High level view

Empagliflozin is an oral prescription medicine from the SGLT2 inhibitor group. In Australian clinical practice it is prescribed primarily to improve glycaemic control in adults and older children with type 2 diabetes and to lower some cardiovascular and heart failure risks. The summary below outlines marks, common strengths, safety planning considerations, medicines that have similar action and indicative Australian costs and access permissions rules.

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Use cases and evidence

Empagliflozin reduces blood glucose by increasing urinary glucose excretion. In Australia clinicians commonly consider it for the following scenarios:

• As an add-on therapy to lifestyle changes and other medicines for adults and adolescents aged 10 years and older with type 2 diabetes who need further glycaemic lowering
• To reduce the risk of cardiovascular death in adults with type 2 diabetes and established cardiovascular disease
• To lower the risk of death or hospitalisation related to heart failure in adults with reduced cardiac function

This agent is not suitable for type 1 diabetes in routine practice. If you are pregnant, considering conceiving, or breastfeeding, talk to your clinician and examine the data important safety measures and conditions that rule out this therapy.

Dosage recommendations and administration steps

Follow the exact dose prescribed by your healthcare professional. Prescribers adjust dose according to response and kidney function. The following are general points and not a replacement for professional advice.

• Usual schedule: one tablet once daily, frequently taken in the morning. It is suitable to take with or without food. Take at the same time each day for consistency.
• Supervisory monitoring: routine blood glucose checks and periodic assessment of renal function are commonly recommended. If you feel unwell or have very high glucose readings, ketone testing may be advised.
• Hydration: empagliflozin may increase urine volume. Maintain adequate fluid intake unless your clinician instructs otherwise.

If your prescriber changes the dose, continue according to the new instructions. See advice on skipping a dose for what to do when you forget a dose.

Cautionary measures to consider before starting

Before you begin the process empagliflozin, make sure your prescriber knows about any past or current medical issues, in particular:

• Repeated urinary tract or bladder infections
• Frequent genital fungal infections
• History of pancreatic disease or pancreatic surgery
• High or chronic alcohol intake
• Recent major dietary changes, reduced calorie intake or very low salt diets
• Liver disease or reduced kidney function
• Older age (for example 65 years or older) which may increase the risk of dehydration or falls

If you become pregnant while taking empagliflozin, contact your healthcare provider promptly to discuss stopping the medicine and switching to a safer option. To reduce dizziness from low blood pressure, stand up slowly from sitting or lying positions and avoid excessive alcohol.

Where use is contraindicated

Do not use empagliflozin if any of these apply to you:

• You have a known allergy to empagliflozin or any ingredient in the formulation
• You have severe renal impairment or are receiving dialysis
• You are in the second or third trimester of pregnancy

Breastfeeding is generally not recommended while taking empagliflozin. If these when this treatment should not be used apply, ask your prescriber about other treatment choices or study backup drug options and related medicines.

What you may feel as adverse reactions and when to seek care

Seek immediate medical attention if you experience signs of a serious allergic reaction, such as widespread rash, breathing difficulty or swelling of the face, lips, tongue or throat.

Serious problems requiring urgent care

• Severe genital infection that worsens quickly: severe burning, persistent itching, abnormal discharge, pain, swelling, fever or feeling generally unwell
• Low blood sugar (hypoglycaemia): mild head pain, hunger, sweating, shaking, dizziness, fast heartbeat, confusion or mood changes — risk rises if combined with insulin or sulfonylureas
• Dehydration: extreme thirst, markedly reduced urine output, lightheadedness or confusion
• Ketoacidosis: nausea, vomiting, abdominal pain, extreme tiredness, difficulty breathing or altered mental state; note ketoacidosis can occur even with mildly raised blood glucose
• Possible urinary tract infection progressing to more serious illness: painful or frequent urination, blood in urine, pelvic or flank pain

More common, usually less severe reactions

• Infection of the urinary tract
• Genital yeast infections such as vaginal irritation or discharge

If symptoms persist or you are concerned, contact your GP or pharmacist for assessment. Review protective safety steps to help reduce risks.

Medicament effective social interactions require clear communication.

Always tell your prescriber and pharmacist about every medicine, vitamin and supplement you take. Pivotal exchanges include:

• Insulin and insulin secretagogues such as sulfonylureas: combined use may increase hypoglycaemia risk and could require dose adjustments
• Diuretics: concomitant use can increase the chance of dehydration and symptomatic low blood pressure

Your clinician may recommend extra observation and tracking or changes to other medicines when empagliflozin is started or stopped.

Advice for when you miss a dose

If you forget to take a dose, take it as soon as you remember unless the next scheduled dose is due soon. If the next dose is coming up, skip the i skipped one dose and return to your normal schedule. Do not increase your dose to make up for a i skipped one dose.

Procedures for take too much medicine

If an an opioid overdose is suspected in addition to the person feels unwell, for example fainting, severe dizziness or difficulty breathing, call emergency services without delay. In Australia you can also contact the Poisons Information Centre on 13 11 26 for specialist advice.

Tips for storage capacity can limit how much you can keep on hand.

• Keep at room temperature, away from direct heat and excessive moisture
• Store out of reach of children and animals
• Do not use after the expiry date printed on the pack.

Alternative treatments and medicines that are alike

Empagliflozin is included in the SGLT2 inhibitor category. Depending on individual clinical factors such as kidney function, cardiovascular risk and tolerance, other medicines may be appropriate.

Other drugs in the SGLT2 inhibitor class

• Dapagliflozin (commonly Forxiga): used for glycaemic control and heart failure indicators
• Ertugliflozin (Steglatro): another SGLT2 option for type 2 diabetes

Drugs from other classes used in type 2 diabetes

• Metformin: widely used first-line oral agent and generally lower cost
• GLP-1 receptor agonists such as semaglutide or dulaglutide, which can improve glycaemic control and support weight loss
• DPP-4 inhibitors like sitagliptin or linagliptin
• Sulfonylureas such as gliclazide or glipizide
• Insulin preparations for basal and mealtime control when needed

Choice of therapy is personalised and takes into account cardiovascular benefit, renal function, risk of hypoglycaemia, weight impact and cost. See pricing overview for a comparative snapshot and access that is legal for how to obtain these medicines in the Commonwealth of Australia.

Rough price range in Australia (AUD)

Prices vary by brand, pack size, pharmacy and whether you receive a subsidy. The figures below are indicative for about one month supply and are approximate only:

• Private prescription (no PBS subsidy): roughly AUD 80 to AUD 130 per month depending on brand and retailer
• PBS general co-payment: around AUD 31 per script for eligible items (check current rates and criteria)
• PBS concession co-payment: typically about AUD 7 to AUD 8 per script for eligible concession card holders

For comparison, dapagliflozin private prices are commonly in a similar bracket. Older, generic medicines such as metformin are substantially less expensive. PBS listing and meeting clinical criteria strongly influence out of pocket costs. Contact your local pharmacist for current retail prices and subsidy eligibility.

Australian policy for access information and legal matters

• Classification: empagliflozin is a Schedule 4 Prescription Only Medicine in Australia
• Prescription requirement: a valid prescription from an Australian-registered prescriber is required to obtain it from community pharmacies
• TGA approval: products must be approved by the Therapeutic Goods Administration to be marketed locally
• Pharmaceutical Benefits Scheme (PBS): subsidised access is available for eligible patients and approved marks when the criteria in the PBS listing are met
• Pediatric use: may be prescribed for patients aged 10 years and older for type 2 diabetes, subject to product information and clinician judgement
• Driving and workplace safety: while empagliflozin on its own has a low direct hypoglycaemia risk, the risk is higher if it is combined with insulin or sulfonylureas; follow clinical advice about driving and hazardous tasks
• Personal importation: importing prescription medicines for personal use is restricted; comply with TGA and Australian Border Force regulations before attempting to import

Always use empagliflozin only under the supervision of an appropriate healthcare professional and in line with Australian law and clinical steady guidance.

Notes - additional

This page provides general information and is not a substitute for individual medical advice. Use it to prepare for discussions with your doctor or pharmacist. For product specific details, refer to the Consumer Medicine Information leaflet supplied with your medicine or ask your pharmacist for more details, see the help page.

If you require immediate or personalised guidance about dosingperhaps possible side effects or legal availability, contact your prescribing clinician or local health services.