Empagliflozin

What is empagliflozin?

Empagliflozin is a medicine used to treat several different long-term health conditions. It belongs to a class of medicines called sodium glucose co-transporter 2 (SGLT2) inhibitors used primarily to manage blood sugar levels. A widely used brand name for empagliflozin is Jardiance[1]. 

What is empagliflozin used for?

Empagliflozin is used to treat type 2 diabetes, by helping lower blood sugar levels. It can be used for heart failure, working to improve cardiovascular outcomes and improve symptoms for the patient. It may also be used for chronic kidney disease (CKD) to slow down kidney damage and reduce complications[1]. 

How does empagliflozin work?

Empagliflozin works by helping to reduce glucose reabsorption in the kidneys thereby increasing glucose leaving the body through urine. This action lowers blood sugar levels in people with type 2 diabetes as well as helps the body remove extra salt and water, therefore reducing pressure on the heart and kidneys, which can lower blood pressure and reduce fluid build-up[1]. 

Who can take empagliflozin?

Empagliflozin is suitable for most adults. It may not be recommended if you have type 1 diabetes, severe kidney problems (or are on dialysis), a history of diabetic ketoacidosis (DKA), are pregnant or breastfeeding, or are allergic to empagliflozin or any of the other ingredients listed as part of this medicine. You should always speak to your doctor or pharmacist before starting this medicine[1]. 

Please tell your doctor or pharmacist about any conditions you may have before you start treatment and always follow the instructions in the Patient Information Leaflet[3]. 

How do you take empagliflozin?

Empagliflozin is normally taken once a day – ideally at the same time each day. It can be taken with or without food, swallowed whole with water.

What is the typical dosage of empagliflozin?

The typical starting dose when first prescribed empagliflozin is 10mg – usually taken once a day. Depending on your condition – and how well you respond to the treatment – your clinician may increase the dose up to 25mg once a day. You should always follow the dose as it is prescribed[1]. 

Can you stop taking empagliflozin suddenly?

It’s important not to stop taking empagliflozin without speaking to your doctor or pharmacist. This is because stopping suddenly can worsen conditions such as heart failure, chronic kidney disease or type 2 diabetes. So, if you need to stop, speak to your doctor or pharmacist and they will advise you on the safest course of action[1]. 

What should you do if you take too much empagliflozin?

Taking too much empagliflozin may cause symptoms like low blood sugar, especially if you take it with other diabetes medicines. It can also cause dehydration and an increased need to urinate[1]. 

Contact your doctor, call NHS 111, or go to A&E if you think you have taken too much empagliflozin. 

What should you do if you forget a dose of empagliflozin?

If you forget a regular dose of empagliflozin, take it as soon as you remember. If it is nearly time for your next dose, skip the missed dose and take the next one at the usual time. You shouldn’t take two doses at the same time as this brings the possibility of unwanted, and potentially dangerous, side effects[1]. 

What medicines should you avoid while taking empagliflozin?

Empagliflozin can interact with a range of other medicines, including[1]: 

• Diuretics (water tablets), which may increase the risk of dehydration 

• Insulin or sulfonylureas, which can increase the risk of low blood sugar 

• Lithium, as its levels in the blood may be affected 

• Other SGLT2 inhibitors, which should not be taken alongside empagliflozin 

Always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine, and follow the instructions in the Patient Information Leaflet[3]. 

What are the side effects of empagliflozin?

The most common side effects when taking empagliflozin include genital thrush, urinary tract infections, needing to urinate more often, or feeling thirsty or nauseous[1].  

Some serious side effects that require immediate medical help are noticing signs of diabetic ketoacidosis (DKA), such as nausea, vomiting, stomach pain, excessive thirst, rapid weight loss, tiredness, confusion or breath that smells fruity, sweet or metallic taste or change in smell to your urine or sweat, especially after major surgery or acute serious illness[1].  

Urgent medical attention should be sort if experience severe pain, tenderness, redness of skin or swelling of genital or perineal area, accompanied by fever or malaise. You should also get medical help if you have signs of a urinary tract infection, such as pain when urinating, fever or back pain[1].  

You should contact your GP if you experience any of these symptoms. In rare cases, the medicine may cause a serious allergic reaction (anaphylaxis). You should call 999 or visit A&E immediately if you believe this is happening[1]. 

If you experience any side effects, including those not listed, you are encouraged to report them via the Yellow Card Scheme or contact your doctor, pharmacist, or nurse. This information is intended as a summary for general awareness and does not replace professional medical advice. 

The information provided in the side effects section is not a comprehensive list of all possible side effects associated with this medication. For a complete list of side effects, please refer to the Patient Information Leaflet (PIL) provided with your medication or consult your healthcare professional[3]. 

Frequently asked questions about empagliflozin

Can I drink alcohol while taking empagliflozin? 

Yes, you can usually drink alcohol safely while taking empagliflozin, but only in moderation. This is because alcohol can increase the risk of dehydration and low blood sugar[1]. 

Can empagliflozin be taken long term? 

Yes, empagliflozin is often used as a long-term treatment for type 2 diabetes, heart failure and chronic kidney disease[1]. 

Will I lose weight while taking empagliflozin? 

Some people may lose weight due to loss of glucose and water through urine – this does not always mean fat loss although that can also occur[1]. 

Can I take empagliflozin if I am fasting? 

You may be able to take empagliflozin while fasting. However, you should speak to your doctor or pharmacist first, particularly if you are diabetic while also fasting for religious or health reasons[1].

For the official NHS guide to empagliflozin, visit their website.