Empagliflozin

Sounds like 'empa-gli-FLOW-zin'

Empagliflozin is used to treat type 2 diabetes. Find out how to take it safely and possible side effects. Empagliflozin is also called Jardiance.

Empagliflozin factsheets: Find out how to take it safely and the possible side effects. Translations are available in 9 languages.

Video: How to take empagliflozin (Jardiance and Jardiamet)

    

(Health Navigator NZ and PHARMAC, 2022)
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How to take empagliflozin (NZ Sign Language)

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), to help manage your glucose levels along with healthy eating and regular exercise. Empagliflozin is also available as a combined tablet with metformin and then it is called Jardiamet. 

Dose

  • In Aotearoa 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 enough water so you don't get thirsty: When you start taking empagliflozin, you may pee more but this gets better over a few weeks. Your doctor may advise how much you should drink, talk to your healthcare team about this if you are not sure. 
  • 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 12 hours or less until your next dose is due. 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 every day. See your healthcare team every 3 months for a new prescription.

While you are taking empagliflozin

Have a sick day plan

If you are unwell, stop taking empagliflozin. Taking empagliflozin when you are unwell increases your risk of high ketone levels, which can cause a serious but rare side effect called diabetic ketoacidosis (DKA). Only restart your empagliflozin when you are well AND eating and drinking normally.

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.

Tell your healthcare team before making any big changes to your diet

If you start eating less or go on a keto (low carbohydrate) diet or are fasting, 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 twice 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, ask your healthcare team when you should stop and restart your empagliflozin. You may need to stop your empagliflozin 2 or 3 days before the operation.

Are you pregnant, trying for a baby or breastfeeding?

It is important to talk to GP or nurse as soon as possible if you are trying to get pregnant, are pregnant or breastfeeding. You may need to change to another diabetes medicine.

Tell your healthcare team if you are taking any other medicines

Empagliflozin may interact some medicines and herbal supplements, so check with your doctor or pharmacist before starting empagliflozin and before starting any new medicines.

What are the side effects of empagliflozin?

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

Side effects What should I do?
  • Peeing (urinating) more often than usual.
  • Pain or burning feeling when you pee.
  • Mild skin rash or itchy skin.
  • Feeling dizzy.
  • These are quite common when you start taking empagliflozin, but they are usually mild and go away with time.
  • Talk to your healthcare provider if these side effects cause you problems or don’t go away.
  • Signs and symptoms of diabetic ketoacidosis (DKA) such as:
    • being sick (vomiting)
    • feeling very thirsty (dehydrated)
    • being confused or unusually tired
    • stomach pain
    • sweet-smelling breath
    • deep or fast breathing.
  • This is a rare but serious side effect of empagliflozin.
  • You are at increased risk if you are dehydrated or experience a sudden illness, have just had surgery, have reduced your calorie intake, are on a low carbohydrate diet or if your insulin requirements have increased. 
  • If you get these signs and symptoms, stop taking empagliflozin and contact your healthcare provider or Healthline 0800 611 116 immediately and tell them you are taking empagliflozin.
  • Signs of Fournier’s gangrene such as:
    • swelling, pain, itching or tenderness in or around your vagina, penis, testicles or bottom
    • changes to the colour of your skin, such as redness or darkened areas around your vagina, penis, testicles or bottom
    • fever or high temperature
    • general unwellness or tiredness.
  • Fournier’s gangrene is a serious bacterial infection around your vagina, penis, testicles or bottom.
  • This is a rare but serious side effect of empagliflozin.
  • If you get these signs and symptoms, stop taking empagliflozin and tell your healthcare provider or Healthline 0800 611 116 immediately and tell them you are taking empagliflozin.
  • Read more about Fournier’s gangrene (EnglishTe reo Māori, Samoan).
Did you know that you can report a side effect to a medicine to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product.

Learn more

Jardiance Medsafe Consumer Information, NZ

References

  1. Empagliflozin NZ Formulary 
  2. Reminder – Flozins and the risks of diabetic ketoacidosis and Fournier’s gangrene Medsafe, NZ, December 2022
  3. Spotlight on empagliflozin Medsafe, NZ, December 2020
  4. Periprocedural diabetic ketoacidosis (DKA) with SGLT2 inhibitor use NZSSD, January 2020
  5. SGLT2 inhibitors Type 2 Diabetes Management, NZSSD, 2021
Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 03 Dec 2022