empagliflozin
Summary
SGLT2 inhibitor that blocks glucose reabsorption in the proximal convoluted tubule, causing glucosuria and lowering blood glucose. Provides cardiovascular and renal protection in type 2 diabetes and heart failure.
Detail
Empagliflozin inhibits sodium-glucose cotransporter 2 in the proximal tubule, producing glucosuria, mild osmotic diuresis, weight loss, and modest blood pressure reduction. Landmark EMPA-REG OUTCOME trial demonstrated reduced cardiovascular mortality in T2DM; it is also approved for HFrEF and HFpEF and slows progression of diabetic kidney disease. Key adverse effects: urinary tract infections, genital mycotic infections (Candida), euglycemic diabetic ketoacidosis, volume depletion, and rare Fournier gangrene. Holds off before surgery to avoid euDKA. Boards: 'flozin' = SGLT2; cardio-renal benefit class.
Sources
- First Aid for USMLE Step 1 2024
- Sketchy Pharmacology
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