Empagliflozin and Metformin are combined in this medicine.
Empagliflozin + Metformin is used to treat type 2 diabetes (a long-term condition in which the body gradually becomes resistant to the effects of insulin or the pancreas does not produce enough insulin).
This medicine helps treat your diabetes by keeping your blood sugar under control.
Empagliflozin + Metformin is meant to be taken as part of a complete diabetes care programme that should include exercise, a healthy diet and regular monitoring of blood sugar levels.
Take Empagliflozin + Metformin exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
Take this medicine together with food or immediately after a meal. Try to take it at the same time each day.
Empagliflozin + Metformin is available as a conventional and extended-release tablet.
If you are taking the extended-release type of tablet (usually labelled as "XR"), swallow it whole. Do not split, chew, or crush the tablet.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your condition and response to the medication.
Empagliflozin + Metformin must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you have the following conditions:
- metabolic acidosis (a condition when there is too much acid in the blood) e.g. diabetic ketoacidosis (a complication of diabetes), lactic acidosis (build up of lactic acid in the blood)
- conditions that may affect kidney function e.g. severe infection, dehydration (excessive water loss from the body)
- heart problems e.g. heart failure (weakness and inability of the heart to pump blood), recent heart attack
- lung problems e.g. respiratory failure (a condition where the lungs are unable to get enough oxygen into the blood or remove enough carbon dioxide from the body)
- severe blood loss
- alcoholism or excessive alcohol intake
- severe kidney disease or undergoing dialysis (a procedure that helps individuals with kidney failure to filter toxic substances from the blood)
- liver disease
as Empagliflozin + Metformin may not be suitable for you.
If you are going to have procedures that involve the injection of contrast agent (a dye that helps improve the image of internal organs) that contains iodine, alert your doctor that you are taking this medicine.
Inform your doctor if you have the following conditions:
- heart failure (weakness and inability of the heart to pump blood)
- low blood pressure
- history of genital or urinary tract fungal infections
- problems with your pancreas e.g. history of pancreatitis (inflammation of the pancreas), had undergone pancreatic surgery
- stress-related state e.g. fever, infection, injury
- mild to moderate kidney disease
Let your doctor know if you are pregnant or breastfeeding.
Be sure to check with your doctor or pharmacist before giving this medicine to the elderly. Elderly people may be more sensitive to the side effects.
Notify your doctor if you consume large amounts of alcohol or if you are a frequent drinker.
If you are going to have an operation, including minor surgery and dental work, inform your doctor or dentist that you are taking Empagliflozin + Metformin.
This medicine may interfere with the results of urine tests for sugar. Discuss with your doctor how you should monitor your urine tests while taking this medicine.
It is important to check your feet regularly and adhere to the routine foot care advised by your doctor. Inform your doctor immediately if you notice any wounds or discolouration, or if you experience any tenderness or pain in your feet.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Routine tests (e.g. blood sugar levels, kidney function) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
- Regular monitoring of signs and symptoms of heart failure, lactic acidosis, diabetic ketoacidosis, and foot, genital, or urinary tract infections may also be needed.
To help control your diabetes, it is important to continue following the diet and exercise recommended by your doctor while you are taking Empagliflozin + Metformin.
If you are taking this medicine with other types of anti-diabetic medicines, you may have been warned about hypoglycaemia (low blood sugar). This medicine itself does not usually cause hypoglycaemia, but it may increase the hypoglycaemic effect of other anti-diabetic medicines.
How do I know if I am experiencing hypoglycaemia?
Hypoglycaemia is the medical term for low blood sugar. Symptoms of hypoglycaemia include dizziness, tremor, shaky hands, feeling hungry, weak or confused, and sweating. These signs are your body's way of warning you that your blood sugar level is low.
It is important to recognise these symptoms and get relief for hypoglycaemia quickly, as the hypoglycaemia may worsen.
What should I do if I am experiencing hypoglycaemia?
Always carry some glucose tablets (also known as dextrose tablets) with you. Take 15 grams of glucose tablet at the first sign of hypoglycaemia, wait for 15 minutes and re-check your blood sugar level. If you are not feeling better or if your blood sugar level is still low (less than 4 mmol/L or 70 mg/dL), take another 15 grams of glucose tablet.
If you don't have glucose tablets, you may take any of the following:
- 1/2 cup (120 mL) of juice or regular soda (not diet)
- 1 tablespoon of sugar, honey, or corn syrup
- hard candies, jellybeans, or gumdrops (not sugar-free)
Get medical help should symptoms not improve after the second serving.
Empagliflozin + Metformin may cause any of the following side effects: nausea, vomiting, diarrhoea, constipation, loss of appetite, thirst, and skin itching.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- signs and symptoms of allergic reactions e.g. rashes, breathlessness, swelling of the face, eyes, mouth, tongue or throat
- signs and symptoms of diabetic ketoacidosis e.g. nausea, vomiting, stomach pain, tiredness, shortness of breath, rapid weight loss, breath with a sweet smell
- pain or difficulty in passing urine, change in how much urine is passed, blood in the urine
- frequent or painful urination, burning sensation when passing urine, lower stomach pain, pelvic pain
- pain, redness, itching, swelling, unusual discharge or foul-smelling odour of the genitals
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor and pharmacist if you are taking any of these medicines:
- other medicines for diabetes e.g. repaglinide, insulin, glipizide
- medicines for high blood pressure e.g. verapamil
- water pills or medicines for water retention e.g. furosemide, hydrochlorothiazide
- certain medicines for cancer e.g. crizotinib, olaparib, vandetanib
- NSAIDs (medicines for pain and inflammation) e.g. aspirin, diclofenac, ibuprofen
- lithium (medicine for mood disorders)
- trimethoprim (certain antibiotic)
- cimetidine (medicine that reduces stomach acid production)
- ranolazine (medicine for chest pain)
- isavuconazole (medicine to treat fungal infection)
- dolutegravir (medicine for HIV infection)
- topiramate (medicine for epilepsy [fits or seizures])
- rifampicin (medicine to treat TB [lung infection known as tuberculosis])
This list does not include all medicines that may interact with Empagliflozin + Metformin.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.
Avoid alcohol.
It is important for you to maintain a healthy diet and weight in order to help keep your diabetes under control.
It may be helpful to discuss your diet plan with your doctor or dietitian to manage your weight and blood sugar levels.
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.
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