Not for use in patients w/ type 1 diabetes. Patients at risk of ketoacidosis while on treatment include patients on a very low carbohydrate diet, w/ an acute illness, pancreatic disorders suggesting insulin deficiency (eg, type 1 diabetes, history of pancreatitis or pancreatic surgery), insulin dose reduction (including insulin pump failure), alcohol abuse, severe dehydration, w/ history of ketoacidosis; discontinue if ketoacidosis is suspected. Discontinue & institute prompt treatment if necrotizing fasciitis of the perineum (Fournier's gangrene) is suspected. Patients for whom an empagliflozin-induced drop in BP could pose a risk eg, w/ known CV disease & on antihypertensive therapy w/ history of hypotension or patients ≥75 yr. Monitor vol status (eg, physical exam, BP, lab tests including hematocrit) & electrolytes in case of conditions that may lead to fluid loss (eg, GI illness). Interrupt treatment temporarily in patients w/ complicated UTI. Rare hereditary problems of galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. Assess renal function prior to initiation & periodically during treatment ie, at least yrly. Avoid use during pregnancy. Lactation. Childn <18 yr. Type 2 DM: Not recommended in patients w/ renal impairment eGFR <30 mL/min/1.73 m
2. Heart failure: Not recommended in patients w/ renal impairment eGFR <20 mL/min/1.73 m
2.
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