What is Empagliflozin and Metformin: Uses, Dosage, Side Effects and More

Empagliflozin and metformin is a combination diabetes medication that helps control blood sugar levels in people with type 2 diabetes. This medication brings together two powerful ingredients that work in different ways to keep your glucose levels steady throughout the day.

Think of this combination as a team approach to diabetes management. While metformin helps your body use insulin more effectively, empagliflozin helps your kidneys remove excess sugar through urine. Together, they provide comprehensive blood sugar control that many people find more effective than taking either medication alone.

What is Empagliflozin and Metformin?

Empagliflozin and metformin is a prescription medication that combines two diabetes drugs into one convenient pill. The empagliflozin component belongs to a class called SGLT2 inhibitors, while metformin is part of the biguanide family of diabetes medications.

This combination medication is specifically designed for adults with type 2 diabetes who need better blood sugar control. Your doctor might prescribe this when single medications aren't keeping your blood sugar in the target range, or when you're already taking both medications separately.

The combination comes in different strengths, allowing your healthcare provider to tailor the dose to your specific needs. Most people find it easier to take one combination pill rather than remembering multiple separate medications throughout the day.

What is Empagliflozin and Metformin Used For?

This medication is primarily used to improve blood sugar control in adults with type 2 diabetes. It works best when combined with a healthy diet and regular exercise to help you maintain stable glucose levels throughout the day.

Your doctor might prescribe this combination if you're already taking metformin but need additional help controlling your blood sugar. It's also used when you're taking both medications separately and your healthcare provider wants to simplify your medication routine.

Beyond blood sugar control, empagliflozin has shown benefits for heart health in people with diabetes and cardiovascular disease. Some people also experience modest weight loss while taking this medication, though weight loss isn't the primary purpose.

This medication is always used alongside lifestyle changes like healthy eating and physical activity. It's not meant to replace these important diabetes management strategies but rather to support them.

How Does Empagliflozin and Metformin Work?

This combination medication works through two different mechanisms to help control your blood sugar levels. Each component targets glucose control in its own unique way, making the combination more effective than either medication alone.

Metformin primarily works by reducing the amount of glucose your liver produces, especially during fasting periods like overnight. It also helps your muscles and other tissues become more sensitive to insulin, allowing them to use glucose more efficiently.

Empagliflozin works by blocking a protein in your kidneys called SGLT2, which normally helps reabsorb glucose back into your bloodstream. When this protein is blocked, excess glucose gets eliminated through your urine instead of staying in your blood.

This is considered a moderately strong diabetes medication combination. While it's not the most potent option available, it provides significant blood sugar lowering effects for most people who take it regularly.

How Should I Take Empagliflozin and Metformin?

Take this medication exactly as your doctor prescribes, usually twice daily with meals. Taking it with food helps reduce stomach upset that can sometimes occur with metformin, and it helps your body absorb the medication more consistently.

Swallow the tablets whole with a full glass of water. Don't crush, chew, or break the tablets, as this can affect how the medication is released in your body. If you have trouble swallowing pills, talk to your pharmacist about alternative options.

Try to take your doses at the same times each day, such as with breakfast and dinner. This helps maintain steady levels of the medication in your system and makes it easier to remember your doses.

You can take this medication with any type of food, but avoid drinking excessive amounts of alcohol while taking it. Alcohol can increase your risk of a serious side effect called lactic acidosis, especially with the metformin component.

How Long Should I Take Empagliflozin and Metformin For?

Most people with type 2 diabetes need to take this medication long-term to maintain good blood sugar control. Diabetes is a chronic condition that requires ongoing management, and stopping your medication typically causes blood sugar levels to rise again.

Your doctor will monitor your response to the medication through regular blood tests, usually every three to six months. These tests help determine if the medication is working effectively and if any dose adjustments are needed.

Some people may need to switch to different medications over time if their diabetes progresses or if they develop side effects. However, many people continue taking this combination successfully for years with good results.

Never stop taking this medication suddenly without talking to your healthcare provider first. Even if you're feeling well, your blood sugar levels need consistent management to prevent complications.

What Are the Side Effects of Empagliflozin and Metformin?

Like all medications, empagliflozin and metformin can cause side effects, though many people tolerate it well. Understanding what to expect can help you feel more confident about taking your medication and know when to contact your healthcare provider.

The most common side effects are generally mild and often improve as your body adjusts to the medication:

• Stomach upset, nausea, or diarrhea (usually from the metformin component)
• Increased urination and thirst (from empagliflozin helping remove sugar through urine)
• Genital yeast infections, especially in women
• Urinary tract infections
• Headache or dizziness
• Metallic taste in your mouth

These common side effects typically become less noticeable within the first few weeks of treatment. Taking the medication with food can help reduce stomach-related side effects significantly.

There are also some less common but more serious side effects that require immediate medical attention:

• Signs of lactic acidosis: unusual muscle pain, trouble breathing, stomach pain, dizziness, or feeling cold
• Ketoacidosis: nausea, vomiting, stomach pain, tiredness, or trouble breathing
• Serious urinary tract infections that may spread to kidneys
• Severe dehydration or kidney problems
• Allergic reactions like rash, itching, or swelling

Some rare but serious complications can occur, including Fournier's gangrene (a serious infection of the genital area) and severe skin reactions. While these are uncommon, it's important to seek immediate medical care if you develop severe pain, swelling, or skin changes in the genital area.

Who Should Not Take Empagliflozin and Metformin?

This medication isn't suitable for everyone, and your doctor will carefully review your medical history before prescribing it. Certain health conditions make this combination medication potentially unsafe or less effective.

You should not take this medication if you have type 1 diabetes, as it's specifically designed for type 2 diabetes. It's also not recommended if you have severe kidney disease, as both components can affect kidney function.

People with certain medical conditions need special consideration before starting this medication:

• Severe kidney disease or dialysis
• Severe liver disease
• Heart failure requiring hospitalization
• History of diabetic ketoacidosis
• Severe dehydration or shock
• Current serious infection or illness

Your doctor will also be cautious about prescribing this medication if you're older than 65, have a history of kidney stones, or frequently get urinary tract infections. These conditions don't necessarily prevent you from taking the medication, but they require closer monitoring.

Always tell your healthcare provider about all your medical conditions and medications before starting this treatment. This includes over-the-counter medications, supplements, and herbal remedies.

Empagliflozin and Metformin Brand Names

The most common brand name for this combination medication is Synjardy, which is available in several different strength combinations. Your pharmacy might also carry generic versions, which contain the same active ingredients but typically cost less.

Synjardy XR is an extended-release version that allows for once-daily dosing instead of twice daily. This can be more convenient for some people, though the immediate-release version works just as effectively when taken as prescribed.

Whether you receive the brand name or generic version depends on your insurance coverage and pharmacy availability. Both versions work equally well, so you can feel confident about either option your healthcare provider recommends.

Empagliflozin and Metformin Alternatives

If this combination medication isn't right for you, there are several other effective options for managing type 2 diabetes. Your doctor can help you find an alternative that works better for your specific situation and health needs.

Other combination medications include different pairings of diabetes drugs, such as metformin with insulin, sulfonylureas, or other SGLT2 inhibitors. Each combination has its own benefits and potential side effects.

Some people do better taking individual medications separately rather than in combination form. This approach allows for more precise dose adjustments and can be helpful if you experience side effects from one component but not the other.

Newer diabetes medications like GLP-1 agonists (such as semaglutide) might be better options for some people, especially those who also need help with weight management. Your healthcare provider can discuss these alternatives based on your individual health profile.

Is Empagliflozin and Metformin Better Than Metformin Alone?

For many people with type 2 diabetes, the combination of empagliflozin and metformin provides better blood sugar control than metformin alone. Studies show that adding empagliflozin to metformin can lower A1C levels by an additional 0.5 to 1 percentage point.

The combination approach targets blood sugar control through two different mechanisms, which often provides more comprehensive glucose management. This can be especially helpful if metformin alone isn't keeping your blood sugar in your target range.

However, better doesn't always mean right for everyone. Some people do very well on metformin alone and don't need the additional medication. Others might benefit more from different combination approaches based on their specific health needs.

Your doctor will consider factors like your current A1C levels, other health conditions, medication tolerance, and personal preferences when deciding whether this combination is better than metformin alone for your situation.