Empagliflozin and Metformin

Hypoglycaemic excluding Insulin · Biguanide/Reversible inhibitor of sodium-glucose co-transporter 2 (SGLT2)

Indications

Type 2 diabetes mellitus not controlled by metformin alone or by metformin in combination with other antidiabetic drugs or insulin.

Dosage

Adults 18-84 yrs: 5/500-5/1000 mg twice daily, based on patient’s current metformin dose, increased if required to 12.5/500-12.5/1000 mg twice daily. >85 yrs: Not recommended.

Adverse Effects

Lactic acidosis, genital mycotic infections, UTIs, vitamin B12 deficiency, increased LDL-C.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Risk cannot be ruled out. Lactation: Caution advised or effect undetermined. Contraindications: Renal impairment (serum creatinine level =1.5 mg/dL for males or 1.4 mg/dL for females, or eGFR <45 mL/min/1.73 m2), acute or chronic metabolic acidosis, including diabetic ketoacidosis. Precautions: Monitor renal function before starting treatment and during treatment. Impaired hepatic function.

Interactions

Ranolazine, selegiline, tranylcypromine, topiramate and other carbonic anhydrase inhibitors, thiazides and other diuretics.

Advice to Patient

Take with meals.

Pharmacokinetics

EMPAGLIFLOZIN: Metabolism: Hepatic. Half-life elimination: 12.4 hrs. Time to peak: 1.5 hrs. Excretion: Urine (54.4%). Faeces (41.2%). METFORMIN: Onset of action: Within days, max effects up to 2 wks. Metabolism: Not metabolized by the liver. Bioavailability: Absolute: Fasting: 50%-60%. Half-life elimination: Plasma: 4-9 hrs. Blood: Approx. 17.6 hrs. Time to peak, serum: Immediate release: 2-3 hrs. Extended release: 7 hrs. (Range: 4-8 hrs). Excretion: Urine.

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.