Empagliflozin

Empagliflozin

Clinical data
Trade names	Jardiance
AHFS/Drugs.com	jardiance
Pregnancy category	US: C (Risk not ruled out)
Routes of administration	by mouth
ATC code	A10BK03 (WHO)
Legal status
Legal status	In general: ℞ (Prescription only)
Identifiers
IUPAC name (2S,3R,4R,5S,6R)-2-[4-Chloro-3-[[4-[(3S)-oxolan-3-yl]oxyphenyl]methyl]phenyl]-6-(hydroxymethyl)oxane-3,4,5-triol
CAS Number	864070-44-0
PubChem CID	11949646
IUPHAR/BPS	4754
ChemSpider	10123957
UNII	HDC1R2M35U
KEGG	D10459 Y
ChEBI	CHEBI:82720 Y
Chemical and physical data
Formula	C23H27ClO7
Molar mass	450.91 g·mol−1
3D model (JSmol)	Interactive image
SMILES C1COC[C@H]1OC2=CC=C(C=C2)CC3=C(C=CC(=C3)[C@H]4[C@@H]([C@H]([C@@H]([C@H](O4)CO)O)O)O)Cl
InChI InChI=1S/C23H27ClO7/c24-18-6-3-14(23-22(28)21(27)20(26)19(11-25)31-23)10-15(18)9-13-1-4-16(5-2-13)30-17-7-8-29-12-17/h1-6,10,17,19-23,25-28H,7-9,11-12H2/t17-,19+,20+,21-,22+,23-/m0/s1 Key:OBWASQILIWPZMG-QZMOQZSNSA-N

Empagliflozin (trade name Jardiance) is a drug of the gliflozin class, approved for the treatment of type 2 diabetes in adults in 2014. It was developed by Boehringer Ingelheim and Eli Lilly and Company.

Empagliflozin is an inhibitor of the sodium glucose co-transporter-2 (SGLT-2), and causes sugar in the blood to be excreted by the kidneys and eliminated in urine.

Empaglifozin in people with type 2 diabetes reduces the risk of death from cardiovascular disease in those with a previous history of cardiovascular disease.

When taken in dosages of 10 or 25 mg once a day, the incidence of adverse events was similar to placebo. However, there was a higher frequency of urinary tract infections.

There are concerns it may increase the risk of diabetic ketoacidosis (DKA). Interestingly, DKA may develop despite only mildly elevated blood glucose levels in people taking SGLT-2 inhibitors, potentially complicating the diagnosis.

Empagliflozin is an inhibitor of the sodium glucose co-transporter-2 (SGLT-2), which is found almost exclusively in the proximal tubules of nephronic components in the kidneys. SGLT-2 accounts for about 90 percent of glucose reabsorption into the blood. Blocking SGLT-2 reduces blood glucose by blocking glucose reabsorption in the kidney and thereby excreting glucose (i.e., blood sugar) via the urine.

As of May 2013, Boehringer and Lilly had submitted applications for marketing approval to the European Medicines Agency and the U.S. Food and Drug Administration (FDA). The drug was approved in Europe in May 2014 and was approved by the FDA in August 2014. The FDA required four postmarketing studies: a cardiovascular outcomes trial, and two studies in children, and a toxicity study in animals related to the pediatric trials.