Adults with normal renal function (GFR ≥90ml/min): The recommended dose is one JARDIANCE DUO tablet twice daily.
The dosage should be individualised on the basis of the patient's current regimen, effectiveness, and tolerability. The maximum recommended daily dose of JARDIANCE DUO is 25 mg of empagliflozin and 2000 mg of metformin (see Table 16 for additional dosing information).
JARDIANCE DUO should be given with meals to reduce the gastrointestinal undesirable effects associated with metformin.
Treatment naïve patients: The recommended starting dose is 5 mg/500 mg twice daily. If additional glycaemic control is required, adjust dosing based on effectiveness and tolerability while not exceeding the maximum recommended daily dose of 25 mg empagliflozin and 2000 mg metformin.
Patients switching from separate tablets of empagliflozin and metformin: Patients switching from separate tablets of empagliflozin (10 mg or 25 mg total daily dose) and metformin to JARDIANCE DUO, should receive the same daily dose of empagliflozin and metformin already being taken or the nearest therapeutically appropriate dose of metformin.
Patients not adequately controlled on the maximal tolerated dose of metformin alone or in combination with other products, including insulin: The recommended starting dose of JARDIANCE DUO should provide empagliflozin 5 mg twice daily (10 mg total daily dose) and the dose of metformin similar to the dose already being taken. In patients tolerating a total daily dose of empagliflozin 10 mg, the dose can be increased to a total daily dose of empagliflozin 25 mg.
Combination use: When JARDIANCE DUO is used in combination with a sulfonylurea and/or insulin, a lower dose of sulfonylurea and/or insulin may be required to reduce the risk of hypoglycaemia (see Interactions and Adverse Reactions).
Renal impairment: No dose adjustment is recommended for patients with mild renal impairment.
An eGFR should be assessed before initiation of treatment with metformin containing products and at least annually thereafter. In patients at increased risk of further progression of renal impairment and in the elderly, renal function should be assessed more frequently, e.g. every 3-6 months.
For dosing recommendations in the paediatric population see subsection paediatric patients as follows. (See Table 16.)

Elderly Patients: Patients age 75 years and older may be at an increased risk of volume depletion, therefore, JARDIANCE DUO should be prescribed with caution in these patients (see Use in the Elderly under Precautions).
Paediatric population: The dosage should be individualised on the basis of the patient's current regimen, effectiveness, and tolerability. The recommended dose is one tablet twice daily.
The maximum recommended daily dose of JARDIANCE DUO is 25 mg of empagliflozin and 2000 mg of metformin (see general information as previously mentioned).
No data are available for children with eGFR <60 ml/min/1.73 m2 and children below 10 years of age.