Empagliflozin

Empagliflozin

Empagliflozin, a groundbreaking medication, has caught the attention of medical professionals worldwide. This innovative drug not only helps manage blood sugar levels but also shows promising results in treating heart conditions. Its unique action sets it apart from traditional diabetes medications, offering hope to millions of patients struggling with these chronic health issues. This comprehensive article delves into the world of empagliflozin, exploring its uses, side effects, and how it works in the body. 

What is Empagliflozin?

Empagliflozin is a medication used to manage type 2 diabetes mellitus in adults & children ten years and older. It belongs to the sodium-glucose co-transporter 2 (SGLT2) inhibitor class of drugs. The FDA approved empagliflozin in 2014. Doctors prescribe it alone or in combination with other antidiabetic medications. Empagliflozin works by increasing glucose excretion through urine and lowering blood sugar levels. This process is independent of insulin. Besides diabetes management, empagliflozin has shown benefits in reducing cardiovascular risks and slowing the progression of chronic kidney disease.

Empagliflozin Uses

The primary application of empagliflozin tablets is to manage type 2 diabetes mellitus (T2DM) in patients aged ten and above. They help improve glycemic control when combined with diet and exercise. Other uses are:

• The medication also has a significant impact on cardiovascular health. It reduces the cardiovascular death risk in adults with type 2 diabetes & cardiovascular diseases. 
• Empagliflozin has shown benefits in reducing hospitalisations for heart failure and slowing the progression of chronic kidney disease. 
• Empagliflozin is particularly effective for patients with atherosclerotic cardiovascular disease, heart failure, or nephropathy who have suboptimal glycemic control despite lifestyle modifications and metformin use.
• Empagliflozin also has beneficial effects on weight management. Patients may experience weight loss of 2-4 kg after 6-12 months of treatment due to caloric wasting through increased urinary glucose excretion.

How to Use Empagliflozin Tablets

• Empagliflozin tablets are available in 10 mg and 25 mg strengths. Patients should take one tablet once daily in the morning, with or without food. Take the drug as directed by your doctor at the same time every day. 
• Do not stop taking empagliflozin without consulting your doctor, even if you feel well. Empagliflozin helps control your condition, but it does not cure it.
• Follow your doctor's diet and exercise recommendations. Maintaining a healthy diet and regularly exercising are very important.
• Do not take more or less or take empagliflozin more often than recommended by your doctor.
• If you missed a dose, take it as soon as you remember. But, if it is time for the subsequent dose, skip the missed one and continue your regular dosing schedule.

Side Effects of Empagliflozin Tablet

Empagliflozin, like all medicines, can cause several empagliflozin side effects, though not everyone experiences them. 
Common empagliflozin side effects include: 

• Thrush
• Increased urination
• Mild skin rashes 
• Generalised weakness and tiredness

These usually improve as the body adjusts to the medication. 
More serious side effects, though rare, can occur. These include:

• Diabetic ketoacidosis (DKA)
• Severe UTIs
• Allergic reactions
• pelvic or back pain
• Fever, nausea, or vomiting
• Genital mycotic infections- women may experience white or yellowish vaginal discharge or vaginal itching; men may experience redness, itching, or swelling in the penis or foul-smelling discharge from the penis.
• Patients should be aware of signs like increased thirst, dark urine, dizziness, or difficulty breathing. Monitoring blood sugar levels and staying hydrated while taking empagliflozin is crucial.

Precautions

• Certain Medical Conditions: Empagliflozin requires careful consideration in certain patient groups, such as those with type 1 diabetes and low renal function, especially those with an eGFR below 45 ml/min/1.73 m2.  
• Allergies: People should exercise caution if they are allergic to tab empagliflozin or any of the ingredients in empagliflozin tablets or other medicines.
• Hydration: The medication can cause volume depletion, particularly in elderly patients or those on diuretics. Patients should stay hydrated and be aware of symptoms like dizziness or low blood pressure. 
• Alcohol Intake: Limit or avoid alcohol consumption
• Precaution For Pregnant Females: Pregnant & breastfeeding women should consult their doctor.
• Genitourinary Considerations: Empagliflozin increases the risk of urinary tract infections and genital mycotic infections. Temporary discontinuation may be necessary in cases of complicated infections or major surgical procedures. Therefore, inform your doctor of these situations as soon as possible to avoid severe complications.

How Empagliflozin Tablet Works

Empagliflozin works by inhibiting the sodium-glucose co-transporter-2 (SGLT-2) in the kidneys' proximal tubules. This inhibition reduces glucose reabsorption and increases urinary glucose excretion, lowering blood sugar levels independently of insulin action. Empagliflozin typically reduces HbA1c by about 0.7%. The medication is taken orally, with a recommended dose of 10 milligrams once daily in the morning, with or without food. If tolerated, the dose may increase to 25 mg. No dose adjustment is necessary for patients with an eGFR ≥ 45 mL/min/1.73 m2. However, empagliflozin is not recommended in individuals with an eGFR > 30 mL/min/1.73 m2 without cardiovascular risk factors.

Can I Take Empagliflozin with Other Medicines?

Empagliflozin can be taken with other medicines, particularly those used to manage diabetes and cardiovascular health. Doctors generally prescribe this medicine as a combination therapy with metformin or linagliptin. For patients with type 2 diabetes & established cardiovascular disease, empagliflozin can be used alongside standard care medications. It's important to note that empagliflozin impacts renal function, so monitoring is essential when combined with other drugs. Patients should always inform their doctor about their ongoing medications to ensure safe and effective treatment.
Empagliflozin can interact with numerous medicines, such as:

• Aspirin
• Insulin
• Metoprolol
• Omega-3 polyunsaturated fatty acids
• Sildenafil
• Sitagliptin
• Tadalafil
• Valsartan

Dosing Information

Empagliflozin is typically taken once daily in the morning, with or without food. The recommended starting dose is ten milligrams, which may increase to 25 mg if tolerated well. It's crucial to maintain proper hydration while taking empagliflozin. Doctors may adjust the dose based on individual patient factors, such as kidney function. Regular monitoring is essential to ensure the medication's effectiveness and safety.

Conclusion

Empagliflozin has proven to be a game-changer in managing type 2 diabetes and heart conditions. By increasing glucose excretion through urine, its unique way of working offers a fresh approach to blood sugar control. This medication doesn't just help with diabetes; it also positively impacts heart health and kidney function. These benefits make it a valuable option for many patients, especially those dealing with multiple health issues.

FAQ's

1. What is empagliflozin mainly used for?

Ans: The primary indication of empagliflozin is to treat type 2 diabetes mellitus (T2DM) in adults and children ten years and older. It helps improve blood sugar levels when combined with diet and exercise. Additionally, it reduces the risk of cardiovascular death in adults with type 2 diabetes and cardiac diseases.

2. Who needs to take empagliflozin?

Ans:  Doctors generally prescribe empagliflozin for individuals with type 2 diabetes, especially those at risk of cardiovascular events. It's also beneficial for adults with heart failure to reduce the risk of hospitalisation and death due to heart disease. People with kidney disease may benefit from empagliflozin to slow disease progression.

3. Is it bad to use empagliflozin every day?

Ans: Empagliflozin is typically taken once daily, either in the morning or evening. Regular use as prescribed by a doctor is not considered harmful. 

4. Is empagliflozin safe?

Ans: Empagliflozin has shown a favourable safety profile in clinical trials. However, like all medications, it can cause side effects. Common ones include urinary tract infections and genital infections.  

5. Who Cannot use empagliflozin?

Ans: Empagliflozin is not recommended for people with type 1 diabetes, diabetic ketoacidosis, severe renal impairment, end-stage renal disease, or those on dialysis. Pregnant women, especially in the second and third trimesters, should avoid empagliflozin.

6. Is empagliflozin safe for kidneys?

Ans: Empagliflozin has shown benefits in slowing the progression of chronic kidney disease. However, doctors do not recommend it for patients with severely impaired kidney function (eGFR below 30 mL/min/1.73 m2

7. Can I take empagliflozin at night?

Ans: Empagliflozin can be taken at any time of day, including at night. The key is to take it at the same time each day to maintain steady blood levels of the medication.

8. What is the best time to take empagliflozin?

Ans: The best time to take empagliflozin is the time that works consistently with your daily routine. It can be taken with or without food.

9. When should empagliflozin be stopped?

Ans: Empagliflozin should be stopped 3-4 days before scheduled surgery to minimise the risk of postoperative ketoacidosis. Additionally, a doctor may recommend discontinuation if severe side effects occur or the medication is ineffective. Always consult your doctor first before stopping empagliflozin.