Empagliflozin

Indications & Dose:

Type 2 diabetes mellitus as monotherapy (if metformin inappropriate) | Type 2 diabetes mellitus in combination with insulin or other antidiabetic drugs (if existing treatment fails to achieve adequate glycaemic control)

▶BY MOUTH

▶Adult 18–84 years: 10 mg once daily, increased to 25 mg once daily if necessary and if tolerated

▶Adult 85 years and over: Initiation not recommended

DOSE ADJUSTMENTS DUE TO INTERACTIONS

Dose of concomitant insulin or drugs that stimulate insulin secretion may need to be reduced.

Contraindications:

Diabetic ketoacidosis

Side Effects:

▶Common or very commonGenital infection .hypoglycaemia (in combination with insulin or sulfonylurea) . polyuria . pruritus .urinary tract infection

▶UncommonDysuria .volume depletion

Cautions:

Cardiovascular disease (increased risk of volume depletion) . complicated urinary tract infections— consider temporarily interrupting treatment . concomitant antihypertensive therapy (increased risk of volume depletion) . elderly patients aged over 75 years (increased risk of volume depletion) . heart failure . history of hypotension (increased risk of volume depletion) . patients at increased risk of volume depletion . predisposition to fluid disturbances e.g. gastro-intestinal illness, concomitant use of diuretics (increased risk of volume depletion)

Precautions:

Interaction:

Warnings:

Adverse Effects:

Lactations:

PREGNANCY Manufacturer advises avoid—toxicity inanimalstudies.

BREAST FEEDING Manufacturer advises avoid—present in milk in animal studies.

HEPATIC IMPAIRMENT Manufacturer advises avoid in severe impairment—no information available.

RENAL IMPAIRMENT Reduce dose to 10mg once daily if eGFR falls persistently below 60 mL/minute/1.73m2. Avoid initiation if eGFR below 60 mL/minute/1.73m2. Avoid if eGFR is persistently below 45 mL/minute/1.73m2. www.nice.org.uk/TA336

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: