Empagliflozin
Also known as: Jardiance
Empagliflozin is a prescription medicine used to treat type 2 diabetes, heart failure and chronic kidney disease. It is a sodium-glucose co-transporter-2 (SGLT2) inhibitor, and its brand name is Jardiance. The main cautions include thrush, dehydration when it is combined with diuretics, and a serious build-up of ketones called diabetic ketoacidosis, which the NHS says needs a 999 call if suspected.
- Generic name
- Empagliflozin
- Active ingredient
- Empagliflozin
- Product type
- Small-molecule medicine
- Drug class
- SGLT2 inhibitors
- Brand names
- UK Jardiance
- Routes
- Oral
- Dosage forms
- Tablet
- Also known as
- Jardiance
- Onset and duration
- The NHS says it starts to lower blood sugar after about 1 to 2 hours and may take up to a week to work fully, while in heart failure it can be a month or 2 before symptoms improve.
- Monitoring
- For chronic heart failure with reduced ejection fraction, NICE says a heart failure specialist should advise on starting empagliflozin and monitoring should be done by the most appropriate healthcare professional.
Availability by country
| Country | Status | Note | Source |
|---|---|---|---|
| UK | Prescription only | UK |
Legal status differs between countries and can change; each row cites the document it was taken from and applies only to the country named.
What it is used for
- Type 2 diabetes, to lower blood sugar levels
- Heart failure, including symptomatic chronic heart failure as recommended by NICE
- Chronic kidney disease in adults, as recommended by NICE under specific conditions
How it works in the body
Empagliflozin is a type of medicine known as a sodium-glucose co-transporter-2 (SGLT2) inhibitor. In diabetes it lowers blood sugar by helping remove extra sugar from the body through the urine. In heart failure it reduces the amount of work the heart has to do.
Common side effects
- The NHS lists thrush, needing to pee more often, feeling more thirsty than usual and skin rash as common side effects.
- The NHS says low blood sugar can happen if meals are skipped, alcohol is drunk or other diabetes medicines are taken.
Serious: seek help
- Diabetic ketoacidosis can make a person feel very thirsty, confused or unusually tired, or give breath that smells sweet, and the NHS says to call 999 if it is suspected; Diabetes UK describes it as a rare side effect.
- Fournier's gangrene is a rare but serious genital infection that can cause severe pain, tenderness, redness or swelling in the genital area with a high temperature or feeling unwell; the NHS says to call 999 if it is suspected, and its side-effects page says to tell a doctor or call 111 straight away.
- A serious allergic reaction (anaphylaxis), with swelling of the lips, mouth, throat or tongue or difficulty breathing, needs a 999 call.
- The NHS says to call 111 straight away for signs of dehydration.
Cautions and interactions
- The NHS says most adults can take it, and suggests checking with a doctor for people aged 75 or older.
- It is not used to treat type 1 diabetes.
- The NHS lists a past allergic reaction, low blood pressure, severe kidney or liver disease, frequent urinary tract infections and upcoming surgery as reasons to check with a doctor first.
- NHS information lists diuretics (water tablets) and blood pressure medicines among medicines that interact with it, and the UK product information says it may add to the diuretic effect of thiazide and loop diuretics and may increase the risk of dehydration and low blood pressure.
- The NHS says it is not recommended in pregnancy because there is little information about whether it could affect the baby, and not usually recommended while breastfeeding because it is not known how much passes into breast milk.
- The NHS says the tablets may need to be stopped before an operation if eating has to stop, and during recovery, because of the risk of diabetic ketoacidosis.
- The NHS says alcohol can be drunk with it, but alcohol can increase the risk of low blood sugar and of side effects such as diabetic ketoacidosis, so it advises trying to limit how much is drunk.
- An NHS hospital trust leaflet says that passing more glucose in the urine increases the risk of a urinary tract infection.
Interactions
Check interactions
Taking Empagliflozin with other medicines? Add them to the checker to see what the official sources say about each pair: the mechanism, general management and monitoring, never a bare "safe".
Interactions documented in the official sources cited on each card. The list covers the medicines represented on this site and is not exhaustive; how the interaction data is compiled.
No pair records for this medicine are in the sources currently represented by Anatomy Nexus. Absence from this list does not mean no interaction exists.
Same-class and related medicines
Same class: SGLT2 inhibitors
Medicines that share the class of Empagliflozin. They are separate medicines with their own licences, doses and interactions, not alternative names for Empagliflozin.
Related medicines
Medicines often discussed alongside Empagliflozin: used together, compared with it, or acting on the same problem by a different route.
Key facts
| Fact | Detail |
|---|---|
| Also called | Jardiance (brand name) |
| Medicine type | SGLT2 inhibitor |
| Used for | Type 2 diabetes, heart failure and chronic kidney disease |
| Not used for | Type 1 diabetes |
| Starts to lower blood sugar | About 1 to 2 hours, up to a week to work fully |
| Weight | Does not cause weight gain; some people lose weight |
| Pregnancy | Not recommended, according to the NHS |
What is empagliflozin used for?
Empagliflozin is used to treat type 2 diabetes, heart failure and chronic kidney disease. Its brand name is Jardiance, and it is not used for type 1 diabetes. It comes as tablets, and the NHS says it is only available with a prescription. For heart failure, NICE recommends it as an option for symptomatic chronic heart failure, both with reduced ejection fraction and with preserved or mildly reduced ejection fraction. NICE says treatment should start on the advice of a heart failure specialist. Where several options are suitable, including dapagliflozin, NICE guidance on preserved or mildly reduced ejection fraction says the least expensive should be used. For chronic kidney disease, NICE recommends it for adults only under specific conditions, including as an add-on to optimised standard care with the highest tolerated licensed dose of an ACE inhibitor or ARB, unless those are contraindicated. The NHS says treatment for diabetes, heart failure or chronic kidney disease is usually for life.
How does empagliflozin work and how soon?
Empagliflozin is a sodium-glucose co-transporter-2 (SGLT2) inhibitor. In diabetes it helps remove extra sugar from the body through the urine, so blood sugar falls. In heart failure it reduces the work the heart has to do. The NHS says it starts to work after about 1 to 2 hours to lower blood sugar, but it may take up to a week to work fully. In heart failure it might be a month or 2 before symptoms improve, and the NHS says it is still reducing the heart's workload even if no change is noticed. The NHS says it does not make people put on weight, and some people lose weight. The NHS advises against stopping it without talking to a doctor first.
What are the side effects of empagliflozin?
The NHS lists thrush, needing to pee more often, feeling thirstier than usual and skin rash as the common side effects. The NHS says a pharmacist can recommend an antifungal treatment for thrush. The NHS says low blood sugar can happen if meals are skipped, alcohol is drunk or other diabetes medicines are taken. The NHS describes more serious side effects as rare. Diabetic ketoacidosis, where ketones build up in the body, can cause great thirst, confusion, unusual tiredness or sweet-smelling breath, and the NHS lists feeling or being sick, stomach pain and deeper or faster breathing among other signs. The NHS says to call 999 if diabetic ketoacidosis, anaphylaxis or Fournier's gangrene is suspected. Fournier's gangrene, a serious genital infection, can cause severe pain, tenderness, redness or swelling in the genital area with a high temperature or feeling unwell, and the NHS side-effects page says to tell a doctor or call 111 straight away. Sudden swelling of the lips, mouth, throat or tongue, or struggling to breathe, may be anaphylaxis and needs a 999 call. The NHS says to call 111 straight away for signs of dehydration.
Taking empagliflozin with other medicines, alcohol and during illness
NHS information lists diuretics and medicines that lower blood pressure among medicines that interact with empagliflozin. The UK product information says it may add to the diuretic effect of thiazide and loop diuretics and may increase the risk of dehydration and low blood pressure. The NHS says people can drink alcohol while taking empagliflozin, but alcohol can increase the risk of low blood sugar levels. It advises trying to limit how much alcohol is drunk, because alcohol can increase the risk of side effects such as diabetic ketoacidosis. The NHS says the tablets may need to be stopped before an operation if eating has to stop, and while recovering afterwards, because of the risk of diabetic ketoacidosis. An NHS hospital trust leaflet says that passing more glucose in the urine increases the risk of a urinary tract infection.
Who needs extra care with empagliflozin?
The NHS says most adults can take empagliflozin and suggests checking with a doctor for people aged 75 or older. It also lists a past allergic reaction, low blood pressure, severe kidney or liver disease, frequent urinary tract infections and upcoming surgery as reasons for a doctor to check first. The NHS says it is not suitable for people with type 1 diabetes or at higher risk of diabetic ketoacidosis. The NHS says it is not recommended in pregnancy because there is little information about whether it could affect the baby. For breastfeeding, the NHS says it is not usually recommended because it is not known how much passes into breast milk, and a doctor may suggest an alternative.
Frequently asked questions
Can I drink alcohol while taking empagliflozin?
The NHS says people can drink alcohol while taking empagliflozin. However, alcohol can increase the risk of low blood sugar levels. The NHS advises trying to limit how much alcohol is drunk, because it can increase the risk of side effects such as diabetic ketoacidosis.
How long does empagliflozin take to work?
The NHS says it starts to lower blood sugar after about 1 to 2 hours, though it may take up to a week to work fully. In heart failure it might be a month or 2 before symptoms improve. The NHS says it is still reducing the heart's workload even if no change is noticed.
Does empagliflozin cause weight gain?
The NHS says empagliflozin does not make people put on weight. Some people find they lose weight.
Is empagliflozin used in pregnancy or breastfeeding?
The NHS says empagliflozin is not recommended in pregnancy because there is little information about whether it could affect the baby. For breastfeeding, the NHS says it is not usually recommended because it is not known how much passes into breast milk. The NHS says that if someone is pregnant or planning a pregnancy, the doctor may switch them to another medicine.
What are the signs of a serious side effect?
Diabetic ketoacidosis can cause great thirst, confusion, unusual tiredness or sweet-smelling breath, and the NHS says to call 999 if it is suspected. Severe pain, tenderness, redness or swelling in the genital area with a high temperature or feeling unwell may be Fournier's gangrene, and the NHS says to call 999 if it is suspected. Sudden swelling of the lips, mouth, throat or tongue needs a 999 call.
Connected pages in detail
What each linked page on Anatomy Nexus covers, in a line, for Empagliflozin.
Conditions
- Type 2 diabetes A metabolic disease in which the body's cells respond poorly to insulin (insulin resistance) and the pancreas gradually fails to compensate.
- Heart failure A syndrome in which the heart cannot pump enough blood to meet the body's needs, or can do so only at raised filling pressures.
- Chronic kidney disease Persistent reduction in kidney function (a filtration rate below 60 ml/min) or evidence of kidney damage such as protein in the urine.
Medical tests
- Kidney function tests Creatinine and urea are waste products the kidneys should clear; how much builds up in blood shows how well they are filtering.
- HbA1c The fraction of haemoglobin that has glucose stuck to it.
- Creatinine and eGFR The everyday measure of how well the kidneys filter.
- Blood glucose The concentration of glucose in blood, measured from a vein or a fingerprick.
Medications
- Dapagliflozin Dapagliflozin is a prescription tablet from the SGLT2 inhibitor group, used for type 2 diabetes, heart failure and chronic kidney disease.
- Metformin The first-line tablet for type 2 diabetes: it reduces the glucose the liver releases and improves the body's response to insulin.
Drug classes
- SGLT2 inhibitors SGLT2 inhibitors are tablets used for type 2 diabetes, heart failure and chronic kidney disease.