Overview
Empagliflozin is an oral sodium-glucose co-transporter 2 (SGLT2) inhibitor. It is prescribed for adults with type 2 diabetes to improve glycemic control and has notable cardiovascular and renal protective benefits, including reducing the risk of cardiovascular death and heart failure hospitalizations.

Mechanism of Action
It inhibits SGLT2, the primary transporter responsible for glucose reabsorption in the proximal renal tubules. By blocking this transporter, empagliflozin reduces renal reabsorption of filtered glucose and lowers the renal threshold for glucose, thereby increasing urinary glucose excretion and lowering blood glucose levels independently of insulin.

Dosage and Administration
The recommended starting dose is 10 mg once daily in the morning, taken with or without food. In patients tolerating the drug well, the dose may be increased to 25 mg daily for additional glycemic control. It requires adequate renal function to be effective.

Side Effects
Common side effects include genital mycotic infections (such as vaginal yeast infections and balanitis), urinary tract infections, and increased urination. It can cause intravascular volume depletion leading to hypotension. A rare but serious risk is euglycemic diabetic ketoacidosis.

Contraindications
It is contraindicated in patients with a history of serious hypersensitivity to empagliflozin and in patients on dialysis. It is not indicated for type 1 diabetes.

Pregnancy and Lactation
Empagliflozin is not recommended during the second and third trimesters of pregnancy due to potential adverse effects on fetal renal development. It is also not recommended during breastfeeding.