Empagliflozin

Question 1

What class of medication is empagliflozin?

Answer 1

SGLT-2 inhibitors

Question 2

What other medications are in the SGLT-2 inhibitor class?

Answer 2

Canagliflozin
Dapagliflozin
Etrugliflozin

Question 3

What is the mechanism of action of empagliflozin

Answer 3

SGLT-2 inhibitors act on the proximal tubules of the kidney, to block the reabsorption of glucose into the blood

Question 4

When should SGLT-2 inhibitors be given in addition to metformin?

Answer 4

Patient has established CVD
Patient has established heart failure
Patient has a QRISK score of 10 or more

Question 5

What are the indications for SGLT-2 inhibitors?

Answer 5

Type 2 diabetes
Symptomatic chronic heart failure
CKD

Question 6

What is the typical dose of empagliflozin?

Answer 6

Starting dose- 10mg OD, can be increased to 25mg OD

Question 7

What are the side effects of empagliflozin?

Answer 7

Hypoglycaemia
Glycosuria
Increased urine output and frequency
UTIs
Weight loss
Diabetic ketoacidosis
Lower limb amputation
Fournier’s gangrene

Question 8

What are the contraindications to empaglifozin?

Answer 8

Diabetic ketoacidosis
Type 1 diabetes

Question 9

What are the cautions for empagliflozin?

Answer 9

Complicated UTI
Elderly
Hypotension
Risk of volume depletion

Question 10

How is SGLT-2 inhibitor use monitored?

Answer 10

Determine renal function before treatment, and before initiation of other drugs that may reduce renal function

Renal function annually

Question 11

What information should patients be given about SGLT-2 inhibitors?

Answer 11

Patients should be counselled about the signs of diabetic ketoacidosis