Empagliflozin

 Empagliflozin – Full Introduction

Empagliflozin is an oral antihyperglycemic agent used in the management of type 2 diabetes mellitus (T2DM). It belongs to the sodium-glucose co-transporter 2 (SGLT2) inhibitor class and works by promoting renal glucose excretion. Empagliflozin also provides cardiovascular and renal protective effects, making it a preferred option in high-risk patients.

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Drug Class

• SGLT2 inhibitor (Gliflozin)

• Oral antidiabetic agent

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Mechanism of Action

Empagliflozin inhibits SGLT2 in the proximal renal tubules, which normally reabsorbs about 90% of filtered glucose. By blocking SGLT2:

• Excess glucose is excreted in urine (glucosuria)

• Blood glucose levels are reduced independently of insulin

• Leads to mild diuresis and reduction in blood pressure

• Promotes weight loss due to caloric loss through glucose

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Therapeutic Uses

• Type 2 diabetes mellitus (monotherapy or in combination with metformin, insulin, or other antidiabetics)

• Reduces cardiovascular mortality in T2DM patients with established cardiovascular disease

• Slows progression of chronic kidney disease in T2DM

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Benefits

• Lowers fasting and postprandial blood glucose

• Reduces body weight

• Lowers blood pressure modestly

• Cardioprotective and renoprotective benefits

• Low risk of hypoglycemia when used as monotherapy

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Common Side Effects

• Genital mycotic infections (yeast infections)

• Urinary tract infections

• Increased urination (polyuria)

• Thirst

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Serious but Rare Side Effects

• Ketoacidosis (euglycemic diabetic ketoacidosis, rare)

• Severe dehydration and hypotension

• Fournier’s gangrene (very rare)

• Acute kidney injury in susceptible patients

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Contraindications & Precautions

• Type 1 diabetes (risk of ketoacidosis)

• Severe renal impairment or end-stage renal disease

• Hypersensitivity to empagliflozin

• History of recurrent genital infections (caution)

• Volume depletion or hypotension (monitor fluid status)

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Dosage & Administration

• Usual starting dose: 10 mg orally once daily

• Can be increased to 25 mg once daily if tolerated and needed

• Take in the morning with or without food

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Conclusion

Empagliflozin is a modern oral antidiabetic agent that not only controls blood glucose but also offers cardiovascular and renal protection in high-risk T2DM patients. Careful monitoring for urinary/genital infections, dehydration, and rare ketoacidosis is important.