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Am J Health Syst Pharm. 2015 Nov 15;72(22):1943-54. doi: 10.2146/ajhp150071.

Empagliflozin: a sodium-glucose cotransporter 2 inhibitor for treatment of type 2 diabetes.

Author information

1
Divisha Dixit, Pharm.D., is Postdoctoral Associate, Pharmaceutical Fellowship Program, Ernest Mario School of Pharmacy at Rutgers, State University of New Jersey (SUNJ), Piscataway; at the time of writing she was a Pharm.D. student, Ernest Mario School of Pharmacy at Rutgers, SUNJ. Youngmin Yoon, is Pharm.D. student, Ernest Mario School of Pharmacy at Rutgers, SUNJ. Lucio R. Volino, Pharm.D., is Clinical Assistant Professor, Ernest Mario School of Pharmacy at Rutgers, SUNJ, and Clinical Pharmacist, Great Atlantic and Pacific Tea Company, Kenilworth, NJ. Rupal Patel Mansukhani, Pharm.D., is Clinical Assistant Professor, Ernest Mario School of Pharmacy at Rutgers, SUNJ, and Clinical Pharmacist, Transitions of Care, Morristown Medical Center, Morristown, NJ.
2
Divisha Dixit, Pharm.D., is Postdoctoral Associate, Pharmaceutical Fellowship Program, Ernest Mario School of Pharmacy at Rutgers, State University of New Jersey (SUNJ), Piscataway; at the time of writing she was a Pharm.D. student, Ernest Mario School of Pharmacy at Rutgers, SUNJ. Youngmin Yoon, is Pharm.D. student, Ernest Mario School of Pharmacy at Rutgers, SUNJ. Lucio R. Volino, Pharm.D., is Clinical Assistant Professor, Ernest Mario School of Pharmacy at Rutgers, SUNJ, and Clinical Pharmacist, Great Atlantic and Pacific Tea Company, Kenilworth, NJ. Rupal Patel Mansukhani, Pharm.D., is Clinical Assistant Professor, Ernest Mario School of Pharmacy at Rutgers, SUNJ, and Clinical Pharmacist, Transitions of Care, Morristown Medical Center, Morristown, NJ. rupie@rci.rutgers.edu.

Abstract

PURPOSE:

The pharmacology, pharmacokinetics, pharmacodynamics, clinical efficacy, adverse effects, dosage and administration, and drug-drug interactions of empagliflozin are reviewed.

SUMMARY:

Empagliflozin is a direct inhibitor of sodium-glucose cotransporter 2 (SGLT2), which acts to lower the renal threshold and increase urinary glucose excretion. SGLT2 is found in the proximal tubules of the kidneys and reabsorbs about 90% of the filtered glucose. Because the mechanism of action of empagliflozin is not insulin dependent or insulin sensitive, it may be used in patients at different stages of diabetes with nonfunctional or impaired pancreatic β cells. Furthermore, empagliflozin can be used with other antidiabetic drugs due to its lack of any additive hypoglycemic effects. Long-term efficacy studies revealed significant reductions with empagliflozin in glycosylated hemoglobin (HbA1c) values at week 78 compared with placebo. Secondary endpoints in clinical trials showed improvements in lowering blood pressure and reductions in body weight. The risk:benefit ratio must be assessed for empagliflozin as the safety profile includes an increase in urinary and genital infections.

CONCLUSION:

Empagliflozin has shown efficacy in lowering HbA1c and blood glucose levels both as monotherapy and as an add-on to existing therapy. Despite the drug's promising outlook, empagliflozin also leads to common but serious adverse events not seen with other classes of antihyperglycemic agents. Considering the current data on its efficacy and its safety profile, empagliflozin can be used as a second- or third-line agent in treating diabetes.

PMID:
26541949
DOI:
10.2146/ajhp150071
[Indexed for MEDLINE]

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