DITIC

Anti Diabetic

Empagliflozin is an antidiabetic agent used in adult patients with type 2 diabetes mellitus. It was FDA-approved in 2014. Empagliflozin can be used as a single agent or as a combination agent with other antidiabetic products.

General Info

Category:	Antidiabetic Agent / Antihyperglycemic Agent
Product information:	Generic Name:Empagliflozin CompositionEach film-coated tablet contains: Empagliflozin 10 mg tablets Empagliflozin 25 mg tablets Therapeutic Class: Antidiabetic Agent / Antihyperglycemic Agent Pharmacological Class:SGLT2 (Sodium-Glucose Co-Transporter 2) Inhibitor Presentation: 10 x 10’S tablet Pregnancy Category: Category C (FDA) Lactation:Avoid use.
INDICATIONS:	Type 2 Diabetes Mellitus (T2DM) Heart Failure with Reduced Ejection Fraction (HFrEF) Chronic Kidney Disease (CKD) Cardiovascular Risk Reduction
MECHANISM OF ACTION:	Glucose is filtered by glomerulus ↓ Reabsorbed by SGLT2 in proximal renal tubule ↓ [Empagliflozin inhibits SGLT2] ↓ ↓ Renal glucose reabsorption ↑ Urinary glucose excretion (glucosuria) ↓ ↓ Blood glucose levels ↓ Improved glycemic control & calorie loss
Pharmacokinetics:	Absorption: Oral bioavailability ~78% Peak Plasma (Tmax): ~1.5 hours (fasting) Half-life (t½):~12.4 hours Metabolism: Mainly glucuronidation (UGT2B7, UGT1A9) Excretion: 54% feces (unchanged), 41% urine
Dosage Information:	Tablets to be taken once daily in the morning, with or without food.
Type 2 Diabetes:	starting dose 10 mg once daily if tolerated maximum dose can be increased to 25 mg once daily
Heart Failure:	starting dose 10 mg once daily
Chronic Kidney Disease:	starting dose 10 mg once daily Note: Dose may vary depending upon patient condition.
Side Effects:	Common Side Effects: Genital infections (fungal) Urinary tract infections (UTIs) Increased urination Dehydration Hypoglycemia (with insulin/sulfonylureas) Thirst, constipation, nausea Serious Side Effects: Diabetic ketoacidosis (even with normal glucose) Fournier’s gangrene (rare) Acute kidney injury Severe urinary tract infection Hypotension Allergic reactions (rash, angioedema)
Contraindications:	Hypersensitivity to empagliflozin Severe renal impairment (eGFR <30 mL/min/1.73 m²) End-stage renal disease (ESRD) or dialysis Diabetic ketoacidosis (DKA)
Drug Interaction :	Diuretics: Increased risk of dehydration and hypotension Insulin/Secretagogues: Risk of hypoglycemia (monitor glucose) ACE inhibitors / ARBs: Enhanced risk of volume depletion Lithium: May decrease lithium levels (monitor closely)