Highlights of facts
- Active substance: empagliflozin
- Common deployment uses: treatment of type 2 diabetes, reduction of cardiovascular mortality in certain patients, and reduction of hospital admission for heart failure
- Typical tablet strengths in the UK: 10 mg and 25 mg
What empagliflozin is and why it is prescribed
Empagliflozin is included in the SGLT2 inhibitor family. It works by reducing the amount of glucose reabsorbed by the kidneys, increasing glucose excretion in the urine and helping to lower blood glucose levels.
In the United Kingdom it is commonly prescribed to:
- Improve blood sugar control in adults and in children from 10 years of age with type 2 diabetes, alongside diet and exercise.
- Lower the risk of death from cardiovascular causes in people with type 2 diabetes who have established cardiovascular disease.
- Reduce death and hospital admissions due to symptomatic heart failure when the heart is not functioning effectively.
Note: it is not a treatment for type 1 diabetes. For more on how to take notes the medicine, see dose management and administration.
Dose and method of administration
Follow the directions on your prescription label and also the patient leaflet. Clinicians will usually pick a starting dose and may change it depending on response and kidney function.
- Typical regimen: once daily, usually in the morning. It can be consumed with or without food.
- Regular monitoring and logging of blood glucose may be advised; in some cases urine or blood ketone checks could be required.
- Keep well hydrated, particularly during hot weather, intercurrent illness, or strenuous exercise.
If you are uncertain about dose changes contact your GP or pharmacist. For important safety advice see warning notices and precautionary steps.
Risk prevention steps and high priority alerts of potential danger
Before you begin empagliflozin tell your prescriber if any of the following apply:
- A history of repeated urinary tract infections or difficulty passing urine
- Previous genital infections such as thrush
- Pancreatic disease or previous surgery on the pancreas
- High alcohol intake or alcohol misuse
- Periods of low food intake, low salt diets, or any situation that increases dehydration risk
- Advanced age, particularly patients aged 65 years and older
- Liver disease or kidney impairment
If you are planning a pregnancy, are pregnant, or are breastfeeding, speak to a clinician promptly, as empagliflozin is not recommended in pregnancy and should be avoided while breastfeeding. See also documents people who should not use.
Which patients are not suitable for empagliflozin?
- People with a known allergy to empagliflozin or any ingredient in the product
- Patients with severe renal impairment or those on dialysis
- Women in the second or third trimester of pregnancy
- Women who are breastfeeding
Be cautious with alcohol as it can increase the chances of dehydration and may contribute to ketoacidosis. Move slowly when standing to reduce the risk of dizziness or light-headedness.
Potential secondary effects and when to seek medical attention
Seek urgent medical help
- Signs of severe allergic reaction such as widespread rash, difficulty breathing, or swelling of the face, lips, tongue or throat
- Severe genital infections that worsen rapidly: intense pain, redness, swelling, offensive discharge, fever, or feeling unwell
Notable impacts requiring prompt medical advice
- Markedly low blood pressure or fainting
- Hypoglycaemia symptoms, especially if used with insulin or sulfonylureas: sweating, shaking, chronic headache, confusion, blurred thinking
- Dehydration signs: extreme thirst, reduced urine output, dizziness, confusion
- Symptoms of ketoacidosis: persistent nausea or vomiting, severe abdominal pain, excessive tiredness, breathing problems
- Urinary tract infection with fever, pelvic or back pain, or blood in the urine
Expected reactions
- Acute urinary tract infections
- Genital fungal infections such as vaginal yeast infections
Suspected side effects should be reported to the Medicines and Healthcare products Regulatory Agency via the Yellow Card scheme. For guidance on online two-way communication in actions connect users across distances. see the dynamics of interactions at scale reveal systemic patterns. and lifestyle advice.
Drug people relating to one another guidance and lifestyle considerations
- Insulin and sulfonylureas: combined use increases the risk of low blood sugar; dose adjustments may be needed
- Diuretics: can raise the risk of dehydration and low blood pressure when taken together
- Other antihypertensive drugs: additive blood pressure lowering may occur and symptoms should be monitored
- Very low carbohydrate or ketogenic diets, and heavy alcohol intake, can increase the risk of ketoacidosis
Always give prescribers a complete list of medicines and supplements you use. For practical day-to-day guidance, see advice on a dose was misseds.
Dose was missed protocol
In the event a dose is forgotten take it as soon as you remember unless the next scheduled dose is due soon. If the next dose is near, skip the missed one. Do not take two doses together to compensate for a failure to take a dose.
Taking too much of a drug treatment actions
If you suspect an she overdosed seek urgent medical attention or contact your local emergency services or poison helpline immediately.
Safekeeping and disposal
- Store at normal room temperature, away from heat and dampness.
- Keep medicines securely stored away from children and pets, both unseen and unreachable.
- Return unused or expired medicines to a pharmacy for safe disposal where possible. Do not dispose in household waste if an an alternative method is available.
Contingent options and analogous medicines
Other pharmacologic inhibitors of SGLT2 and combination products offer similar a mechanisms of action. Choices will depend on goals such as glucose lowering, weight management, kidney and heart protection, side effect profile and cost.
- Dapagliflozin (Forxiga) - a commonly used SGLT2 option often started at 10 mg once daily
- Canagliflozin (Invokana) - effective for glucose and cardiovascular outcomes; some reports have noted rare risks such as effects on bone density and lower limb events
- Ertugliflozin (Steglatro) - another once-daily SGLT2 inhibitor with a broadly comparable profile
Available combination medicines that reduce pill burden include:
- Empagliflozin plus metformin (brand examples include Synjardy)
- Empagliflozin plus a DPP-4 inhibitor such as linagliptin (Glyxambi)
Other diabetes medicine classes to discuss with your clinician:
- Metformin - low cost, commonly first-line
- GLP-1 receptor agonists such as semaglutide or dulaglutide - often associated with weight loss and cardiovascular benefit
- DPP-4 inhibitors - weight neutral and low hypoglycaemia risk
- Sulfonylureas - effective but carry greater hypoglycaemia risk and within the realm of possibility weight gain
- Insulin - required in some patients or when oral therapies do not achieve targets
Visit the price difference analysis page indicative Price indices for the United Kingdom. Discuss which option suits you best with your prescriber by your side.
UK indicative tiered pricing (private purchase)
The following are approximate out-of-pocket prices for a pack of about 28 to 30 tablets. Actual costs vary by supplier and over time.
- Empagliflozin 10 mg: around 30 to 50 GBP
- Empagliflozin 25 mg: around 35 to 55 GBP
- Dapagliflozin 10 mg: around 30 to 50 GBP
- Canagliflozin 100 to 300 mg: around 35 to 55 GBP
- Ertugliflozin 5 to 15 mg: around 35 to 55 GBP
- Dual purpose products (for example empagliflozin plus metformin): commonly 45 to 80 GBP
NHS prescription charges in England are a flat fee per item for most adults; as of 2024 the fee is approximately 9.90 GBP per item. Prescriptions are free in Scotland, Wales and Northern Ireland for most patients. These figures are indicative only; check with a registered UK pharmacy or NHS service for current costs.
UK legal compliance and regulatory guidance
- Empagliflozin is listed as a Prescription Only Medicine in the United Kingdom.
- Regulatory oversight: licensed and monitored by the MHRA; suspected adverse reactions can be reported via the Yellow Card scheme.
- Supply rules: must be dispensed by or under supervision of a UK-registered pharmacist against a valid prescription from a UK-registered prescriber, such as a GP or independent prescriber.
- Online pharmacies: only use providers registered with the General Pharmaceutical Council (GPhC) and those that operate legitimate remote consultation processes.
- Remote prescribing: permitted but should follow a documented clinical assessment. Reputable services will collect medical history and, with consent, may contact your GP.
- Importation: do not import prescription medicines without meeting UK rules and having a valid prescription; unauthorised import may contravene customs and medicines regulations.
- Driving and safety: the main driving concern is hypoglycaemia when empagliflozin is used with insulin or sulfonylureas; follow DVLA guidance if you have recurrent hypoglycaemia.
- Gestation and lactation: contraindicated in the second and third trimesters and not recommended while breastfeeding; seek specialist advice if pregnancy is planned or suspected.
- Paediatric use: licensed for type 2 diabetes from 10 years of age in selected circumstances; dosing and real time monitoring should follow specialist guidance.
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