Emjard
Generic Name
Empagliflozin
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| emjard 25 mg tablet | ৳ 40.00 | ৳ 400.00 |
Description
Overview of the medicine
Empagliflozin is an oral antidiabetic drug used to treat type 2 diabetes mellitus. It belongs to a class of drugs called SGLT2 inhibitors. It helps the kidneys remove glucose from the body through urine. It is also indicated for reducing the risk of cardiovascular death and hospitalization for heart failure in adults with heart failure.
Uses & Indications
Dosage
Adults
Initial dose is 10 mg once daily. May be increased to 25 mg once daily if needed and tolerated. Take in the morning, with or without food.
Elderly
No dose adjustment is recommended based on age alone. Consider renal function.
Renal_impairment
eGFR 60 mL/min/1.73 m² or greater: No dose adjustment needed. eGFR 30 to <60 mL/min/1.73 m²: Initiate at 10 mg; if already on 10 mg and tolerating, may increase to 25 mg for glycemic control. Continue for cardiovascular and renal benefits. eGFR <30 mL/min/1.73 m²: Not recommended for glycemic control. For cardiovascular/renal indications, continue 10 mg or 25 mg if already initiated, but not recommended to initiate.
How to Take
Oral. Take once daily in the morning, with or without food.
Mechanism of Action
Empagliflozin inhibits sodium-glucose co-transporter 2 (SGLT2) in the renal proximal tubules, reducing glucose reabsorption and increasing urinary glucose excretion, thereby lowering blood glucose levels. It also promotes osmotic diuresis, leading to a reduction in blood pressure and body weight. Its cardiovascular and renal benefits are partly due to these mechanisms and other pleiotropic effects.
Pharmacokinetics
Onset
Within 30 minutes for glucosuria.
Excretion
Approximately 54.5% renally (mostly unchanged drug), 41.2% fecally.
Half life
Approximately 12.4 hours.
Absorption
Rapidly absorbed, Cmax reached 1.5 hours post-dose. Absolute bioavailability is approximately 78%.
Metabolism
Primarily by glucuronidation by UGT1A8, UGT1A9, UGT2B7, UGT2B4.
Side Effects
Contraindications
- Hypersensitivity to empagliflozin or any component of the formulation
- Severe renal impairment (eGFR <30 mL/min/1.73 m² for glycemic control)
- End-stage renal disease
- Dialysis
Drug Interactions
Lithium
SGLT2 inhibitors may decrease serum lithium concentrations. Monitor lithium levels.
Diuretics
May increase the risk of dehydration and hypotension. Monitor fluid status and blood pressure.
Insulin and Insulin Secretagogues (e.g., sulfonylureas)
Increased risk of hypoglycemia. A lower dose of insulin or secretagogue may be required.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
In case of an overdose, discontinue Emjard and initiate appropriate supportive treatment. No specific antidote is known.
Pregnancy & Lactation
Pregnancy: Not recommended during the second and third trimesters due to potential for adverse renal development in the fetus. Lactation: Not recommended. It is not known if empagliflozin is excreted in human milk.
Side Effects
Contraindications
- Hypersensitivity to empagliflozin or any component of the formulation
- Severe renal impairment (eGFR <30 mL/min/1.73 m² for glycemic control)
- End-stage renal disease
- Dialysis
Drug Interactions
Lithium
SGLT2 inhibitors may decrease serum lithium concentrations. Monitor lithium levels.
Diuretics
May increase the risk of dehydration and hypotension. Monitor fluid status and blood pressure.
Insulin and Insulin Secretagogues (e.g., sulfonylureas)
Increased risk of hypoglycemia. A lower dose of insulin or secretagogue may be required.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
In case of an overdose, discontinue Emjard and initiate appropriate supportive treatment. No specific antidote is known.
Pregnancy & Lactation
Pregnancy: Not recommended during the second and third trimesters due to potential for adverse renal development in the fetus. Lactation: Not recommended. It is not known if empagliflozin is excreted in human milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months
Availability
Pharmacies, Hospitals
Approval Status
Approved by FDA, DGDA
Patent Status
Patented (active ingredient)
Clinical Trials
Extensive clinical trials (e.g., EMPA-REG OUTCOME, EMPEROR-Reduced, EMPEROR-Preserved) have demonstrated empagliflozin's efficacy in glycemic control and its cardiovascular/renal benefits.
Lab Monitoring
- Renal function (eGFR) prior to initiation and periodically thereafter
- Glycemic control (HbA1c)
- Lipid profile (periodically)
- Electrolytes (if risk of dehydration)
Doctor Notes
- Educate patients on symptoms of urogenital infections and ketoacidosis.
- Monitor renal function, especially in elderly or patients with pre-existing renal impairment.
- Consider dose adjustment of insulin/sulfonylureas when co-administered to reduce hypoglycemia risk.
- Empagliflozin has demonstrated significant cardiovascular and renal protective benefits beyond glycemic control.
Patient Guidelines
- Take Emjard once daily in the morning.
- Stay hydrated by drinking plenty of fluids.
- Be aware of symptoms of urinary tract infections or genital yeast infections and report to your doctor.
- Monitor blood glucose levels regularly as advised by your doctor.
- Inform your doctor if you experience symptoms of ketoacidosis (e.g., nausea, vomiting, abdominal pain, shortness of breath).
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is close to the time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at once.
Driving Precautions
No direct effect on ability to drive or use machines. However, dizziness or hypoglycemia (if used with insulin/sulfonylurea) may occur, which could affect these abilities.
Lifestyle Advice
- Maintain a balanced diet and regular exercise routine.
- Avoid excessive alcohol consumption.
- Regularly monitor blood sugar levels.
- Follow up with your doctor regularly for check-ups.
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