Emjard
Generic Name
Empagliflozin
Manufacturer
Beximco Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| emjard 10 mg tablet | ৳ 25.00 | ৳ 250.00 |
Description
Overview of the medicine
Emjard 10 mg tablet contains Empagliflozin, an SGLT2 inhibitor used to treat type 2 diabetes mellitus, reduce the risk of cardiovascular death and hospitalization for heart failure, and reduce the risk of kidney disease progression in adults.
Uses & Indications
Dosage
Adults
Initial dose is 10 mg once daily, taken in the morning, with or without food. May be increased to 25 mg once daily if additional glycemic control is needed and 10 mg is well-tolerated.
Elderly
No dose adjustment based on age alone is recommended. Renal function should be monitored.
Renal_impairment
Not recommended for initiation in patients with eGFR < 20 mL/min/1.73m². Dosage adjustment may be needed for moderate impairment (eGFR 20 to < 60 mL/min/1.73m²) - generally, 10 mg once daily is used. Discontinue if eGFR falls persistently below 20 mL/min/1.73m² during treatment.
How to Take
Take orally once daily in the morning, with or without food.
Mechanism of Action
Empagliflozin works by blocking the sodium-glucose cotransporter 2 (SGLT2) protein in the kidneys. This action reduces glucose reabsorption in the renal tubules and increases glucose excretion in the urine, leading to reduced blood glucose levels.
Pharmacokinetics
Onset
Glucose-lowering effects observed within hours of administration.
Excretion
Approximately 50% renally excreted and 50% fecally excreted.
Half life
Approximately 12-19 hours (mean terminal half-life of 12.4 hours).
Absorption
Rapidly absorbed after oral administration, with peak plasma concentrations (Cmax) reached within approximately 1.5 hours. Absolute bioavailability is about 78%.
Metabolism
Primarily metabolized by glucuronidation via uridine 5'-diphospho-glucuronosyltransferases (UGTs), specifically UGT1A3, UGT1A8, UGT1A9, UGT2B7, UGT2B4, and UGT2B17.
Side Effects
Contraindications
- Hypersensitivity to empagliflozin or any excipients.
- Severe renal impairment (eGFR < 20 mL/min/1.73m²), end-stage renal disease, or dialysis.
Drug Interactions
Lithium
SGLT2 inhibitors may decrease serum lithium concentrations. Monitor lithium levels.
Diuretics
May increase the risk of dehydration and hypotension.
Insulin and Insulin Secretagogues (e.g., sulfonylureas)
May increase the risk of hypoglycemia. A lower dose of insulin or secretagogue may be required.
Storage
Store below 30°C. Protect from moisture and light. Keep out of reach of children.
Overdose
In case of an overdose, initiate appropriate supportive treatment. Empagliflozin is not dialyzable.
Pregnancy & Lactation
Not recommended during pregnancy, especially during the second and third trimesters, due to potential adverse effects on fetal kidney development. Avoid use during lactation as empagliflozin may be excreted in breast milk.
Side Effects
Contraindications
- Hypersensitivity to empagliflozin or any excipients.
- Severe renal impairment (eGFR < 20 mL/min/1.73m²), end-stage renal disease, or dialysis.
Drug Interactions
Lithium
SGLT2 inhibitors may decrease serum lithium concentrations. Monitor lithium levels.
Diuretics
May increase the risk of dehydration and hypotension.
Insulin and Insulin Secretagogues (e.g., sulfonylureas)
May increase the risk of hypoglycemia. A lower dose of insulin or secretagogue may be required.
Storage
Store below 30°C. Protect from moisture and light. Keep out of reach of children.
Overdose
In case of an overdose, initiate appropriate supportive treatment. Empagliflozin is not dialyzable.
Pregnancy & Lactation
Not recommended during pregnancy, especially during the second and third trimesters, due to potential adverse effects on fetal kidney development. Avoid use during lactation as empagliflozin may be excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Available in pharmacies and hospitals
Approval Status
FDA and DGDA approved
Patent Status
Under patent (for innovator drug)
Clinical Trials
Empagliflozin has been extensively studied in major clinical trials such as EMPA-REG OUTCOME (cardiovascular outcomes in T2DM), EMPEROR-Reduced and EMPEROR-Preserved (heart failure), and EMPA-KIDNEY (chronic kidney disease).
Lab Monitoring
- Renal function (eGFR) should be assessed before initiating Emjard and periodically thereafter.
- Glycemic control (HbA1c, blood glucose) should be monitored regularly.
- Lipid panel monitoring (especially LDL-C) may be considered.
- Ketone levels should be checked if ketoacidosis is suspected.
Doctor Notes
- Counsel patients on signs and symptoms of ketoacidosis and prompt medical evaluation if they occur.
- Emphasize adequate fluid intake to minimize the risk of volume depletion.
- Monitor renal function prior to initiation and periodically during treatment.
- Advise on genital hygiene to reduce the risk of mycotic infections.
Patient Guidelines
- Take Emjard exactly as prescribed by your doctor.
- Maintain adequate hydration, especially during illness or in warm weather.
- Monitor blood sugar levels regularly as advised.
- Be aware of symptoms of urinary tract infections (e.g., burning sensation during urination, frequent urination) or genital yeast infections and report them to your doctor.
- Seek immediate medical attention if you experience symptoms of ketoacidosis (e.g., nausea, vomiting, abdominal pain, fruity-smelling breath, difficulty breathing).
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. Do not take a double dose to make up for a missed one.
Driving Precautions
Emjard itself is unlikely to affect the ability to drive or operate machinery. However, if used in combination with other anti-diabetic medications that can cause hypoglycemia (e.g., insulin, sulfonylureas), caution should be exercised as hypoglycemia can impair concentration.
Lifestyle Advice
- Follow a healthy diet plan recommended by your doctor or dietitian.
- Engage in regular physical activity as appropriate for your condition.
- Ensure adequate fluid intake to prevent dehydration.
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