Empagliflozin

Jardiance or empagliflozin was approved on August 1^st, 2014 for the treatment of type 2 diabetes. It is a SGLT2 inhibitor and in the same class as Invokana. The mechanism involves blocking the reabsorption of glucose by the kidney. This will cause more glucose to be excreted and therefore lower blood glucose levels. It can cause dehydration, low blood pressure, dizziness, yeast infections in women, and UTI’s. There is a risk of hypoglycemia with this medication and it may cause an increase in LDL. It is an expensive medication. A 30 day supply is around $360 according to lexicomp. The benefits of this medication include lowering A1C by 1%, weight reduction of 4-7 pounds, and lowering BP in patients with hypertension.  You should avoid using this in patients with severe renal impairment. In practice, this should be considered a 2^nd or 3^rd line option. Advise patients to take this in the morning as it can cause diuresis.

References: 

Pharmacist Letter: http://pharmacistsletter.therapeuticresearch.com/ce/ceNewsletter.aspx?nidchk=1&cs=STUDENT&s=PL&is=102014&ceid=CE4272634

Lexicomp: http://online.lexi.com.proxy.lib.uiowa.edu/lco/action/doc/retrieve/docid/patch_f/5279964