Here are some things to know when you're taking empagliflozin. Other things may be important as well, so ask your healthcare provider what you should know about.
You are at increased risk of fungal genital infections (thrush)
Empagliflozin causes you to pee more and have more glucose in your urine, which increases your risk of getting thrush (a fungal infection) around the vagina or penis. Germs (bacteria and fungus) like to grow in body fluids with a high sugar content. As your blood glucose level decreases, this tends to settle.
Wash your genital area (privates) with warm water using non-perfumed soap and avoid wearing tight underwear to reduce your risk of infection. Also any drops of pee left behind on your penis or vagina need to be removed.
- People with a vagina should wash their vulval area twice a day. Also, every time after peeing, rinse the area with water and then pat dry with toilet paper. If rinsing isn't possible, just pat dry carefully with toilet paper.
- People with a penis should wash their groin area at least once a day. Also, every time after peeing, rinse your penis with water and then pat dry with toilet paper. If rinsing isn't possible, just pat dry carefully with toilet paper. If you are able, pull back your foreskin before you pee, to avoid drops of urine spilling into the foreskin fold.
If you get any irritation or itching, pain or swelling in your genital area (privates) or around your bottom, contact your healthcare provider immediately. It's important to treat this early.
Have a sick day plan
If you're unwell, with vomiting, diarrhoea or a fever, or not eating or drinking as usual, stop taking empagliflozin.
- Taking empagliflozin when you are unwell increases your risk of high ketone levels, which can cause a serious side effect called ketoacidosis.
- Only restart your empagliflozin when you are well AND you're eating and drinking normally.
- This advice is the same for people taking empagliflozin for diabetes or heart failure.
| If you have nausea (feeling sick), vomiting (being sick/puking) or pain in your tummy (puku), or feel very unwell and confused, go to your GP clinic, after hours medical centre or hospital straight away. Ketoacidosis is very serious and needs immediate treatment. |
Being dehydrated and not eating enough carbohydrates can cause serious side effects
Being dehydrated and not eating enough carbohydrates can lead to high ketone levels, which can cause a serious but rare side effect called ketoacidosis.
- Tell your healthcare team before making any big changes to your diet: It's a good idea to cut down on foods with added sugar if you have diabetes. However, having too few carbohydrates in your diet while you're taking empagliflozin may increase your risk of ketoacidosis. Tell your healthcare team if you start eating less, go on a keto (low carbohydrate) diet or if you're fasting.
- Fasting during Ramadan: If you're fasting during Ramadan and are still getting enough carbohydrates, you can keep taking empagliflozin. It's important to talk to your healthcare provider about getting enough carbohydrates and drinking plenty of water while taking empagliflozin. It's not recommended to start empagliflozin as a new medicine immediately before or during Ramadan.
- Marathon or long-distance runners: If you're going to run a long distance or marathon while you're taking empagliflozin, it's important to let your healthcare provider know. You may need to stop empagliflozin the day before the marathon and restart 24 hours or so afterwards when you are well hydrated and eating normally.
Prepare before an operation or a procedure
If you are going to have an operation or a procedure where you will need to stop eating for 12 hours or more (eg, a colonoscopy or dental surgery), ask your healthcare team when you should stop and restart your empagliflozin. You may need to stop your empagliflozin 3 days before the operation or procedure.
Are you pregnant, trying for a baby or breastfeeding?
It is important to talk to your healthcare provider as soon as possible if you are trying to get pregnant, are pregnant (hapū) or breastfeeding. You may need to change to another medicine.
Tell your healthcare team if you are taking any other medicines
Empagliflozin may interact with some medicines and herbal supplements, so check with your doctor or pharmacist before starting empagliflozin and before starting any new medicines.
