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Empagliflozin is an inhibitor of the sodium glucose co-transporter-2 (SGLT-2), and works by increasing sugar loss in urine. [2] Empagliflozin was approved for medical use in the United States and in the European Union in 2014. [13] [23] [24] It is on the World Health Organization's List of Essential Medicines. [25]
Empagliflozin/metformin was approved for use in the European Union in May 2015. [5] Empagliflozin/metformin was approved for use in the United States in August 2015. [6] [11] The extended release version was approved for use in the United States in December 2016. [12] [13] Empagliflozin/metformin was approved for use in Australia in May 2020. [2]
To reduce the risk of developing ketoacidosis (a serious condition where the body produces high levels of blood acids called ketones) after surgery, the FDA has approved changes to the prescribing information for SGLT2 inhibitor diabetes medications, recommending they be temporarily stopped before scheduled surgery.
An analysis by KFF, a private nonprofit health policy organization, found that of the 167 million people with employer health insurance, 3.4 million took one of 10 drugs negotiated by Medicare.
In the sugar analogues of dapagliflozin, the β-C series are more active than α-C series so it is critical that the β-configuration is at C-1 for the inhibitory activity. [55] Both dapagliflozin and empagliflozin contain a chlorine (Cl) atom in their chemical structure.
The most common side effects include urinary infections, nasopharyngitis, and upper respiratory tract infections . [5] [6] The most serious side effects include ketoacidosis (high blood levels of acids called ‘ketoacids’), pancreatitis (inflammation of the pancreas), hypersensitivity (allergic reactions) and hypoglycaemia (low blood sugar levels).
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Canagliflozin, dapagliflozin, and empagliflozin should each be stopped at least three days before, and ertugliflozin should be stopped at least four days before scheduled surgery. [ 8 ] Symptoms of ketoacidosis include nausea, vomiting, abdominal pain, tiredness, and trouble breathing.
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