NICE guidance - empagliflozin in combination therapy for treating type 2 diabetes

Last reviewed 07/2018

NICE guidance states (1):

  • empagliflozin in a dual therapy regimen in combination with metformin is recommended as an option for treating type 2 diabetes, only if:
    • a sulfonylurea is contraindicated or not tolerated, or
    • the person is at significant risk of hypoglycaemia or its consequences

  • empagliflozin in a triple therapy regimen is recommended as an option for treating type 2 diabetes in combination with: metformin and a sulfonylurea or metformin and a thiazolidinedione

  • empagliflozin in combination with insulin with or without other antidiabetic drugs is recommended as an option for treating type 2 diabetes

For full details then see NICE guidance (1).


  • recommended starting dosage is 10 mg once daily for both monotherapy and as an add-on combination therapy with other glucose-lowering medicinal products including insulin. According to the summary of product characteristics, the dosage can be increased to a maximum of 25 mg daily for people who tolerate empagliflozin well and need tighter glycaemic control, if they have an estimated glomerular filtration rate (eGFR) of 60 ml/min/1.73 m2 or more
  • summary of product characteristics states the following adverse reactions for empagliflozin as the most commonly reported: hypoglycaemia in combination with insulin or a sulfonylurea, vulvovaginal candidiasis, urinary tract infection, and polyuria or pollakiuria (that is, urinary frequency). For full details of adverse reactions and contraindications, see the summary of product characteristics