GetWiki

Medical uses

Contraindications

• History of a severe allergic reaction to empagliflozin
• End-stage kidney disease
• Diabetic ketoacidosis

Side effects

Common

• Empagliflozin increases the risk of genital fungal infections. The risk is highest in people with a prior history of genital fungal infections.
• Empagliflozin has been thought to be associated with increased risk of urinary tract infections. Reviews of clinical trials have shown there is no significant risk of developing urinary tract infections while taking empagliflozin when compared to placebo or other diabetic medications. JOURNAL, Donnan JR, Grandy CA, Chibrikov E, Marra CA, Aubrey-Bassler K, Johnston K, Swab M, Hache J, Curnew D, Nguyen H, Gamble JM, Comparative safety of the sodium glucose co-transporter 2 (SGLT2) inhibitors: a systematic review and meta-analysis, BMJ Open, 9, 1, e022577, February 2019, 30813108, 6361337, 10.1136/bmjopen-2018-022577, JOURNAL, Kinduryte Schorling O, Clark D, Zwiener I, Kaspers S, Lee J, Iliev H, Pooled Safety and Tolerability Analysis of Empagliflozin in Patients with Type 2 Diabetes Mellitus, Advances in Therapy, 37, 8, 3463–3484, August 2020, 32372290, 7370973, 10.1007/s12325-020-01329-7,
• Empagliflozin reduces systolic and diastolic blood pressure and can increase the risk of low blood pressure, which can cause fainting and/or falls. The risk is higher in older people, people taking diuretics, and people with reduced kidney function.
• Slight increases in Low-density lipoprotein (LDL) cholesterol can be seen with empagliflozin, in the range of 2–4% from baseline.

Serious

• Diabetic ketoacidosis, a rare but potentially life-threatening condition, may occur more commonly with empagliflozin and other SGLT-2 inhibitors.JOURNAL, Rosenstock J, Ferrannini E, Euglycemic Diabetic Ketoacidosis: A Predictable, Detectable, and Preventable Safety Concern With SGLT2 Inhibitors, Diabetes Care, 38, 9, 1638–1642, September 2015, 26294774, 10.2337/dc15-1380, doi, free, JOURNAL, Handelsman Y, Henry RR, Bloomgarden ZT, Dagogo-Jack S, DeFronzo RA, Einhorn D, Ferrannini E, Fonseca VA, Garber AJ, Grunberger G, LeRoith D, Umpierrez GE, Weir MR, American Association of Clinical Endocrinologists and American College of Endocrinology Position Statement on the Association of Sglt-2 Inhibitors and Diabetic Ketoacidosis, Endocrine Practice, 22, 6, 753–762, June 2016, 27082665, 10.4158/EP161292.PS, doi, free, While diabetic ketoacidosis is usually associated with elevated blood glucose levels, in people taking SGLT-2 inhibitors diabetic ketoacidosis may be seen with uncharacteristically normal blood glucose levels, a phenomenon called euglycemic diabetic ketoacidosis. The absence of elevated blood glucose levels in people on an SGLT-2 inhibitor may make it more difficult to diagnose diabetic ketoacidosis. The risk of empagliflozin-associated euglycemic diabetic ketoacidosis may be higher in the setting of illness, dehydration, surgery, and/or alcohol consumption. It is also seen in type{{nbsp}}1 diabetes who take empagliflozin, which notably is an unapproved or “off-label” use of the medication. To lessen the risk of developing ketoacidosis (a serious condition in which the body produces high levels of blood acids called ketones) after surgery, the FDA has approved changes to the prescribing information for SGLT2 inhibitor diabetes medicines to recommend they be stopped temporarily before scheduled surgery. Empagliflozin should each be stopped at least three days before scheduled surgery.WEB, FDA revises labels of SGLT2 inhibitors for diabetes to include warning, U.S. Food and Drug Administration (FDA), 19 March 2020,www.fda.gov/drugs/drug-safety-and-availability/fda-revises-labels-sglt2-inhibitors-diabetes-include-warnings-about-too-much-acid-blood-and-serious, 6 June 2020, 7 June 2020,web.archive.org/web/20200607011955/https://www.fda.gov/drugs/drug-safety-and-availability/fda-revises-labels-sglt2-inhibitors-diabetes-include-warnings-about-too-much-acid-blood-and-serious, live, {{PD-notice}} Symptoms of diabetic ketoacidosis include nausea, vomiting, abdominal pain, tiredness, and trouble breathing.
• Fournier’s gangrene, a rare but serious infection of the groin, occurs more commonly in people taking empagliflozin and other SGLT-2 inhibitors. Symptoms include feverishness, a general sense of malaise, and pain or swelling around the genitals or in the skin behind them. The infection progresses quickly and urgent medical attention is recommended.
• Empagliflozin can increase the risk of low blood sugar when it is used together with a sulfonylurea or insulin.WEB, Empagliflozin in combination therapy for treating type{{nbsp, 2 diabetes |url=https://www.nice.org.uk/guidance/ta336/chapter/2-The-technology |website=NICE |access-date=21 December 2018 |date=25 March 2015 |archive-date=21 December 2018 |archive-url=https://web.archive.org/web/20181221182906www.nice.org.uk/guidance/ta336/chapter/2-The-technology |url-status=live }} When used by itself or in addition to metformin it does not appear to increase the risk of hypoglycemia.

Mechanism of action

History

Legal status

Research

Weight and blood pressure