Empagliflozin Brand Name– JARDIANCE
What is Empagliflozin
Empagliflozin is an oral sodium-glucose co-transporter 2 (SGLT2) inhibitor.
Empagliflozin works by blocking the reabsorption of glucose by the kidney, which results in increased glucose excretion and reduced blood glucose concentrations.
Empagliflozin is used to improve glycemic control in adults with type 2 diabetes mellitus (DM) and to reduce the risk of cardiovascular death in type 2 DM patients who also have cardiovascular disease.
The drug is not recommended for use in patients with severe renal impairment, as drug efficacy is reduced, and the risk for renal-related adverse events may be increased.
Empagliflozin has been shown to reduce cardiovascular (CV) risk.
Empagliflozin significantly reduced the risk of major adverse cardiovascular events (MACE: cardiovascular death, the first occurrence of non-fatal myocardial infarction, or non-fatal stroke) by 14% relative to placebo (HR 0.86, 95% CI 0.74 to 0.99) in patients with type 2 DM and established, stable, atherosclerotic CV disease.
Empagliflozin also significantly reduced the risk of hospitalization for heart failure (HF) compared with placebo.
Metformin is first-line in the treatment of type 2 DM. Additional therapy with an SGLT2 inhibitor with evidence of reducing HF and/or chronic kidney disease (CKD) progression should be considered in patients with indicators of high-risk or established CKD or HF, independent of baseline A1C or individualized A1C target.
SGLT2 inhibitors with proven CV-risk reduction, like empagliflozin, are also an alternative treatment option in DM patients with indicators of high-risk or established CV disease who cannot tolerate a glucagon-like peptide-1 receptor agonist (GLP-1 RA)
Indications
- reduction of cardiovascular mortality
- reduction of heart failure hospitalizations
- type 2 diabetes mellitus
For the treatment of type 2 diabetes mellitus (T2DM) in combination with diet and exercise
Side Effects
- angioedema
- arthralgia
- balanitis
- candidiasis
- cystitis
- dehydration
- diabetic ketoacidosis
- diuresis
- hypercholesterolemia
- hyperlipidemia
- hypoglycemia
- hypotension
- hypovolemia
- increased urinary frequency
- infection
- nausea
- necrotizing fasciitis
- nocturia
- orthostatic hypotension
- pharyngitis
- phimosis
- polydipsia
- polyuria
- rash
- renal failure (unspecified)
- syncope
- tissue necrosis
- urticaria
- vaginitis
Monitoring Parameters
- blood glucose
- glycosylated hemoglobin A1c (HbA1c)
- serum cholesterol profile
- serum creatinine/BUN
Contraindications
- adrenal insufficiency
- balanitis
- breast-feeding
- burns
- children
- dehydration
- diabetic ketoacidosis
- dialysis
- fever
- geriatric
- hypercholesterolemia
- hypercortisolism
- hyperglycemia
- hyperthyroidism
- hypoglycemia
- hypotension
- hypothyroidism
- hypovolemia
- infants
- infection
- malnutrition
- pituitary insufficiency
- pregnancy
- pyelonephritis
- renal failure
- renal impairment
- surgery
- tissue necrosis
- trauma
- type 1 diabetes mellitus
- urinary tract infection (UTI)
- vaginitis
Interactions
- Acebutolol
- Acetazolamide
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Aliskiren; Hydrochlorothiazide, HCTZ
- Aliskiren; Valsartan
- Amiloride
- Amiloride; Hydrochlorothiazide, HCTZ
- Amlodipine
- Amlodipine; Atorvastatin
- Amlodipine; Benazepril
- Amlodipine; Celecoxib
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Olmesartan
- Amlodipine; Telmisartan
- Amlodipine; Valsartan
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amprenavir
- Androgens
- Angiotensin II receptor antagonists
- Angiotensin-converting enzyme inhibitors
- Atazanavir
- Atazanavir; Cobicistat
- Atenolol
- Atenolol; Chlorthalidone
- atypical antipsychotic
- Azilsartan
- Azilsartan; Chlorthalidone
- Benazepril
- Benazepril; Hydrochlorothiazide, HCTZ
- Bendroflumethiazide; Nadolol
- Beta-blockers
- Betaxolol
- Bisoprolol
- Bisoprolol; Hydrochlorothiazide, HCTZ
- Bortezomib
- Brimonidine; Timolol
- Bumetanide
- Calcium-channel blockers
- Candesartan
- Candesartan; Hydrochlorothiazide, HCTZ
- Captopril
- Captopril; Hydrochlorothiazide, HCTZ
- Carbonic anhydrase inhibitors
- Carteolol
- Carvedilol
- Chloroquine
- Chlorothiazide
- Chlorthalidone
- Chlorthalidone; Clonidine
- Chromium
- Clarithromycin
- Clevidipine
- Clonidine
- Conjugated Estrogens; Medroxyprogesterone
- Corticosteroids
- Daclatasvir
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Diazoxide
- Dienogest; Estradiol valerate
- Diltiazem
- Dorzolamide; Timolol
- Drospirenone
- Drospirenone; Estradiol
- Drospirenone; Ethinyl Estradiol
- Drospirenone; Ethinyl Estradiol; Levomefolate
- Elagolix; Estradiol; Norethindrone acetate
- Elbasvir; Grazoprevir
- Enalapril, Enalaprilat
- Enalapril; Felodipine
- Enalapril; Hydrochlorothiazide, HCTZ
- Eprosartan
- Eprosartan; Hydrochlorothiazide, HCTZ
- Esmolol
- Estradiol Cypionate; Medroxyprogesterone
- Estradiol; Levonorgestrel
- Estradiol; Norethindrone
- Estradiol; Norgestimate
- Estradiol; Progesterone
- Estrogens
- Ethacrynic Acid
- Ethanol
- Ethinyl Estradiol; Desogestrel
- Ethinyl Estradiol; Ethynodiol Diacetate
- Ethinyl Estradiol; Etonogestrel
- Ethinyl Estradiol; Levonorgestrel
- Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
- Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
- Ethinyl Estradiol; Norelgestromin
- Ethinyl Estradiol; Norethindrone
- Ethinyl Estradiol; Norethindrone Acetate
- Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
- Ethinyl Estradiol; Norethindrone; Ferrous fumarate
- Ethinyl Estradiol; Norgestimate
- Ethinyl Estradiol; Norgestrel
- Ethotoin
- Etonogestrel
- Felodipine
- Fibric acid derivatives
- Fluoxetine
- Fluoxetine; Olanzapine
- Fosamprenavir
- Fosinopril
- Fosinopril; Hydrochlorothiazide, HCTZ
- Fosphenytoin
- Furosemide
- Garlic, Allium sativum
- Glecaprevir; Pibrentasvir
- Green Tea
- Hydantoins
- Hydralazine; Hydrochlorothiazide, HCTZ
- Hydrochlorothiazide, HCTZ
- Hydrochlorothiazide, HCTZ; Irbesartan
- Hydrochlorothiazide, HCTZ; Lisinopril
- Hydrochlorothiazide, HCTZ; Losartan
- Hydrochlorothiazide, HCTZ; Methyldopa
- Hydrochlorothiazide, HCTZ; Metoprolol
- Hydrochlorothiazide, HCTZ; Moexipril
- Hydrochlorothiazide, HCTZ; Olmesartan
- Hydrochlorothiazide, HCTZ; Propranolol
- Hydrochlorothiazide, HCTZ; Quinapril
- Hydrochlorothiazide, HCTZ; Spironolactone
- Hydrochlorothiazide, HCTZ; Telmisartan
- Hydrochlorothiazide, HCTZ; Triamterene
- Hydrochlorothiazide, HCTZ; Valsartan
- Hydroxychloroquine
- Hydroxyprogesterone
- Indapamide
- Indinavir
- Irbesartan
- Isocarboxazid
- Isradipine
- Labetalol
- Lanreotide
- Ledipasvir; Sofosbuvir
- Leuprolide; Norethindrone
- Levobetaxolol
- Levobunolol
- Levonorgestrel
- Levothyroxine
- Levothyroxine; Liothyronine (Porcine)
- Levothyroxine; Liothyronine (Synthetic)
- Liothyronine
- Lisinopril
- Lithium
- Lomefloxacin
- Loop diuretics
- Lopinavir; Ritonavir
- Losartan
- Lovastatin; Niacin
- Mecasermin rinfabate
- Mecasermin, Recombinant, rh-IGF-1
- Medroxyprogesterone
- Mestranol; Norethindrone
- Methazolamide
- Methyclothiazide
- Metolazone
- Metoprolol
- Moexipril
- Monoamine oxidase inhibitors
- Nadolol
- Nebivolol
- Nebivolol; Valsartan
- Nelfinavir
- Niacin, Niacinamide
- Niacin; Simvastatin
- Nicardipine
- Nicotine
- Nifedipine
- Nimodipine
- Nisoldipine
- Norethindrone
- Norgestrel
- Octreotide
- Olmesartan
- Ombitasvir; Paritaprevir; Ritonavir
- Orlistat
- Pasireotide
- Pegvisomant
- Penbutolol
- Pentamidine
- Perindopril
- Perindopril; Amlodipine
- Phenelzine
- Phenothiazines
- Phenytoin
- Pindolol
- Potassium-sparing diuretics
- Progesterone
- Progestins
- Propranolol
- Protease inhibitors
- Quinapril
- Quinolones
- Ramipril
- Reserpine
- Ritonavir
- Sacubitril; Valsartan
- Salicylates
- Saquinavir
- Segesterone Acetate; Ethinyl Estradiol
- Selegiline
- Sofosbuvir
- Sofosbuvir; Velpatasvir
- Sofosbuvir; Velpatasvir; Voxilaprevir
- Somatropin, rh-GH
- Sotalol
- Sparfloxacin
- Spironolactone
- Sulfonamides
- Sympathomimetics
- Tacrolimus
- Tegaserod
- Telmisartan
- Thiazide diuretics
- Thyroid hormones
- Timolol
- Tipranavir
- tobacco
- Torsemide
- Trandolapril
- Trandolapril; Verapamil
- Tranylcypromine
- Triamterene
- Trovafloxacin, Alatrofloxacin
- Valsartan
- Verapamil
