Empagliflozin

Sounds like 'em-pag-lee-flow-zin'

Easy-to-read medicine information about empagliflozin – what it is, how to take it safely and possible side effects. Empagliflozin is also called Jardiance.

What is empagliflozin?

Empagliflozin is used to treat type 2 diabetes. Read more about type 2 diabetes. 

Empagliflozin controls your blood glucose level by helping your kidneys remove glucose when you pee. Empagliflozin can be used alone or with other diabetes medicines (such as metformin), along with healthy eating and regular exercise.

Using empagliflozin to improve your blood glucose levels can reduce your risk of diabetes complications such as heart disease, stroke and damage to your eyes, nerves and kidneys. 

Benefits to your heart

Empagliflozin can also benefit people with heart disease, eg, with weight loss, lowering your blood pressure if it's high and reducing your chance of hospital admission due to heart failure. It may also help you to live longer. 

Note: Empagliflozin is also available in combination with metformin, called Jardiamet. 

Dose

  • In New Zealand empagliflozin is available as tablets (10 mg and 25 mg). 
  • The usual starting dose is 1 tablet (10 mg) once a day. Depending on your blood glucose levels, your doctor may increase your dose to 25 mg once a day. 
  • Always take your empagliflozin exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to take, how often to take it and any special instructions.

How to take empagliflozin

  • Timing: Take empagliflozin once a day, in the morning. Swallow your tablets with a drink of water. You can take empagliflozin with or without food. 
  • Drink plenty of water: Empagliflozin may make you pee more often. Make sure you drink plenty of water so you don't get dehydrated. If your doctor has asked you to drink no more than a certain amount each day, keep to that amount. 
  • Limit or avoid alcohol while you are taking empagliflozin: It may affect the control of your blood glucose and increases your risk of side effects.
  • Missed dose: If you forget your dose, take it as soon as you remember that day. But if it is nearly time for your next dose (less than 12 hours), just take the next dose at the right time. Do not take double the dose.

Cautions while you are taking empagliflozin

Have a sick day plan

If you are unwell for any reason, such as have runny poos (diarrhoea) or vomiting (being sick), a urinary tract infection or dehydration (feeling very thirsty) from other causes, it’s important to let your doctor know. You will need to stop taking empagliflozin for a few days and start again when you feel better. 

Tell your healthcare provider of any changes to your diet

Tell your healthcare provider if you have changes to your diet, such as if are eating a lot less, planning to start a keto diet (low carbohydrate diet) or fasting for Ramadan.

Prepare before surgery or a colonoscopy

Tell your doctor if you are going to have surgery or a procedure such as colonoscopy that requires bowel preparation. You may have to stop empagliflozin at least 2 days before the operation or procedure.

Practise good genital hygiene

Because empagliflozin removes glucose through your pee, your risk of thrush is increased. Good hygiene helps prevent this. Tell your healthcare provider if you get signs of thrush such as itch, redness or discharge from your vagina or penis. Thrush is easily treated with antifungal medicine. Read more about thrush.

Pregnant or planning a pregnancy?

Tell your doctor if you become pregnant or are planning a pregnancy while you are taking empagliflozin.

Side effects

Like all medicines, empagliflozin can cause side effects, although not everyone gets them. 

Common side effects

These are usually mild and go away with time. Talk to your doctor or pharmacist if these side effects bother you or do not go away.

  • Peeing more often than usual.
  • Pain or burning feeling when you pee.
  • Mild skin rash or itchy skin.
  • Increased risk of thrush: Tell your healthcare provider if you get signs of thrush such as itch, redness or discharge from your vagina or penis.
Rare and serious side effects 

Tell your doctor straight away or phone Healthline 0800 611 116 if you have the following:

  • Feel sick (nausea) or are sick (vomiting), feel very thirsty, confused or unusually tired, have stomach pain, fruity-smelling breath and deep or fast breathing. These can be signs of diabetic ketoacidosis.

  • Fever, severe swelling, pain or redness in your genital area. Empagliflozin can rarely cause a serious skin infection around your anus and genitals (vagina and penis).

  • Feel weak, faint, dizzy or irritable and maybe a headache, tremor (shakes) or blurred vision. These are sign of low blood glucose (hypoglycaemia).
    • If you are taking empagliflozin with other medicines for diabetes, such as glipizide, gliclazide or insulin, you are at increased risk of very low blood glucose. 
    • Drink a small glass of sweetened soft drink or fruit juice, or eat something sweet like lollies. Follow this with a snack such as a sandwich.
    • Contact your doctor or nurse immediately, as the doses of your medicines may need to be changed. 

Interactions

Empagliflozin may interact with a few medicines and herbal supplements, so check with your doctor or pharmacist before starting empagliflozin and before starting any new medicines. Also check with your doctor if you are taking medicines to lower your blood pressure. Empagliflozin may lower your blood pressure

Learn more

Jardiance Medsafe Consumer Information, NZ

References

  1. Empagliflozin NZ Formulary 
  2. Spotlight on empagliflozin Medsafe, NZ, December 2020
  3. Periprocedural diabetic ketoacidosis (DKA) with SGLT2 inhibitor use NZSSD, January 2020
  4. SGLT2 inhibitors Type 2 Diabetes Management,  NZSSD, 2021
Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 02 Feb 2021