Empagliflozin

Empagliflozin, sold under the brand name Jardiance (/ˈdʒɑːrdiəns/ JAR-dee-əns), among others, is an antidiabetic medication used to improve glucose control in people with type 2 diabetes and/or for patients with established heart failure with reduced ejection fraction (HFrEF). Studies have shown great benefits for heart failure (HF) outcomes and decreased hospitalisations. It is taken by mouth.

Common side effects of empagliflozin include genital yeast infections and hypotension, particularly in patients with volume depletion. Other symptoms such as nausea and vomiting may occur and seem more pronounced in combination with metformin. Rare but serious adverse events, such as euglycemic diabetic ketoacidosis (DKA) which may present with hyperventilation, lethargy, or mental status changes have been reported but are infrequent in trials. Other serious but rare serious adverse events include Fournier's gangrene, a severe skin infection of the groin, and diabetic ketoacidosis that may occur even with normal blood glucose levels. Use during pregnancy or breastfeeding is not recommended.

Empagliflozin is a SGLT2 inhibitor: a reversible inhibitor of the sodium glucose co-transporter-2 (SGLT-2). It reduces the kidney’s glucose reabsorption and excretes the excess glucose through the urine, thus its place in the treatment of type two diabetes. It is dependent on blood glucose concentrations and the glomerular filtration rate of the kidney. This excretion of glucose in the urine, which does not seem to disturb other blood electrolytes, is accompanied by some diuresis which may be what contributes to many other physiological functions, potentially explaining its place in heart failure treatment.

Empagliflozin was approved for medical use in the United States and in the European Union in 2014. It is on the World Health Organization's List of Essential Medicines. In 2022, it was the 56th most commonly prescribed medication in the United States, with more than 12 million prescriptions. It has received approval as a generic medication from the US Food and Drug Administration (FDA).