10 mg once daily covers four PBS indications — type 2 diabetes, heart failure (reduced or preserved EF) and chronic kidney disease. A CV-risk/ATSI fast-track has removed the HbA1c requirement for T2DM since 1 Apr 2025, and CKD eligibility was broadened from 1 Nov 2025. Confirm the exact current eGFR/UACR bands and wording at pbs.gov.au.
1Eligibility — four pathways
✓T2DM — standard — T2DM confirmed (not T1DM, LADA or gestational); with metformin unless contraindicated/intolerant. Standard listing still needs HbA1c above the PBS threshold despite metformin.
✓T2DM — CV-risk/ATSI — No HbA1c threshold if established cardiovascular disease, high CV risk, or Aboriginal or Torres Strait Islander, with metformin — in force from 1 Apr 2025.
✓Heart failure — PBS-listed as adjunct to standard HF therapy across the EF spectrum (HFrEF and HFpEF), irrespective of diabetes status.
✓Chronic kidney disease — eGFR/albuminuria-based; broadened 1 Nov 2025 to cover earlier-stage disease; funded with or without diabetes. Exact bands are detailed — confirm directly at pbs.gov.au.
2By indication
| Indication | Dose | Key note |
|---|
| Type 2 diabetes | 10 mg; may increase to 25 mg if tolerated and more glycaemic control is needed | Combine with metformin, SU, DPP-4i or insulin; not with a GLP-1 RA or another SGLT-2i |
| Heart failure | 10 mg only — 25 mg not studied or funded for HF | Adjunct to standard HF therapy; not monotherapy |
| CKD | 10 mg only, irrespective of eGFR within range | No renal dose adjustment; eligibility eGFR differs by indication |
Verify at PBS — Expect a small, reversible eGFR dip in the first ~4 weeks — don't stop for this alone. Exact eGFR/UACR bands, HbA1c thresholds and item codes are not reproduced here — confirm at pbs.gov.au.
Safety
- Sick-day rules: stop temporarily during acute illness with vomiting/diarrhoea/dehydration, major surgery, prolonged fasting, or severe infection — euglycaemic DKA risk; check ketones if unwell despite normal glucose.
- Genital thrush is common — counsel and treat; rare but serious: Fournier's gangrene — urgent review for perineal pain.
- Volume depletion, especially in older patients on diuretics — review BP and hydration.
- Hypoglycaemia risk only if combined with a sulfonylurea or insulin.
Check / exclude
- Confirm current eGFR/UACR bands for the CKD indication at pbs.gov.au — broadened Nov 2025 and multi-tiered, not a single cut-off.
- Exclude: T1DM/DKA history, dialysis/transplant (stop before), pregnancy/breastfeeding; caution with recurrent genital infection/UTI.
- eGFR under 20: avoid initiation; existing patients may continue.
- Don't combine with another SGLT-2 inhibitor.
EN-05 v1.0 · Reviewed Jun 2026 · Review Dec 2026
For health-professional use. Eligibility summarised from public PBS reporting — confirm exact eGFR/UACR bands and item codes at pbs.gov.au. Covers empagliflozin (Jardiance) across T2DM, HFrEF, HFpEF and CKD — not a complete dose-and-criteria matrix.
