Known brand names include Jardiance.
A once-daily SGLT2 inhibitor pill that makes the kidneys pass extra sugar into the urine. It lowers blood sugar in type 2 diabetes and, in adults, lowers the risk of heart failure hospitalization, cardiovascular death, and kidney decline in heart failure and chronic kidney disease.
Empagliflozin blocks SGLT2, the main transporter the kidneys use to pull filtered sugar back into the blood. With it blocked, extra sugar leaves the body in the urine. It also makes the kidneys take back less sodium, so more sodium travels further along the kidney's tubes. That may lower pressure inside the kidney's filters, ease the workload on the heart, and calm the body's stress nerves.
Sugar loss in the urine rises right after a dose, stays up with daily use, and fades over about 3 days after it is stopped. People pass more urine, especially in the first days, which can drain body fluid and lead to low blood pressure or sudden kidney injury. The extra sugar in the urine comes with a higher risk of urinary and genital infections. Because it acts through the kidneys, it is unlikely to lower blood sugar when kidney function is very low.
Empagliflozin lowers blood sugar in type 2 diabetes, a condition in which the body does not make or use insulin normally, so sugar builds up in the blood. In adults with type 2 diabetes and heart disease, it also lowers the chance of dying from heart disease. In adults with heart failure, it lowers the chance of dying from heart disease or being hospitalized for heart failure. In adults with chronic kidney disease that is likely to worsen, it slows kidney decline and lowers the chance of kidney failure, heart-related death, and hospitalization.
Adults and children 10 and older with type 2 diabetes take it along with diet and exercise. It is a tablet taken by mouth, and it controls these conditions without curing them. It is not used for blood sugar control in type 1 diabetes, where it raises the risk of ketoacidosis, or in type 2 diabetes when kidney function is very low. It is not recommended for kidney disease caused by polycystic kidney disease, or for people who need or recently needed strong immune-suppressing treatment for kidney disease.
Urinary tract infections and genital yeast infections are the most common side effects, along with passing more urine and feeling thirsty. The label treats ketoacidosis as a serious risk, which can happen even when blood sugar is not very high. It also warns about dehydration and low blood pressure, kidney injury, serious urinary and genital infections, low blood sugar with insulin or sulfonylureas, lower limb amputation, and serious allergic reactions.