Empagliflozin

Sounds like 'empa-gli-FLOW-zin'

Overview
Clinicians
Clinicians

Empagliflozin is used to treat type 2 diabetes. Find out 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 and protect your kidneys and heart. Read more about type 2 diabetes.

Empagliflozin lowers your blood glucose and blood pressure by helping your kidneys get rid of glucose, salt and fluid when you pass urine (pee). Empagliflozin has other benefits such as weight loss, helping your kidneys work better and lowering your chance of having a heart attack or stroke. It may also help you to live longer.

Empagliflozin can be used alone or with other diabetes medicines (such as metformin), along with healthy eating and regular exercise. Empagliflozin is available as a combined tablet with metformin and is 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, at the same time each day. Swallow your tablets with a drink of water. You can take empagliflozin with or without food.
Drink plenty of water: When you start taking empagliflozin, your may pee more but this gets better over a few weeks. Drink enough water so you don't get thirsty. If you've been told by your doctor to limit how much you drink, talk to your healthcare team.
Avoid or limit alcohol while you are taking empagliflozin: It may affect your blood glucose control and increase your risk of side effects.
Missed dose: If you forget your dose, take it as soon as you remember that day unless it is less than 12 hours until your next dose. If that's the case, take your next dose at the usual time and skip the forgotten dose.
Don't run out of tablets: Empagliflozin works best when taken long term. See your healthcare team every 3 months to renew your prescription.

While you are taking empagliflozin
Have a sick day plan If you are unwell you should stop your empagliflozin until you are well again. Discuss with your healthcare team when to restart your empagliflozin. If you have nausea (feeling sick), vomiting (being sick) or tummy pain, you need to have a finger prick blood test immediately at either your GP clinic, after hours medical centre or hospital to check your ketone levels. High ketone levels can cause a serious but rare side effect, known as ketoacidosis.
Tell your healthcare team straight away of any changes to your diet If you start eating less or go on a keto (low carbohydrate) diet, this may increase your risk of ketoacidosis.
Keep your genitals clean Because you will pee more and have more glucose in your urine, you have a higher risk of getting thrush or groin infections. Regular washing helps prevent this. Women should wash their groin and vulval area 2 times a day and men should wash their penis, foreskin and groin area at least once per day.
Prepare before an operation or a procedure If you are going to have an operation or a procedure such as a colonoscopy, you need to stop your empagliflozin at least 3 days before (2 days before the operation and on the day of the operation or procedure). You should discuss with your healthcare team when to stop and restart your empagliflozin.
Are you pregnant, trying for a baby or breastfeeding? Tell your doctor if you become pregnant, are trying for a baby or start breastfeeding. You will need to change to another diabetes medicine.

While you are taking empagliflozin

Have a sick day plan

If you are unwell you should stop your empagliflozin until you are well again. Discuss with your healthcare team when to restart your empagliflozin.

If you have nausea (feeling sick), vomiting (being sick) or tummy pain, you need to have a finger prick blood test immediately at either your GP clinic, after hours medical centre or hospital to check your ketone levels.

High ketone levels can cause a serious but rare side effect, known as ketoacidosis.

Tell your healthcare team straight away of any changes to your diet

If you start eating less or go on a keto (low carbohydrate) diet, this may increase your risk of ketoacidosis.

Keep your genitals clean

Because you will pee more and have more glucose in your urine, you have a higher risk of getting thrush or groin infections.

Regular washing helps prevent this. Women should wash their groin and vulval area 2 times a day and men should wash their penis, foreskin and groin area at least once per day.

Prepare before an operation or a procedure

If you are going to have an operation or a procedure such as a colonoscopy, you need to stop your empagliflozin at least 3 days before (2 days before the operation and on the day of the operation or procedure).

You should discuss with your healthcare team when to stop and restart your empagliflozin.

Are you pregnant, trying for a baby or breastfeeding?

Tell your doctor if you become pregnant, are trying for a baby or start breastfeeding. You will need to change to another diabetes medicine.

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 healthcare team if these side effects cause you problems or don’t go away: peeing more often than usual pain or burning feeling when you pee mild skin rash or itchy skin.

Common side effects

These are usually mild and go away with time. Talk to your healthcare team if these side effects cause you problems or don’t go away:

peeing more often than usual
pain or burning feeling when you pee
mild skin rash or itchy skin.

Rare, serious side effects
Tell your healthcare team or Healthline 0800 611 116 immediately if you notice these side effects and tell them you are taking empagliflozin: being sick (vomiting) feeling very thirsty (dehydrated) being confused or unusually tired stomach pain sweet-smelling breath deep or fast breathing fever (high temperature) severe swelling, pain or redness in your anus (bottom) and genitals (vagina and penis) feeling weak, faint, dizzy feeling irritable headache tremor (shakes) blurred vision.

Rare, serious side effects

Tell your healthcare team or Healthline 0800 611 116 immediately if you notice these side effects and tell them you are taking empagliflozin:

being sick (vomiting)
feeling very thirsty (dehydrated)
being confused or unusually tired
stomach pain
sweet-smelling breath
deep or fast breathing
fever (high temperature)
severe swelling, pain or redness in your anus (bottom) and genitals (vagina and penis)
feeling weak, faint, dizzy
feeling irritable
headache
tremor (shakes)
blurred vision.

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.

Translated medicine leaflets

Download easy-to-understand information for consumers about dabigatran, rivaroxaban and empagliflozin in different languages.

Learn more

Jardiance Medsafe Consumer Information, NZ

References

Empagliflozin NZ Formulary
Spotlight on empagliflozin Medsafe, NZ, December 2020
Periprocedural diabetic ketoacidosis (DKA) with SGLT2 inhibitor use NZSSD, January 2020
SGLT2 inhibitors Type 2 Diabetes Management, NZSSD, 2021

Resources

The Māori Pharmacists’ Association Ngā Kaitiaki o Te Puna Rongoā has a free phone line to answer questions whānau have about their medicines. Call 0800 664 688.

Note: This is a non-urgent service and they will get back to you within 24 hours.
For urgent health advice freephone Healthline 0800 611 116.