Discontinue use if diabetic ketoacidosis, necrotizing fasciitis, pancreatitis or bullous pemphigoid is suspected. Consider temporary discontinuation for at least 3 days prior to surgery in patients who undergo scheduled surgery. Temporary interruption of treatment until fluid loss is corrected; in patients w/ complicated UTI. Not to be used in patients w/ type 1 diabetes; ketoacidosis; severe infection or accident. Bacterial & fungus infection on genital area & urinary tract. Increased risk of severe joint pain. Patients w/ very low carbohydrate diet, acute illness, pancreatic disorders suggesting insulin deficiency (eg, type 1 diabetes, history of pancreatitis or pancreatic surgery), insulin dose reduction (including pump failure), alcohol abuse, severe dehydration, & history of ketoacidosis; known CV disease, on antihypertensive therapy w/ history of hypotension, or patients ≥75 yr for whom an empagliflozin-induced decrease in BP could pose a risk. Immediately assess patients if symptoms of ketoacidosis occur regardless of blood glucose level. Consider monitoring for ketoacidosis & temporarily discontinue treatment in clinical situations known to predispose to ketoacidosis. Monitor ketones; vol status & electrolytes. Evaluate patients who present w/ pain or tenderness, erythema, genital or perineal swelling, fever, malaise for necrotizing fasciitis. Assess renal function prior to initiation of treatment & periodically during treatment, ie, at least yrly. Concomitant use w/ sulphonylurea or insulin. Not to be taken w/ alcohol beverage. Not recommended in patients w/ persistent estimated GFR <30 mL/min/1.73 m
2. Avoid use during pregnancy. Discontinue breastfeeding during treatment. Not recommended in childn <18 yr & elderly ≥85 yr. Elderly ≥75 yr (increased risk of vol depletion).
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