empagliflozin at a glance
Medicine class
Sodium-glucose co-transporter-2 (SGLT2) inhibitor.
Main uses
Type 2 diabetes, symptomatic chronic heart failure and chronic kidney disease.
Taking the tablet
Swallow whole with water, with or without food.
Important safety issue
Ketoacidosis can occur even when blood glucose is not very high.
What is empagliflozin used for?
Empagliflozin is licensed for:
Insufficiently controlled type 2 diabetes in adults and children aged 10 years and over, alongside diet and exercise, when metformin is unsuitable because of intolerance or in addition to other diabetes medicines.
Symptomatic chronic heart failure in adults.
Chronic kidney disease in adults.
How does empagliflozin work?
Empagliflozin blocks SGLT2 in the kidneys, reducing the return of filtered glucose and sodium to the bloodstream. More glucose, sodium and water leave in urine. This lowers blood glucose in type 2 diabetes and changes pressure and fluid handling in ways that benefit the heart and kidneys.
empagliflozin preparations and strengths
Tablet
Route: Oral
Strengths: 10 mg, 25 mg
How to take empagliflozin
Follow the dispensing label and your prescriber's instructions. Do not stop treatment without discussing it with your clinical team unless urgent safety advice directs you to stop.
Swallow the film-coated tablet whole with water.
It may be taken with or without food.
Tell your clinical team before surgery or if acutely unwell, particularly with vomiting, restricted food intake or dehydration; treatment may need to be interrupted.
empagliflozin side effects
Common or expected effects
- Genital thrush or another genital infection
- Pain or burning when urinating or another urinary tract infection symptom
- Passing urine more often
- Thirst
- Itching or mild rash
- Low blood glucose when used with insulin or a sulfonylurea
Get urgent medical advice
- Ketoacidosis, which can occur without markedly raised blood glucose
- Severe dehydration or symptomatic low blood pressure
- Kidney infection, urosepsis or another complicated urinary infection
- Fournier's gangrene: severe infection around the genitals or perineum
- Serious allergic reaction
empagliflozin in pregnancy
Empagliflozin is not recommended during pregnancy because human information is limited and animal studies raise concerns about development after birth. Contact the prescriber promptly if pregnant or planning pregnancy; do not stop essential treatment without advice.
empagliflozin while breastfeeding
Empagliflozin should not be used during breastfeeding because transfer into human milk is unknown and risk to the infant cannot be excluded. The prescriber should review alternatives, especially when feeding a newborn or premature infant.
empagliflozin interactions
Tell the prescriber or pharmacist about all prescribed, over-the-counter and herbal products. Important examples include:
Insulin and sulfonylureas, such as gliclazide
The combination increases hypoglycaemia risk, so the other diabetes treatment may require clinical review.
Loop or thiazide diuretics
Their fluid-losing effect may increase dehydration and low-blood-pressure risk.
Blood-pressure-lowering medicines
Dizziness or symptomatic low blood pressure may be more likely, particularly with fluid depletion.
Common questions about empagliflozin
Answers are fully visible for fast scanning and source review.
Can empagliflozin be used without diabetes?
Yes. It is licensed for adults with symptomatic chronic heart failure or chronic kidney disease, including some people without diabetes.
Why does urine test positive for glucose?
Empagliflozin blocks glucose reabsorption by the kidneys, so more glucose passes into urine. This expected effect does not by itself mean treatment is failing.
Can empagliflozin cause low blood sugar?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.