제2형 당뇨병에서 자디앙정, 용량, Diabetes mellitus, type 2, Jardiance, dosing

1. Volume depletion이 존재한다면, 약물(자디앙정, Jardiance) 투약 이전에 volume depletion을 교정하고 25 mg까지 용량을 증량할 수 있습니다.

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2. eGFR ≥45 mL/minute/1.73 m2까지는 용량 조절이 필요하지 않습니다.

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자디앙(Jardiance)

Dosing: Adult

Note: If present, correct volume depletion prior to initiation

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Diabetes mellitus, type 2: Oral: Initial: 10 mg once daily; may increase to 25 mg once daily as tolerated

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Dosing: Renal Impairment: Adult

eGFR ≥45 mL/minute/1.73 m2: No dosage adjustment necessary.

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eGFR 30 to <45 mL/minute/1.73 m2: The US manufacturer recommends to not initiate therapy, or in patients already taking empagliflozin, discontinue therapy when eGFR is persistently <45 mL/minute/1.73 m2. Recommendations regarding indicated level of eGFR for initiation or continued use may vary in other regions (ADA 2019). Post-hoc analysis of the EMPA-REG OUTCOME trial suggests use of empagliflozin (at doses of 10 mg or 25 mg once daily) in diabetic patients with cardiovascular disease and renal impairment (eGFR 30 to <60 mL/minute/1.73 m2) may be associated with decreases in incident or worsening nephropathy as well as decreased cardiovascular mortality (Wanner 2016; Wanner 2018). However, additional trials may be necessary to define the role of empagliflozin in improving these outcomes in patients with eGFR 30 to <45 mL/minute/1.73 m2.

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eGFR <30 mL/minute/1.73 m2: Use is contraindicated.

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ESRD, dialysis: Use is contraindicated.

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REF. UpToDate 2019.04.21