Glusod (Empagliflozin)

Glusod (empagliflozin) is indicated for adults with type 2 diabetes mellitus as part of a comprehensive glycemic control plan.

• Adjunct to diet and exercise when metformin alone does not achieve target glycaemic levels.
• Combination therapy with other oral antidiabetic agents such as DPP‑4 inhibitors or sulfonylureas.
• May be considered in patients with established cardiovascular disease to provide additional risk reduction.
• Used when renal function is adequate (eGFR ≥45 mL/min/1.73 m²) as per prescribing information.
• Prescribed in fixed‑dose combinations that include empagliflozin and other glucose‑lowering drugs.

The safety profile of empagliflozin includes a range of observed adverse events that are generally categorized by frequency.

Common

• Increased urinary frequency or volume.
• Genital mycotic infections (e.g., yeast infections).
• Mild dehydration or thirst.
• Lower limb edema.

Serious

• Ketoacidosis (euglycemic diabetic ketoacidosis).
• Acute kidney injury.
• Severe hypersensitivity reactions such as Stevens‑Johnson syndrome.

Before initiating Glusod, clinicians should evaluate several clinical factors to minimise risk and ensure appropriate use.

• Assess renal function; avoid use in patients with severely reduced eGFR.
• Monitor for signs of volume depletion, especially in the elderly or those on diuretics.
• Caution in patients with a history of genital or urinary tract infections.
• Evaluate cardiovascular status; empagliflozin has demonstrated benefit but may require dose adjustment in heart failure.
• Review concomitant medications that affect glucose levels to prevent hypoglycaemia.
• Consider pregnancy and lactation status; safety data are limited.

Empagliflozin can interact with other medicines, altering its effectiveness or increasing the risk of adverse effects.

Avoid

• Concurrent use of insulin or sulfonylureas without dose adjustment, which may increase hypoglycaemia risk.
• Combination with strong diuretics that may exacerbate dehydration or hypotension.

Use with caution

• Co‑administration with renin‑angiotensin‑system blockers (ACE inhibitors, ARBs) requiring renal function monitoring.
• Use alongside other SGLT2 inhibitors is not recommended.
• NSAIDs or other nephrotoxic agents may increase risk of kidney injury.
• Rifampin or other CYP3A4 inducers may reduce empagliflozin exposure.