afterward.

UGT-inducing drugs (e.g., Rifampicin)

May reduce empagliflozin exposure.

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

Increased risk of hypoglycemia when used with empagliflozin/metformin.