Common questions about empagliflozin - Brand name: Jardiance

Empagliflozin is a type of medicine known as a sodium-glucose co-transporter-2 (SGLT2) inhibitor.

It reduces blood sugar levels in people with diabetes.

It does this by helping remove extra sugar from your body through your pee.

If you have heart failure, empagliflozin reduces the amount of work your heart has to do to pump blood around your body. This helps improve the symptoms of heart failure such as breathlessness, tiredness and swelling in your lower legs. It also reduces the chances of your heart getting weaker.

If you have chronic kidney disease it works by reducing pressure and swelling (inflammation) in the kidneys.

Empagliflozin starts to work within an hour or 2 to reduce your blood glucose levels, but it may take a week for it to work fully.

You may not have had any symptoms of diabetes, so you will not necessarily feel any different when you take empagliflozin. This does not mean that empagliflozin is not working. It's important to keep taking it.

Empagliflozin will help keep your blood sugar level stable and reduce your chances of diabetes-related problems in the future.

If you're taking empagliflozin for heart failure, it might be a month or 2 before you notice any improvement in your symptoms. Although you may not feel different, empagliflozin is still working to reduce the workload on your heart. This will reduce your chances of your heart failure getting worse.

If you're taking it for chronic kidney disease, you may not feel any different, but it helps to slow down how quickly your condition gets worse.

Empagliflozin is safe to take for a long time. There is no evidence that this medicine harms your general health.

There are different groups of medicines that can lower blood sugar levels if you have type 2 diabetes:

• metformin
• pioglitazone
• DPP-4 inhibitors or gliptins, such as saxagliptin
• GLP-1 agonists, such as exenatide
• SGLT2 inhibitors, such as empagliflozin and dapagliflozin
• insulin

Empagliflozin can be prescribed on its own or together with some of these other medicines.

Empagliflozin can be taken on its own when diet and exercise are not enough to control your blood sugar levels, or if you cannot take metformin. It can also be taken with other diabetes medicines, including insulin, when the medicines you're already taking do not control your blood sugar properly.

SGLT2 inhibitors all work in the same way, by increasing the amount of sugar removed from your body when you pee.

These medicines can cause urinary tract infections because of the way they work.

Find out more about medicines for type 2 diabetes

Empagliflozin is usually added to other heart failure medicines to help control your condition. Other heart failure medicines include:

• ACE inhibitors, such as enalapril, lisinopril and ramipril
• angiotensin receptor blockers (ARBs), such as candesartan, losartan and valsartan
• beta blockers, such as bisoprolol
• diuretics (tablets that make you pee more), such as furosemide and bumetanide

Empagliflozin is usually added to other medicines to help control your condition. Other medicines used for chronic kidney disease include:

• angiotensin-converting enzyme (ACE) inhibitors such as enalapril, lisinopril or ramipril
• angiotensin receptor blockers (ARBs) such as candesartan, losartan or valsartan

If you have diabetes, you're entitled to free prescriptions for all your medicines, not just your diabetes ones.

To claim your free prescriptions, you'll need to have a medical exemption certificate (FP92A).

You can get an application form at your GP surgery.

If you're going to have an operation, tell the doctor that you're taking empagliflozin.

You may need to stop taking your empagliflozin tablets if you need to stop eating before your operation, and while you recover after the operation.

This is because there's a risk of diabetic ketoacidosis.

Empagliflozin can cause weight loss by increasing the amount of sugar that's removed from your body when you pee.

Empagliflozin does not stop any type of contraception from working, including the combined pill and emergency contraception.

Empagliflozin should not affect your ability to drive or ride a bike.

But if you're taking empagliflozin together with other diabetes medicines, such as sulfonylureas or insulin, it can cause your blood sugar levels to go too low (hypoglycaemia or a "hypo").

Hypos can reduce your concentration. If this happens to you, do not drive, cycle or use machines or tools until you feel better.

It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.

Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking empagliflozin. GOV.UK has more information on the law on drugs and driving.

Yes, you can drink alcohol while taking empagliflozin.

However, alcohol can increase the risk of low blood sugar levels.

Try not to drink on an empty stomach, and try to stick to no more than the recommended guidelines of 14 units of alcohol a week, and 2 units a day.

A standard glass of wine (175ml) is 2 units. A pint of lager or beer is usually 2 to 3 units of alcohol.

It's a good idea to cut down on foods with added sugar. However, ask your doctor for advice before starting a low-calorie, reduced carbohydrate or ketogenic (keto) diet.

Check the nutrition labels, as many foods and drinks are high in sugar. This can increase your blood sugar levels, so your diabetes is not controlled as well as it could be. These foods include:

• sweets
• cakes
• biscuits
• chocolate
• some fizzy drinks
• juice drinks

Be careful when eating food and drink containing karela (also called bitter gourd or bitter melon). This is because it can lower your blood sugar levels, and you could have a hypo.

Karela is used to flavour foods, such as curries like bitter gourd masala. It has a bitter taste, and can also be made into juice and tea.

There are some lifestyle changes you can make to help control the symptoms of type 2 diabetes, heart failure or chronic kidney disease.

These include:

• eating a healthy diet
• losing any excess weight
• quitting smoking
• cutting down on alcohol – try to keep to the recommended guidelines of no more than 14 units of alcohol a week
• exercising – at least 30 minutes a day, 5 times a week is ideal

Empagliflozin is usually prescribed for type 2 diabetes when diet and exercise alone have not been enough to control your blood sugar levels.