Empagliflozin
- Class: SGLT2 inhibitor
- Used for: type 2 diabetes
- Say it: em-puh-glih-FLOH-zin
- Forms: tablet
SGLT2 inhibitors block glucose reabsorption in the proximal tubule, so glucose is lost in the urine. The surprise of the class is that the heart and kidney benefits turned out to be larger than the glucose-lowering.
The stem marks an SGLT2 inhibitor, blocking glucose reabsorption in the proximal tubule. The surprise of this class is that the heart and kidney benefits turned out larger than the glucose-lowering — which is why they are now given to people with no diabetes at all. All drug suffixes ›
Side effects
Common: genital yeast infection, urinary tract infection, frequent urination
Serious: ketoacidosis, Fournier's gangrene (rare)
Typical dose
10–25 mg once daily
Start at 10 mg; 25 mg adds little glucose-lowering. Not started if eGFR is below 20.
Check yourself
What makes euglycaemic ketoacidosis with an SGLT2 inhibitor particularly dangerous?
- The blood glucose is near normal, so the diagnosis is easily missed
- It occurs only in type 1 diabetes
- It causes no acidosis
- It develops over several weeks
Show answer
A. The blood glucose is near normal, so the diagnosis is easily missed
Clinicians screen for ketoacidosis with a high glucose. Urinary glucose loss keeps the level deceptively normal while ketones and acidosis climb, so the test that would normally raise suspicion is reassuring instead.
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