Description

Empagliflozin is an oral medication used to treat type 2 diabetes and heart failure. It belongs to a class of drugs known as sodium-glucose co-transporter 2 (SGLT2) inhibitors. It works by a unique, insulin-independent mechanism to remove excess glucose from the body.

Indications

Empagliflozin is indicated for:

• Type 2 Diabetes Mellitus: To improve blood sugar control in adults, either alone or in combination with other anti-diabetic medications.

• Cardiovascular Risk Reduction: In adults with type 2 diabetes and established cardiovascular disease, it is used to reduce the risk of cardiovascular death.

• Heart Failure: It is indicated to reduce the risk of cardiovascular death and hospitalization for heart failure in adults with a specific type of heart failure, regardless of whether they have diabetes.

• Chronic Kidney Disease: It is also indicated to reduce the risk of progression of chronic kidney disease in specific patient populations.

Mechanism of Action

Empagliflozin’s mechanism is centered on the kidneys, where it targets the SGLT2 protein.

1. SGLT2 Inhibition: The sodium-glucose co-transporter 2 (SGLT2) is a protein located in the proximal convoluted tubule of the kidneys. Its primary function is to reabsorb about 90% of the glucose that is filtered from the blood back into the bloodstream. Empagliflozin selectively and reversibly inhibits this protein.

2. Increased Glucose Excretion: By blocking the SGLT2 transporter, empagliflozin prevents the reabsorption of glucose from the kidney tubules. This leads to a significant increase in the amount of glucose excreted in the urine, a process called glucosuria.
3. Blood Glucose Reduction: The loss of glucose through the urine directly lowers blood glucose levels. This effect is independent of insulin, which means it can be effective even in patients with insulin resistance.

4. Additional Benefits (for Heart Failure and Kidney Disease): The SGLT2 inhibition also leads to a modest increase in sodium and water excretion (osmotic diuresis). This reduces blood volume and blood pressure, which in turn reduces the workload on the heart and kidneys. This effect is a key reason for its benefits in heart failure and chronic kidney disease, as it reduces cardiac and renal strain.