EMPIGET 25MG 14S

Empiget contains Empagliflozin 25mg, an SGLT-2 (sodium-glucose cotransporter-2) inhibitor that reduces blood glucose by blocking glucose reabsorption in the kidneys, leading to urinary glucose excretion.

Empagliflozin was the first SGLT-2 inhibitor to demonstrate a statistically significant reduction in cardiovascular mortality in the landmark EMPA-REG OUTCOME trial, establishing the class as essential therapy in patients with Type 2 Diabetes and established cardiovascular disease.

Beyond glucose control, Empagliflozin provides cardiorenal protection: it reduces hospitalisation for heart failure, slows CKD progression, and lowers blood pressure and body weight.

In Kenya, Empiget 25mg provides these proven benefits as a more accessible generic option. It is used as monotherapy or combination therapy in T2D management and increasingly in cardiology and nephrology practice.

Starting Dose

10mg once daily in the morning, with or without food. Empiget 25mg may be the maintenance dose as determined by the prescriber.

Maintenance Dose

25mg once daily for enhanced cardiovascular, renal, and glycaemic benefit in appropriate patients.

Timing

Take in the morning consistently. Avoid evening dosing to minimise nocturnal polyuria.

Renal Assessment

eGFR must be assessed before starting. Glycaemic efficacy is reduced below eGFR 45 ml/min.

Missed Dose

Take as soon as remembered. If close to the next dose, skip the missed dose. Never double.

Common Side Effects

·       Genital mycotic infections (candidiasis, especially in women)

·       Urinary tract infections

·       Polyuria (increased urination)

·       Nasopharyngitis (runny nose)

·       Mild volume depletion / dizziness

Uncommon Side Effects

·       Hypoglycaemia (when combined with insulin or sulphonylureas)

·       Nausea

·       Thirst

·       Elevated haematocrit

Serious Side Effects, Seek Immediate Medical Attention

·       Diabetic Ketoacidosis (DKA), including euglycaemic DKA (near-normal blood glucose)

·       Fournier's Gangrene (necrotising fasciitis of the perineum, rare but life-threatening)

·       Acute kidney injury (especially in dehydrated patients)

·       Lower limb amputation risk (class-wide signal, monitor peripheral circulation)

·       DKA RISK: Stop Empiget at least 3 days before elective surgery, during prolonged fasting, or during serious acute illness. Euglycaemic DKA can occur, symptoms include nausea, vomiting, abdominal pain, and malaise.

·       VOLUME DEPLETION: Assess volume status before starting. Use caution in elderly patients and those on diuretics.

·       GENITAL INFECTIONS: Counsel on hygiene. Patients with recurrent infections may require antifungal treatment.

·       RENAL MONITORING: Monitor eGFR at baseline and periodically; dose adjustment or discontinuation may be required.

·       FOOT CARE: Advise regular foot inspection. SGLT-2 inhibitors carry a small increased risk of lower limb complications.

·       BLOOD PRESSURE: Empagliflozin has a modest antihypertensive effect; monitor BP, especially in patients already on antihypertensives.

Insulin / Sulphonylureas: Increased hypoglycaemia risk, consider dose reduction.

Diuretics (furosemide, thiazides): Additive volume depletion and electrolyte imbalance.

Antihypertensives: Additive hypotensive effect, monitor blood pressure.

NSAIDs: Increased risk of acute kidney injury.

Rifampicin and CYP inducers: May reduce empagliflozin exposure.

·       Store below 30°C in a cool, dry place.

·       Keep in original blister packaging.

·       Protect from moisture and light.

·       Keep out of reach of children.

Empiget 25mg is a prescription-only medicine (POM) in Kenya. It is prescribed by physicians, diabetologists, cardiologists, and nephrologists. Available at Pharmily with a valid prescription.

Empiget (Empagliflozin 25mg) is a generic of Jardiance (Boehringer Ingelheim/Lilly) and carries the same robust cardiovascular mortality reduction evidence from EMPA-REG OUTCOME. In patients with established CVD, HFrEF, or CKD, empagliflozin should be considered first-line alongside metformin per current international guidelines. The 25mg dose (vs 10mg) provides additional glycaemic lowering but the cardiovascular mortality benefit was observed at both doses.

Euglycaemic DKA is the most important safety counselling point; patients and prescribers may not recognise DKA when blood sugars appear near-normal. Pre-surgical cessation protocol (3 days before elective procedure) should be documented and communicated clearly. 14-tablet pack size may be suitable for a 2-week trial initiation; standard 30-tablet packs recommended for maintenance.

How is Empagliflozin different from other diabetes tablets?

A: Unlike metformin or sulphonylureas, empagliflozin works through the kidneys; it causes excess glucose to be excreted in urine. It also has unique proven heart and kidney protection benefits beyond blood sugar control.

Can Empagliflozin cause low blood sugar on its own?

A: Rarely. Empagliflozin alone rarely causes hypoglycaemia. The risk is higher if taken with insulin or sulphonylureas; your doctor may reduce those doses.

What is euglycaemic DKA and why does it matter?

A: This is a dangerous condition where the blood becomes acidic (ketoacidosis) even though blood sugar appears near-normal. Symptoms include nausea, vomiting, and fatigue. Stop Empiget immediately if these occur and seek urgent medical care.

Is Empiget safe for my kidneys?

A: Yes, empagliflozin actually protects the kidneys and slows the progression of chronic kidney disease. However, efficacy for blood sugar lowering is reduced if kidney function is severely impaired.