Empagliflozin + Metformin brands and prices in Pakistan

About Empagliflozin with metformin

This is a prescription tablet for type 2 diabetes that contains two diabetes medicines in one. Empagliflozin is an SGLT2 inhibitor: it helps the kidneys get rid of extra sugar in the urine. Metformin mainly cuts down the amount of sugar the liver makes. Together they lower blood sugar. It is used alongside a healthy diet and exercise, and it can replace taking empagliflozin and metformin as two separate tablets.

Who should not take it, or should take care

• Do not take it if you are allergic to empagliflozin, metformin or any other ingredient.
• Do not take it if you have type 1 diabetes, diabetic ketoacidosis or diabetic pre-coma.
• Do not take it if you have serious kidney problems or liver problems.
• Do not take it if you have a severe infection, are dehydrated, or have a condition that lowers oxygen in the blood, such as sudden heart failure, a recent heart attack, shock or severe breathing problems.
• Do not take it if you drink a lot of alcohol.
• Pregnancy and breastfeeding: the product leaflet says not to take it while pregnant or breastfeeding. Talk to your doctor if you are pregnant, planning a pregnancy or breastfeeding.
• Tell your doctor if you are aged 75 or over, have low blood pressure, take water tablets (diuretics), or often get urine infections.
• Tell your doctor if you have had low vitamin B12, a heart attack, stroke, heart disease or ketoacidosis in the past.
• Tell your doctor if you are due to have an operation or a scan or X-ray that uses an injected dye. You will usually need to stop the tablets for a time, and your doctor will tell you when to restart.
• If you become ill with vomiting, diarrhoea or fever, or cannot eat or drink normally, contact your doctor. You may need to stop the tablets for a while ('sick day' advice).
• Your kidney function will be checked with blood tests regularly.

Medicines and drinks that can interact

• Insulin and sulphonylureas (such as gliclazide): higher risk of low blood sugar, so their dose may need lowering
• Water tablets (diuretics): can increase fluid loss and the risk of dehydration
• Anti-inflammatory painkillers (NSAIDs) such as ibuprofen, and celecoxib
• Blood pressure medicines called ACE inhibitors and angiotensin II receptor blockers
• Steroid medicines (tablets, injections or inhalers) and some asthma reliever inhalers (beta-2 agonists), which can raise blood sugar
• Medicines that can raise metformin levels, such as verapamil, rifampicin, cimetidine, dolutegravir, ranolazine, trimethoprim and some cancer and antifungal medicines
• Medicines that may raise the risk of lactic acidosis, such as topiramate, zonisamide and acetazolamide
• Lithium: its blood level may fall
• Injected X-ray or scan dyes (iodinated contrast)
• Alcohol and medicines that contain alcohol: avoid drinking a lot, as it raises the risk of lactic acidosis

Always tell your doctor and pharmacist about every medicine, supplement and herbal product you take.

Using it safely

• Take it exactly as your doctor tells you. Take it with meals to reduce stomach upset, and swallow the tablet whole with water.
• If you forget a dose, take it when you remember unless it is nearly time for the next one. Never take two doses together.
• Do not stop taking it without talking to your doctor first, unless you think you have ketoacidosis, lactic acidosis or dehydration.
• Drink water or other sugar-free drinks to avoid dehydration.
• Learn the signs of a hypo and carry sweets or a sugary drink, especially if you also take insulin or a sulphonylurea.
• Your urine will test positive for sugar while taking it. This is expected.
• Check your feet regularly, as everyone with diabetes should.
• Keep out of the reach of children and take unused tablets back to a pharmacy.

Common questions

Why do I pee more and get thrush on this medicine?
The empagliflozin part works by sending extra sugar out in your urine. This makes you pee more, and the sugar can encourage thrush and urine infections. A pharmacist can suggest treatment for thrush; see a doctor if it keeps coming back or does not clear.

Can I drink alcohol while taking it?
Avoid drinking a lot of alcohol. Heavy or binge drinking raises the risk of lactic acidosis and can also lower blood sugar. Ask your doctor what is safe for you.

What should I do if I get ill?
If you have vomiting, diarrhoea or a fever, or you cannot eat or drink normally, contact your doctor or diabetes team. You may need to stop the tablets for a while to avoid dehydration, ketoacidosis or lactic acidosis. Get urgent help for any signs of ketoacidosis.

Will it make me put on weight?
NHS advice says empagliflozin does not cause weight gain, and some people lose weight. Quick, unexplained weight loss together with sickness or thirst can be a sign of ketoacidosis and needs urgent help.

Why do I need to stop it before an operation or a scan?
Surgery and injected scan dyes can affect your kidneys and fluid levels, which raises the risk of lactic acidosis and ketoacidosis. Your doctor will tell you when to stop and when it is safe to restart.

Prepared from the sources listed by the MedInfoBase team. General information, not medical advice: it gives no doses. Your doctor or pharmacist decides the medicine and dose for you.