Empagliflozin: Advanced SGLT2 Inhibition for Cardiorenal Protection
| Product dosage: 10 mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 30 | $5.13 | $153.88 (0%) | 🛒 Add to cart |
| 60 | $4.91 | $307.77 $294.69 (4%) | 🛒 Add to cart |
| 120 | $4.82
Best per pill | $615.53 $578.32 (6%) | 🛒 Add to cart |
| Product dosage: 25 mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 30 | $6.40 | $192.10 (0%) | 🛒 Add to cart |
| 60 | $6.19 | $384.20 $371.13 (3%) | 🛒 Add to cart |
| 120 | $6.09
Best per pill | $768.41 $731.19 (5%) | 🛒 Add to cart |
Synonyms | |||
Empagliflozin is a potent, selective sodium-glucose cotransporter 2 (SGLT2) inhibitor indicated for the management of type 2 diabetes mellitus, heart failure, and chronic kidney disease. It functions by blocking glucose reabsorption in the proximal tubule of the nephron, promoting glucosuria and thereby reducing hyperglycemia. Beyond glycemic control, empagliflozin demonstrates significant cardiorenal benefits, including reductions in cardiovascular mortality, hospitalization for heart failure, and progression of renal disease. Its mechanism offers a multifaceted approach in high-risk patient populations, supported by robust clinical trial evidence.
Features
- Selective inhibition of SGLT2 in the renal proximal tubule
- Once-daily oral dosing regimen for patient adherence
- Available in 10 mg and 25 mg film-coated tablets
- Not dependent on insulin secretion for efficacy
- Exhibits consistent pharmacokinetics with low potential for accumulation
- Can be used as monotherapy or in combination with other antidiabetic agents
Benefits
- Significantly reduces the risk of cardiovascular death in patients with type 2 diabetes and established cardiovascular disease
- Lowers hospitalization rates for heart failure in both diabetic and non-diabetic populations
- Slows the progression of chronic kidney disease, including reduction in albuminuria and decline in estimated glomerular filtration rate (eGFR)
- Provides effective glycemic control with a low intrinsic risk of hypoglycemia when used without insulin or sulfonylureas
- Promotes weight loss and modest blood pressure reduction through osmotic diuresis and caloric excretion
- Offers a convenient dosing schedule that supports long-term treatment adherence
Common use
Empagliflozin is primarily prescribed for adults with type 2 diabetes mellitus to improve glycemic control, particularly when cardiovascular or renal comorbidities are present. It is also approved for reducing the risk of cardiovascular death in adults with heart failure and for slowing the progression of kidney disease in patients with chronic kidney disease, irrespective of diabetic status. It may be used as part of a comprehensive treatment plan that includes diet, exercise, and other medications.
Dosage and direction
The recommended starting dose is 10 mg orally once daily, taken in the morning with or without food. Depending on glycemic response and tolerability, the dose may be increased to 25 mg once daily. For heart failure and chronic kidney disease indications, the same dosing regimen applies. Dosage adjustment is not typically required based on age, gender, or hepatic impairment. In patients with eGFR below 20 mL/min/1.73 m², use is not recommended due to reduced efficacy. Patients should be advised to maintain adequate hydration to reduce the risk of volume depletion.
Precautions
Monitor renal function before initiation and periodically during treatment; discontinue if eGFR falls persistently below 20 mL/min/1.73 m². Assess volume status and correct volume depletion before starting therapy. Observe for signs and symptoms of ketoacidosis, even in the presence of normal or mildly elevated blood glucose levels. Increased risk of genital mycotic infections; advise preventive hygiene. Monitor for lower limb amputations, particularly in patients with a history of amputation, peripheral vascular disease, neuropathy, or diabetic foot ulcers. Not recommended during the second and third trimesters of pregnancy.
Contraindications
History of serious hypersensitivity reaction to empagliflozin or any excipient in the formulation. Severe renal impairment (eGFR <20 mL/min/1.73 m²), end-stage renal disease, or patients on dialysis. Concomitant use with other SGLT2 inhibitors is contraindicated.
Possible side effect
Common adverse reactions include urinary tract infections, female genital mycotic infections, and increased urination. Less frequently, volume depletion, dyslipidemia, and male genital mycotic infections may occur. Rare but serious side effects include ketoacidosis, acute kidney injury, Fournier’s gangrene, and lower limb amputations. Hypersensitivity reactions such as angioedema and urticaria have been reported.
Drug interaction
No clinically significant interactions with metformin, glimepiride, pioglitazone, sitagliptin, linagliptin, warfarin, verapamil, ramipril, simvastatin, or oral contraceptives. Concomitant use with diuretics may increase the risk of volume depletion. Insulin or insulin secretagogues may increase the risk of hypoglycemia; consider dose reduction of these agents. Drugs that reduce glomerular filtration or affect tubular function may alter efficacy.
Missed dose
If a dose is missed, it should be taken as soon as remembered on the same day. If missed entirely, resume the regular dosing schedule the following day; do not double the dose.
Overdose
Limited data exist on overdose. Expected effects may include hypoglycemia and disorders related to SGLT2 inhibition, such as dehydration and electrolyte disturbances. In case of suspected overdose, provide supportive measures including correction of fluid and electrolyte imbalance and monitoring of blood glucose. Hemodialysis is unlikely to be effective due to high protein binding.
Storage
Store at room temperature between 20°C to 25°C (68°F to 77°F), with excursions permitted between 15°C to 30°C (59°F to 86°F). Keep in the original container to protect from moisture. Keep out of reach of children and pets.
Disclaimer
This information is intended for healthcare professionals and should not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider for personalized recommendations. Dosage, indications, and safety information may vary by region; refer to local prescribing information.
Reviews
Clinical trials and real-world evidence consistently support the efficacy and safety of empagliflozin. The EMPA-REG OUTCOME trial demonstrated a 38% reduction in cardiovascular death and 35% reduction in hospitalization for heart failure. Subsequent studies, including EMPEROR-Reduced and EMPEROR-Preserved, confirmed benefits in heart failure with reduced and preserved ejection fraction. The EMPA-KIDNEY trial highlighted renal protective effects, showing a 28% risk reduction in kidney disease progression. Overall, empagliflozin is regarded as a cornerstone therapy in modern cardiorenal medicine.