Empagliflozin
Indications
Empagliflozin is indicated in:
- As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
- To reduce the risk of cardiovascular death in adult patients with type 2 diabetes mellitus and established cardiovascular disease.
Pharmacology
Empagliflozin is a sodium glucose co-transporter-2 (SGLT-2) inhibitor. SGLT2 co-transporters are responsible for reabsorption of glucose from the glomerular filtrate in the kidney. The glucuretic effect resulting from SGLT2 inhibition reduces renal absorption and lowers the renal threshold for glucose, resulting in increased glucose excretion. Additionally, it contributes to reduced hyperglycaemia, assists weight loss, and reduces blood pressure.
Dosage & Administration
The recommended dose of Empagliflozin is 10 mg once daily, taken in the morning, with or without food. In patients tolerating Empagliflozin, the dose may be increased to 25 mg once daily. In patients with volume depletion, correcting this condition prior to initiation of Empagliflozin is recommended.
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Interaction
Diuretics: Co-administration of Empagliflozin with diuretics resulted in increased urine volume.
Insulin or Insulin Secretagogues: Co-administration of Empagliflozin with insulin or insulin secretagogues increases the risk for hypoglycemia.
Positive Urine Glucose Test: Monitoring glycemic control with urine glucose tests is not recommended in patients taking SGLT2 inhibitors as SGLT2 inhibitors increase urinary glucose excretion and will lead to positive urine glucose tests. Use alternative methods to monitor glycemic control.
Interference with 1,5-anhydroglucitol (1,5-AG) Assay: Monitoring glycemic control with 1,5-AG assay is not recommended as measurements of 1,5-AG are unreliable in assessing glycemic control in patients taking SGLT2 inhibitors. Use alternative methods to monitor glycemic control.
Insulin or Insulin Secretagogues: Co-administration of Empagliflozin with insulin or insulin secretagogues increases the risk for hypoglycemia.
Positive Urine Glucose Test: Monitoring glycemic control with urine glucose tests is not recommended in patients taking SGLT2 inhibitors as SGLT2 inhibitors increase urinary glucose excretion and will lead to positive urine glucose tests. Use alternative methods to monitor glycemic control.
Interference with 1,5-anhydroglucitol (1,5-AG) Assay: Monitoring glycemic control with 1,5-AG assay is not recommended as measurements of 1,5-AG are unreliable in assessing glycemic control in patients taking SGLT2 inhibitors. Use alternative methods to monitor glycemic control.
Contraindications
Empagliflozin is contraindicated in patients with history of serious hypersensitivity reaction to Empagliflozin or any of its ingredients, severe renal impairment, end-stage renal disease, or dialysis.
Side Effects
The most common adverse reactions associated with Empagliflozin are urinary tract infections and female genital mycotic infections. Others common side effects includes dehydration, hypotension, weakness, dizziness and increased thirstiness.
Pregnancy & Lactation
There are no adequate and well-controlled studies of Empagliflozin in pregnant women. Empagliflozin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known if Empagliflozin is excreted in human milk. It is not recommended when breastfeeding.
Precautions & Warnings
Assessment of renal function is recommended prior to initiation of Empagliflozin and periodically thereafter. Empagliflozin should not initiated in patients with an eGFR less than 45 ml/min/1.73 m2. No dose adjustment is needed in patients with an eGFR greater than or equal to 45 ml/min/1.73 m2.
Overdose Effects
In the event of an overdose with Empagliflozin the usual supportive measures (e.g., remove unabsorbed material from the gastrointestinal tract, perform clinical monitoring, and institute supportive treatment) should be employed. Removal of Empagliflozin by hemodialysis has not been studied.
Therapeutic Class
Sodium-glucose Cotransporter-2 (SGLT2) Inhibitors
Storage Conditions
Keep in a cool & dry place (below 30° C), protected from light & moisture. Keep out of the reach of children.
Chemical Structure
| Molecular Formula : | C23H27ClO7 |
| Chemical Structure : |  |
Common Questions about Empagliflozin
What is Empagliflozin?
Empagliflozin is a SGLT-2 inhibitor which reduces the reabsorption of glucose from kidney.
What is Empagliflozin used for?
Empagliflozin is commonly used to improve glycemic control in adults.
Are there any pregnancy warnings?
Empagliflozin may be unsafe to use during pregnancy.
Are there any breast-feeding warnings?
Empagliflozin is probably unsafe to use during breastfeeding.
Does this affect kidney function?
Empagliflozin should be used cautiously in patients with an underlying kidney disease.
Does this affect liver function?
No dose adjustment is needed for patients with the mild to moderate liver disease.
Quick Tips
- Empagliflozin is used alone or together with other diabetes medicines to control blood sugar and avoid long-term complications.
- Empagliflozin may cause your body to lose too much fluid (dehydration) or you may urinate more often. Drink plenty of water and stay hydrated.
- Empagliflozin may cause hypoglycemia (low blood sugar level) when used with other antidiabetic medicines, alcohol or if you delay or miss a meal.
- Always carry some sugary food or fruit juice with you in case you experience hypoglycemia symptoms such as cold sweats, cool pale skin, tremor and anxiety.
- Empagliflozin can cause genital fungal and/or urinary tract infections (UTIs) in both females and males, so practice good hygiene.
- Monitor your blood sugar regularly while taking Empagliflozin.
- Inform your doctor immediately if you experience constant dizziness, joint pain, cold-like symptoms or unexplained nausea/vomiting.
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