Molecule

Empagliflozin

3 brands of Empagliflozin in stock, compared side by side.

We stock 3 brands of Empagliflozin from 1 manufacturer (tablet; 10 Mg and 25 Mg). The lowest per-unit price is USD $ 0.67, for Gibtulio 10 Mg Tablets. Every brand listed is prescription-only: you can upload your prescription at checkout or from your account.

Brands of this molecule, with strength, pack size and price
Brand Manufacturer Strength Pack Price Per unit Availability
Gibtulio 10 Mg Tablets Lupin Ltd. 10 Mg 30 Tablets USD $ 20.00 USD $ 0.67 In stock
Ajaduo 10 Mg 5 Mg Tablet Lupin Ltd. 10 Mg 30 Tablets USD $ 50.00 USD $ 1.67 In stock
Ajaduo 25 Mg 5 Mg Tablet Lupin Ltd. 25 Mg 90 Tablets USD $ 100.00 USD $ 1.11 In stock

About Empagliflozin

Empagliflozin is an orally administered, targeted prescription medicine belonging to the pharmacological class of sodium-glucose co-transporter-2 (SGLT2) inhibitors, often referred to as "gliflozins."
Originally developed as an antidiabetic agent, empagliflozin has evolved into a foundational cardio-renal-metabolic therapy. Large-scale global clinical trials (including EMPA-REG OUTCOME, EMPEROR-Reduced, EMPEROR-Preserved, and EMPA-KIDNEY) have established its clinical role beyond blood glucose lowering. Today, it is prescribed by endocrinologists, cardiologists, and nephrologists to manage Type 2 Diabetes Mellitus, reduce heart failure hospitalizations across the entire ejection fraction spectrum, and slow disease progression in Chronic Kidney Disease (CKD).

Quick Product Fact Sheet

Feature Details
Molecule / Generic Name Empagliflozin
Original Brand Name Jardiance
Therapeutic Classification Antidiabetic agent / Cardio-renal protective agent
Pharmacological Class Selective Sodium-Glucose Co-Transporter-2 (SGLT2) Inhibitor
Available Strengths 10 mg and 25 mg film-coated oral tablets
Standard Adult Dose 10 mg once daily (can be increased to 25 mg for additional glycemic control)
Dietary Rule Taken orally once daily in the morning, with or without food
Primary Clinical Focus Type 2 Diabetes, Heart Failure (HFrEF/HFpEF), and Chronic Kidney Disease

Molecular Pharmacology and Mechanism of Action

Empagliflozin selectively inhibits the sodium-glucose co-transporter-2 (SGLT2) protein located in the S1 segment of the proximal convoluted tubule in the kidneys.
[Glomerular Filtration of Blood Glucose & Sodium]
                         │
                         ▼
   [Renal Proximal Tubule: SGLT2 Reabsorbs 90% Glucose]
                         │
        [EMPAGLIFOZIN INTERVENES]
        • Reversibly inhibits SGLT2 cotransporters
        • Blocks glucose & sodium reabsorption
                         │
         ┌───────────────┴───────────────┐
         ▼                               ▼
 [GLYCOSURIC PATHWAY]           [NATRIURETIC & HEMODYNAMIC PATHWAY]
 • Glucosuria (~78g glucose/day) • Mild osmotic diuresis (natriuresis)
 • Lowers plasma blood glucose   • Restores tubuloglomerular feedback
 • Promotes caloric deficit/loss • Afferent arteriole vasoconstriction
 • Hemoglobin A1c reduction      • Decreases intraglomerular pressure
                                 • Long-term nephron preservation

1. Glycemic Control (Glucosuria)

Under normal physiology, the kidneys filter approximately 180 grams of glucose daily, with SGLT2 reabsorbing roughly 90% back into circulation. By selectively blocking SGLT2, empagliflozin lowers the renal threshold for glucose, causing the excretion of approximately 64 to 78 grams of glucose per day into the urine. This reduces fasting and postprandial blood glucose independently of insulin secretion or peripheral insulin resistance.

2. Renal Protection (Tubuloglomerular Feedback)

In diabetic nephropathy, hyperfiltration causes glomerular hypertension and progressive nephron loss. Empagliflozin increases sodium delivery to the macula densa. This reactivates the body's natural tubuloglomerular feedback, inducing vasoconstriction of the afferent arteriole. The result is a reduction in intraglomerular pressure, which halts hyperfiltration injury, decreases albuminuria, and protects long-term kidney function.

3. Cardiovascular and Hemodynamic Benefits

Beyond glycemic lowering, empagliflozin promotes mild osmotic diuresis and natriuresis without triggering reflex tachycardia. This reduces plasma volume, systemic vascular resistance, and both cardiac preload and afterload. Empagliflozin also prompts a shift toward myocardial ketone utilization, optimizing cardiac energy metabolism and improving left ventricular remodeling in patients with heart failure.

Approved Medical Indications

Empagliflozin is indicated for adult patients in the following clinical settings:
  • Glycemic Control in Type 2 Diabetes Mellitus: As an adjunct to diet and exercise to improve blood sugar control in adults and pediatric patients aged 10 years and older with type 2 diabetes.
  • Cardiovascular Death Reduction in T2D: To reduce the risk of cardiovascular death in adults with type 2 diabetes mellitus and established atherosclerotic cardiovascular disease.
  • Heart Failure (Across All Ejection Fractions): To reduce the risk of cardiovascular death and hospitalization for heart failure in adults with heart failure, whether heart failure with reduced ejection fraction (HFrEF) or preserved ejection fraction (HFpEF).
  • Chronic Kidney Disease (CKD): To reduce the risk of sustained decline in estimated glomerular filtration rate (eGFR), end-stage kidney disease (ESKD), cardiovascular death, and hospitalization in adults with chronic kidney disease at risk of progression.

Limitations of Use

  • Not recommended for improving glycemic control in patients with Type 1 Diabetes Mellitus due to an increased risk of diabetic ketoacidosis.
  • Not indicated for glycemic control in patients with an eGFR below 30 mL/min/1.73 $m^2$ (as glucose-lowering efficacy depends on renal filtration), although it is used for heart failure and CKD preservation in lower filtration brackets down to 20 mL/min/1.73 $m^2$.
  • Not recommended for treating CKD in patients with polycystic kidney disease or those requiring acute high-dose immunosuppression for kidney disease.

Standard Dosage and Administration Guidelines

Empagliflozin is administered as a once-daily tablet.

Dosing Schedules by Indication

Clinical Indication Standard Starting Dose Maximum / Target Dose
Type 2 Diabetes Mellitus 10 mg once daily in the morning May increase to 25 mg once daily if additional blood glucose lowering is needed and 10 mg is tolerated.
Heart Failure (HFrEF & HFpEF) 10 mg once daily in the morning 10 mg once daily (higher doses do not confer additional cardiovascular benefit).
Chronic Kidney Disease (CKD) 10 mg once daily in the morning 10 mg once daily.

Practical Administration Instructions

  • Morning Administration: Take once daily in the morning. Because empagliflozin increases urinary frequency due to osmotic diuresis, morning administration minimizes nighttime awakenings to urinate (nocturia).
  • With or Without Food: Can be swallowed with or without meals.
  • Swallow Whole: Ingest the tablet whole with water.
  • Hydration Advice: Maintain adequate daily fluid intake, particularly in warm weather or during physical activity, to prevent volume depletion and dehydration.
  • Missed Dose Protocol: If a dose is missed, take it as soon as remembered on that day. If not remembered until the next morning, skip the missed dose and resume the normal daily schedule. Never take two doses on the same day.

Renal Thresholds & Dosing Adjustments

Before starting empagliflozin, renal function (eGFR) must be evaluated:
eGFR Category Clinical Recommendation
eGFR 60 mL/min/1.73 m² or higher Standard dosing: 10 mg daily; can titrate to 25 mg daily for glycemic control.
eGFR 30 to 59 mL/min/1.73 m² 10 mg once daily. Glycemic efficacy is modest, but cardiovascular and kidney protection remains intact.
eGFR 20 to 29 mL/min/1.73 m² 10 mg once daily for heart failure and CKD progression reduction. (Not recommended for blood glucose lowering alone).
eGFR less than 20 mL/min/1.73 m² Initiation is generally not recommended due to limited data; however, patients already on treatment may continue until dialysis initiation.
Dialysis / End-Stage Renal Disease Contraindicated. Ineffective and not recommended in dialysis patients.

Potential Side Effects & Clinical Management

Common Side Effects

  • Genital Mycotic Infections: Fungal infections such as vulvovaginitis in women and balanitis in men occur due to glucose excretion in urine. Managed with good personal hygiene and standard over-the-counter or prescription topical/oral antifungals.
  • Urinary Tract Infections (UTIs): Increased frequency of mild-to-moderate bacterial bladder infections.
  • Increased Urination: Mild polyuria, pollakiuria, and nocturia during initial weeks of therapy.
  • Volume Depletion / Hypotension: Mild dizziness or lightheadedness upon standing, particularly in elderly individuals or those taking loop diuretics.

Serious Warnings & Class Precautions

Serious Adverse Event Clinical Signs Clinical Management
Euglycemic Diabetic Ketoacidosis (euDKA) Nausea, vomiting, abdominal pain, deep rapid breathing (Kussmaul breathing), confusion, generalized malaise, with normal or only mildly elevated blood sugar (<250 mg/dL). Discontinue immediately. Emergency hospital admission; administer IV fluids, dextrose, and insulin. Check serum ketones.
Necrotizing Fasciitis of the Perineum (Fournier's Gangrene) Severe pain, tenderness, redness, or swelling in the genital or perineal area accompanied by fever or chills. Rare surgical emergency. Stop drug immediately; initiate broad-spectrum IV antibiotics and surgical debridement.
Urosepsis and Pyelonephritis High fever, flank or lower back pain, chills, painful urination. Hospital evaluation; initiate targeted intravenous/oral antibiotics.
Hypoglycemia Risk (when combined) Shakiness, sweating, palpitations, confusion, lightheadedness. Empagliflozin monotherapy carries low hypoglycemia risk; risk rises when combined with insulin or sulfonylureas. Reduce companion insulin/secretagogue doses.

Drug Interactions & Precautionary Protocols

  • Loop Diuretics (e.g., Furosemide, Torsemide): Co-administration enhances diuretic and natriuretic effects. May require a minor downward dose adjustment of the diuretic to prevent dehydration, severe hypotension, and acute prerenal azotemia.
  • Insulin and Sulfonylureas (e.g., Glimepiride, Gliclazide): SGLT2 inhibition lowers baseline glucose requirements. To reduce the risk of severe hypoglycemia, clinicians typically lower the starting background dose of insulin or secretagogues by 10% to 20% upon initiating empagliflozin.
  • NSAIDs & ACEi / ARBs: Concurrent use can transiently deepen the initial "dip" in eGFR through combined hemodynamics. Monitor renal parameters after initiation.
  • Urine Glucose Tests: SGLT2 inhibitors induce glucosuria. Monitoring glycemic control with urine glucose tests is unreliable; use blood glucose and HbA1c tests instead.
  • 1,5-Anhydroglucitol (1,5-AG) Assay: Measurements of 1,5-AG are unreliable in patients taking SGLT2 inhibitors and should not be used to assess glycemic control.

Special Clinical Protocols: Surgery & Illness

The "Sick Day" Rule and Planned Surgeries

During acute physical stressors—such as severe systemic illness, prolonged fasting, major surgery, or extreme endurance athletics—the body shifts toward lipolysis and ketone production. Under SGLT2 inhibition, this significantly increases the risk of euglycemic diabetic ketoacidosis.
  • Planned Surgery Protocol: Discontinue empagliflozin at least 3 days prior to major scheduled surgical procedures or operations requiring prolonged fasting.
  • Acute Illness Protocol: Withhold empagliflozin during acute dehydrating illnesses (such as gastroenteritis, high fevers, or vomiting).
  • Resuming Therapy: Therapy should only be restarted once oral fluid and food intake have fully normalized and the risk of metabolic acidosis has resolved.

Special Population Guidance

Population Clinical Advice
Pregnancy Not recommended during the second and third trimesters of pregnancy. Animal studies have demonstrated adverse renal pelvic and tubule dilatation in developing fetuses.
Breastfeeding Not recommended during lactation. It is unknown if empagliflozin transfers into human milk, and potential risks to infant kidney development exist.
Pediatric Use Approved for pediatric patients aged 10 years and older for Type 2 Diabetes. Not established in children under 10 years or pediatric heart failure/CKD.
Geriatric Patients Individuals aged 65 years and older have a higher incidence of volume depletion, hypotension, and renal impairment. Lower blood pressure monitoring is recommended.
Hepatic Impairment Safe in mild to moderate hepatic impairment without dosage adjustments. Can be used in severe liver disease, though clinical experience is limited.

Storage and Handling Protocols

  • Store tablets at room temperature between 20°C and 25°C (68°F to 77°F). Excursions between 15°C and 30°C (59°F to 86°F) are permitted.
  • Keep in the original blister pack or container to protect against excessive moisture and heat.
  • Keep strictly out of reach of children and domestic pets.

Frequently Asked Questions (FAQs)

Q1: Why did my doctor prescribe Empagliflozin if I do not have diabetes?
Empagliflozin is approved for Heart Failure (both HFrEF and HFpEF) and Chronic Kidney Disease (CKD), regardless of whether you have diabetes. It works by easing fluid strain on the heart, reducing blood pressure, and lowering internal pressure inside kidney filters, helping keep your heart and kidneys functioning longer.
Q2: What is the initial "eGFR dip" after starting Empagliflozin?
Within the first 2 to 4 weeks of starting empagliflozin, blood tests often show a small, harmless drop in estimated kidney filtration (eGFR of roughly 2 to 5 mL/min/1.73 $m^2$). This happens because the medicine narrows the inlet blood vessel to the kidney filters, relieving excess pressure. Over time, this initial dip stabilizes, and kidney function is preserved far better than without the medication.
Q3: How can I prevent fungal yeast infections while taking Empagliflozin?
Because empagliflozin flushes sugar into your urine, yeast naturally thrives in warm, moist genital environments. Maintain good daily hygiene, wear breathable cotton underwear, wipe front-to-back, and stay well hydrated. If mild itching or discharge develops, speak with your healthcare provider; it is easily treated with standard antifungal treatments without necessarily stopping your medication.
Q4: What is Euglycemic DKA, and why is it dangerous?
Diabetic ketoacidosis (DKA) normally presents with very high blood sugar levels. However, in euglycemic DKA, ketones build up to dangerous levels while blood sugars remain normal or only slightly elevated (below 250 mg/dL), making it easy to miss. If you experience severe nausea, vomiting, shortness of breath, or deep stomach pain, seek emergency medical care immediately and tell emergency staff you are taking an SGLT2 inhibitor.

Medical Disclaimer

This clinical guide is strictly for educational, informational, and professional onboarding purposes and must not replace individualized medical advice, clinical diagnosis, or professional treatment. Always consult a qualified endocrinologist, cardiologist, nephrologist, or primary care physician before initiating, modifying, or discontinuing any prescription medication.

References

  1. U.S. Food and Drug Administration (FDA):
    JARDIANCE (empagliflozin tablets) Full Prescribing Information & Updates.
  2. National Center for Biotechnology Information (NCBI):
    StatPearls Review: Empagliflozin Pharmacology, Indications, and Clinical Applications.
  3. New England Journal of Medicine (NEJM):
    Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes (EMPA-REG OUTCOME).
  4. The Lancet:
    Empagliflozin in Patients with Chronic Kidney Disease (EMPA-KIDNEY Trial).
  5. American Diabetes Association (ADA):
    Standards of Care in Diabetes: Cardio-Renal Risk Reduction with SGLT2 Inhibitors.

At a glance

Brands in stock
3
Strengths
10 Mg / 25 Mg
Manufacturers
1
From
USD $ 20.00