Empagliflozin
Pronunciation: em-pa-gli-FLOE-zin.
Last medically reviewed: August 14, 2026, by Dr. Rina Basnet, MBBS, MD (Internal Medicine).
- Generic name
- empagliflozin
- Brand names
- Jardiance
- Drug class
- Sodium-glucose co-transporter 2 (SGLT2) inhibitor
- Form
- Tablet
- Route
- Oral
- Legal status
- Prescription-only medicine
Availability and supply rules vary by country
Trade names by country: United States · Canada
Australia: · Full directory
What empagliflozin is and how it works
Empagliflozin is an SGLT2 inhibitor that works in the kidney to increase glucose excretion in urine, lowering blood glucose in adults with type 2 diabetes. (1)
It is used alongside diet and exercise for blood sugar control, and in the United States is also used to reduce the risk of cardiovascular death in people with type 2 diabetes and established heart disease. It carries a real, serious risk of ketoacidosis that can occur even when blood glucose is normal or only mildly raised.
Mechanism of action: how empagliflozin works
Empagliflozin inhibits SGLT2 in the renal proximal tubule, reducing glucose reabsorption and increasing urinary glucose excretion, which lowers blood glucose independent of insulin secretion or action. (1)
What empagliflozin is used for
Type 2 diabetes glycaemic control
Used as an adjunct to diet and exercise to improve blood glucose control in adults with type 2 diabetes. It is not indicated for type 1 diabetes. (1)
Cardiovascular risk reduction (United States)
Used to reduce the risk of cardiovascular death in adults with type 2 diabetes and established cardiovascular disease, per the current US label. (1)
Chronic kidney disease and paediatric use (United Kingdom)
UK product information also describes use for chronic kidney disease in adults and for type 2 diabetes in adolescents 10 years and older; confirm the exact current UK indication and age criteria against the local product information before relying on this. (2)
Before taking empagliflozin
Do not take / not appropriate for
- Do not take empagliflozin if you have had a serious hypersensitivity reaction to it or a product ingredient, or if you have severe kidney impairment, end-stage kidney disease, or are on dialysis. (all products) (1)
Tell your clinician about
- Type of diabetes you have, since empagliflozin is not for type 1 diabetes.
- Kidney function and any kidney disease.
- Low blood pressure, dehydration, or use of diuretics ('water tablets').
- Any history of urinary tract infections or genital yeast infections.
- Whether you use insulin or a sulfonylurea, since combining with empagliflozin can increase low-blood-sugar risk.
- Pregnancy, plans for pregnancy, or breastfeeding.
How to take empagliflozin
- Take exactly as prescribed, usually once daily in the morning, with or without food.
- Do not change your dose or stop taking empagliflozin without talking to your prescriber first.
- If you are unable to eat or drink normally, or become significantly unwell, contact your prescriber promptly for advice rather than continuing or stopping on your own.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2)
Missed dose
Follow the product instructions for missed doses, or ask your prescriber or pharmacist. Do not take a double dose to make up for a missed one.
Overdose
Contact your prescriber, pharmacist, or a poison-control/emergency service if an overdose is suspected. (1)
Side effects
The most commonly reported effects relate to increased urination and genitourinary infections. Some effects, especially signs of ketoacidosis or a urinary/kidney infection, need prompt medical attention.
Urinary tract infection or genital yeast infection
What to notice: Burning or pain when urinating, unusual discharge, or genital itching/irritation.
What to do: Tell your prescriber if these occur or are troublesome. (1)
Increased urination or thirst
What to notice: A recognised effect of how empagliflozin works.
What to do: Tell your prescriber if this is bothersome or you feel dehydrated. (1)
Signs of dehydration or low blood pressure
What to notice: Dizziness, lightheadedness, or fainting, especially on standing.
What to do: Contact your prescriber promptly; this risk is higher with dehydration, low starting blood pressure, or diuretic use. (1)
Possible kidney infection
What to notice: Fever, back or side pain, or worsening urinary symptoms.
What to do: Seek prompt medical evaluation. (1)
Serious warnings
Ketoacidosis — emergency
Symptoms: Nausea, vomiting, abdominal pain, tiredness, or difficulty breathing. Blood glucose may be normal or only mildly elevated, so do not assume ketoacidosis is ruled out just because blood sugar looks fine.
Action: Seek emergency medical care immediately if these symptoms occur; a clinician or emergency service will evaluate for ketoacidosis and decide whether empagliflozin needs to be stopped. Fatal cases have been reported, so do not wait to see if symptoms resolve on their own. (1)
Acute kidney injury — urgent
Symptoms: Reduced urination, swelling, or unusual tiredness.
Action: Contact your prescriber urgently; kidney function is assessed before starting and periodically during treatment. (1)
Urosepsis or pyelonephritis (serious urinary tract infection) — urgent
Symptoms: Fever, chills, back pain, or worsening urinary symptoms requiring hospitalisation in some cases.
Action: Seek prompt medical evaluation for any urinary infection symptoms. (1)
Serious allergic reaction — emergency
Symptoms: Swelling of the face, lips, tongue, or throat, or difficulty breathing.
Action: Seek emergency medical help immediately. (1)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Diuretics ('water tablets') | Can increase the risk of dehydration and low blood pressure when combined with empagliflozin. | Tell your prescriber about all diuretics you take. (1) |
| Insulin and insulin secretagogues (e.g. sulfonylureas) | Combined use increases the risk of low blood sugar (hypoglycemia). | Your prescriber may reduce the dose of insulin or the other diabetes medicine. (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Kidney impairment
Empagliflozin is not started if kidney function (eGFR) is below a certain threshold, and is stopped if kidney function falls persistently below that threshold during treatment. Kidney function is checked before starting and periodically afterward. (1)
Pregnancy
Not recommended during the second and third trimesters of pregnancy. Discuss with your prescriber if pregnant or planning pregnancy. (1)
Breastfeeding
Not recommended while breastfeeding, due to potential effects on kidney development in the infant. (1)
Liver impairment
No dose adjustment is described for liver impairment in the source reviewed. (1)
Monitoring
Before starting
- Assess kidney function (eGFR) before starting.
- Confirm the type of diabetes and rule out unsuitability (type 1 diabetes, severe kidney impairment, dialysis).
- Review blood pressure, volume status, and use of diuretics, insulin, or sulfonylureas.
During treatment
- Monitor kidney function periodically.
- Watch for signs of ketoacidosis, dehydration/low blood pressure, urinary tract infection, and genital yeast infection.
- Contact the prescriber promptly during acute illness or if unable to eat or drink normally, rather than deciding alone whether to continue.
Storage
Store as directed on the product label, out of reach of children.
Professional information
Clinician-facing context only. Use the current local product information for exact dosing and renal thresholds.
United States
Indication: Type 2 diabetes / cardiovascular risk reduction
Dose summary: 10 mg once daily in the morning, with or without food.
Renal context: Do not initiate if eGFR is below 45 mL/min/1.73m^2; discontinue if eGFR falls persistently below 45. Contraindicated in severe renal impairment, end-stage renal disease, or dialysis. (1)
Hepatic guidance
No dose adjustment is described for hepatic impairment in the US label reviewed.
Overdose note
Manage suspected overdose supportively per local poison-control and emergency guidance; no specific antidote is described in the source reviewed. (1)
Frequently asked questions
What is empagliflozin used for?
empagliflozin is prescribed for approved indications. Always follow your healthcare provider's guidance.
What are the side effects of empagliflozin?
Common side effects may include gastrointestinal symptoms and headache. Serious side effects require immediate medical attention.
Can I take empagliflozin with other medications?
Always inform your healthcare provider about all medications you are taking, including over-the-counter products and supplements.
What is the mechanism of action of empagliflozin?
Empagliflozin inhibits SGLT2 in the renal proximal tubule, reducing glucose reabsorption and increasing urinary glucose excretion, which lowers blood glucose independent of insulin secretion or action. (1)
References
- JARDIANCE (empagliflozin) tablet, film coated — prescribing informationDailyMed, U.S. National Library of Medicine (FDA-approved label) · United States · accessed 2026-07-26 · source 1
- Empagliflozin / Jardiance 10 mg and 25 mg film-coated tablets -- SmPC (search-summarised)electronic Medicines Compendium (UK) -- via aggregated web search summary, not a direct full-page fetch · United Kingdom · accessed 2026-07-26 · source 2
- JARDIANCE (EMPAGLIFLOZIN) TABLET, FILM COATED [APHENA PHARMA SOLUTIONS - TENNESSEE, LLC ] — US prescribing information (DailyMed SPL)U.S. National Library of Medicine (DailyMed) · US · accessed 2026-08-14 · source 3
- Empagliflozin — patient drug information (MedlinePlus)U.S. National Library of Medicine (MedlinePlus) · US · accessed 2026-08-14 · source 4
- Synjardy — FDA approval record (Drugs@FDA NDA206111)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 5
- empagliflozin — RxNorm normalized drug concept (RXCUI 1545653)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 6
Brand names by country
Single-ingredient empagliflozin names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- Jardiance10 mg, 25 mg · a-s medication solutions
Canada
- JARDIANCE