Approved Hospital Formulary
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Approved Hospital Formulary
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empagliflozin

empagliflozin
Drug Name Form Strength Notes
Jardiance TABLET, ORAL 10 mg (formulary, restricted), 25 mg (non-formulary)


Additional Information:

Formulary Restricted to patients with a diagnosis of heart failure. 

For new starts - The provider or their designee, please check coverage and affordability, by sending a discharge prescription to outpatient pharmacy, in order to ensure continuity of care.

Non-Formulary SGLT2-inhibitors, including empagliflozin 25 mg dose, interchange to empagliflozin 10 mg.  See Therapeutic Interchange.


Last updated: Jan. 23, 2026







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