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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, approved in the United States in August 2014, under the brand name Jardiance by Boehringer Ingelheim. [30] Of the gliflozins, empagliflozin and tofogliflozin have the highest specificity for SGLT2 inhibition. [1] This oral medicine for type 2 diabetes has been shown to reduce the risk of cardiovascular death. [31]
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.
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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SGLT2 is only found in kidney tubules and in conjunction with SGLT1 resorbs glucose into the blood from the forming urine. By inhibiting SGLT2, and not targeting SGLT1, glucose is excreted which in turn lowers blood glucose levels. Examples include dapagliflozin (Farxiga in US, Forxiga in EU), canagliflozin (Invokana) and empagliflozin (Jardiance).
Drugs used in diabetes treat diabetes mellitus by decreasing glucose levels in the blood.With the exception of insulin, most GLP-1 receptor agonists (liraglutide, exenatide, and others), and pramlintide, all diabetes medications are administered orally and are thus called oral hypoglycemic agents or oral antihyperglycemic agents.