Empagliflozin: what it treats, how to take it, side effects
Last updated September 3, 2026.
Empagliflozin is an SGLT2 inhibitor - it makes your kidneys pass extra sugar out of your body in your urine. You may know it as Jardiance. Beyond blood sugar, it protects the heart and kidneys, and it is prescribed for heart failure and kidney disease even on their own.
What does it treat?
Blood sugar control in type 2 diabetes in adults and children 10 and older, alongside diet and exercise; reducing the risk of stroke, heart attack, or death in adults with type 2 diabetes and heart and blood vessel disease; reducing the risk of hospitalization and death in people with heart failure; and slowing the worsening of kidney disease in certain adults. It is not used to treat type 1 diabetes.
How do you take it?
One tablet once a day in the morning, with or without food. The label starts at 10 mg and can rise to 25 mg if you tolerate it and need more blood sugar control. Drink enough fluids through the day - the drug moves water out with the sugar. Getting up: it can cause dizziness, lightheadedness, and fainting when you stand too fast, especially in the first days - sit on the edge of the bed a moment before standing. The surgery rule: your doctor may tell you to stop it at least 3 days before any operation. Otherwise, never stop it on your own. Missed dose: take it when you remember unless the next one is close; never double up.
Side effects to know
- Common: urinating a lot, including at night, and increased thirst - the mechanism itself.
- Serious - call your doctor immediately: urinary tract infection signs (frequent, urgent, burning, or painful urination; cloudy, red, pink, or brown or strong-smelling urine; pelvic or rectal pain; fever, back pain, nausea, or vomiting); genital yeast infections in women (vaginal odor, discharge, itching) and men (redness, itching, or swelling of the penis, rash, foul-smelling discharge); and a rare severe genital-area infection - feeling tired, weak, or unwell with fever plus pain, tenderness, redness, or swelling of the genitals or the area between the genitals and rectum.
- Stop and get emergency care: ketoacidosis - nausea, vomiting, stomach-area pain, tiredness, or difficulty breathing, even if your blood sugar reads below 250. Check urine ketones if you can. Also stop-and-call for allergic reactions: rash, hives, itching, trouble breathing or swallowing, swelling of the face, throat, tongue, lips, mouth, or eyes, or hoarseness.
Who should not take it?
Anyone with type 1 diabetes - the label warns it raises ketoacidosis risk there. The disclosure list is long and each item matters: regular or binge alcohol use, a past amputation, a low-sodium diet, urinary tract infections or urination problems, low blood pressure, pancreatic disease or pancreas surgery, past genital yeast infections, peripheral vascular disease, neuropathy, foot ulcers or sores, kidney or liver disease, and - for men - being uncircumcised. Eating or drinking less from illness, a ketogenic diet, and recent vomiting, diarrhea, or heavy sweating all raise the ketoacidosis and dehydration risk too. Empagliflozin can increase the risk of lower-limb amputation: learn the foot-care routine your doctor gives you and call right away for any pain, tenderness, sores, ulcers, or warm, red, swollen areas on a leg or foot. Do not breastfeed on it; if you become pregnant, call your doctor.
When is it an emergency?
Ketoacidosis symptoms - nausea, vomiting, stomach-area pain, exhaustion, trouble breathing - mean stopping the drug and getting emergency care, even when your sugar reads normal. Fever with pain and swelling in the genital area, or allergic-reaction signs like throat swelling or trouble breathing, mean the same. For an overdose, call Poison Control at 1-800-222-1222. Pymander's escalation routing is built and tested specifically for this class of decision; see the safety architecture working paper.
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Common questions
Why does empagliflozin make me urinate more?
That is the drug working. It routes extra blood sugar out through the kidneys, and sugar carries water with it - MedlinePlus lists frequent urination, including at night, and increased thirst as the expected effects. The answer is not restricting fluids but replacing them: drink enough water through the day, per your doctor's guidance.
Why did my doctor prescribe a diabetes drug for my heart failure?
Because the evidence goes beyond blood sugar. The label includes reducing the risk of cardiovascular death and hospitalization in people with heart failure - empagliflozin earned that indication in its own right. Same tablet, different job.
What is ketoacidosis, and why can it happen with normal blood sugar?
Ketoacidosis is a dangerous acid buildup from burning fat instead of sugar. MedlinePlus warns it can occur on empagliflozin even when blood sugar reads below 250 - symptoms are nausea, vomiting, stomach-area pain, tiredness, and trouble breathing. Stop the drug and get emergency care, checking urine ketones if you can. The stop-3-days-before-surgery rule exists because operations push the body toward ketones.
Can I drink alcohol while taking empagliflozin?
Ask your doctor - MedlinePlus says alcohol can change blood sugar, and it lists regular or binge drinking among the things to disclose before starting. Alcohol also dehydrates, and this drug already moves water out. Get the explicit personal rule.
Why am I getting yeast infections on empagliflozin?
Sugar in the urine feeds yeast - MedlinePlus lists genital yeast infections in both women and men among the serious effects, along with urinary tract infections. Call your doctor rather than stopping the drug on your own; both are treatable, and the pattern matters for whether you stay on it. Fever with genital pain or swelling is the severe version - immediate care.
Why do I have to stop empagliflozin before surgery?
Ketoacidosis risk. MedlinePlus says your doctor may tell you to stop empagliflozin at least 3 days before surgery - the fasting and stress around an operation push the body toward ketones, and the drug adds to it. Tell every surgeon and dentist you take it, and follow the exact stop-and-restart timing you are given.