Can I take Glibenclamide and Empagliflozin together?

Why this happens

Both medicines work to lower blood sugar but in different ways. Glibenclamide stimulates the pancreas to release more insulin, while empagliflozin helps the kidneys remove sugar through urine. When used together, their effects add up, which can lower blood sugar more than intended. Additionally, both can have a mild diuretic effect, increasing the risk of fluid loss.

What you should do

You must speak to your doctor before taking these together. Your doctor may need to reduce your dose of glibenclamide to prevent your blood sugar from dropping too low. Ensure you know how to recognise and treat a 'hypo' (shaking, sweating, hunger, irritability) and drink plenty of water to stay hydrated.

Important precautions

Diabetic Ketoacidosis (DKA)

Empagliflozin can cause a serious condition called ketoacidosis even if your blood sugar levels are near normal. You must seek urgent medical help if you experience nausea, vomiting, abdominal pain, or fruity-smelling breath. Stop taking this medicine if you are fasting for surgery or have a severe illness.

Hypoglycaemia (Low Blood Sugar)

Glibenclamide carries a high risk of severe, prolonged low blood sugar (hypoglycaemia). You must carry sugar with you at all times. Be aware that this risk is significantly higher in older people or those with kidney problems.

Fournier’s Gangrene

Seek immediate medical attention if you experience pain, tenderness, redness, or swelling in the genital or anal area, accompanied by fever or malaise. This could be a sign of a rare but life-threatening infection.

Food and drink warnings

Alcohol

Drinking alcohol while taking these medicines can increase the risk of low blood sugar (hypoglycaemia). Alcohol can also mask the warning signs of a 'hypo'. Additionally, for empagliflozin, excessive alcohol consumption can increase the risk of a rare but serious condition called ketoacidosis. You should limit your alcohol intake and avoid drinking on an empty stomach.

Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.