Empagliflozin

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Empagliflozin Introduction:

Empagliflozin, sold under the trade name Jardiance among others, is a medication used together with
diet and exercise to treat type 2 diabetes. It is less preferred than metformin and sulfonylureas. It may
be used together with other medications such as metformin or insulin. It is not recommended for type 1
diabetes. It is taken by mouth.

Mechanism of action

Empagliflozin is a sodium glucose co-transporter-2 (SGLT-2) inhibitor. SGLT2 co-transporters are


responsible for reabsorption of glucose from the glomerular filtrate in the kidney. The glucuretic effect
resulting from SGLT2 inhibition reduces renal absorption and lowers the renal threshold for glucose,
resulting in increased glucose excretion. Additionally, it contributes to reduced hyperglycaemia, assists
weight loss, and reduces blood pressure.

Medical use
Type 2 diabetes
Empagliflozin is used in combination with proper diet and exercise to help people with type 2 diabetes
lower their blood sugar levels. It can be used alongside other medications for type 2 diabetes such as
metformin, sulfonylureas, and insulin. When compared against a placebo, empagliflozin led to a drop of
0.7% in hemoglobin A1c, a long-term marker of blood glucose levels.

Weight and blood pressure


Empagliflozin causes moderate reductions in blood pressure and body weight. These effects are likely
due to the excretion of glucose in the urine and a slight increase in urinary sodium excretion. In clinical
trials, patients taking empagliflozin lost an average of 2% of their baseline body weight. A higher
percentage of people taking empagliflozin achieved weight loss greater than 5% from their baseline. The
medication reduced systolic blood pressure by 3 to 5 millimeters of mercury (mmHg).The effects on
blood pressure and body weight are generally viewed as favorable, as many patients with type 2
diabetes have high blood pressure or are overweight or obese.

Heart kidney disease


SGLT2 inhibitors, including empagliflozin, appear to reduce the likelihood of hospitalization for heart
failure or progression of chronic kidney disease in persons with type 2 diabetes. Empagliflozin may
reduce the likelihood of death due to cardiovascular causes in people with type 2 diabetes who have
known cardiovascular disease. One concern regarding the trial on which these claims are based is that
the different arms received different amounts of other medications; thus, the reduced risk cannot
necessarily be attributed to empaglifozin. In some countries it has also been approved to reduce the risk
of death from cardiovascular causes in people with type 2 diabetes and heart disease.

Side Effects:
Common side effects include urinary tract infections, fungal infections of the groin, and joint pains.
Rarer but more serious side effects include a skin infection of the groin called Fournier's gangrene and a
form of diabetic ketoacidosis with normal blood sugar levels. Use in pregnancy and breastfeeding is not
recommended. Use is not recommended in those with significant kidney disease, though it may help
slow the progression of mild kidney problems. Empagliflozin is an inhibitor of the sodium glucose co-
transporter-2 (SGLT-2), and works by increasing sugar lost in the urine.

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