From the Research
Empagliflozin is not associated with an increased risk of pancreatitis, as evidenced by the most recent and highest quality study 1. The study, published in 2024, found that patients newly initiating empagliflozin did not have an increased risk of acute pancreatitis compared with those initiating a sulfonylurea, with a pooled propensity score-matched hazard ratio of 0.88 [0.76-1.02] 1. This suggests that empagliflozin can be used safely in patients with type 2 diabetes without a significant concern for pancreatitis. Some case reports have suggested a possible association between empagliflozin and pancreatitis 2, 3, 4, 5, but these reports are limited by their small sample size and lack of control groups. In contrast, the 2024 study 1 provides more robust evidence, with a large sample size and a matched cohort design. The most common side effects of empagliflozin include urinary tract infections, genital mycotic infections, and volume depletion. Patients should be more concerned about other potential risks such as diabetic ketoacidosis, acute kidney injury, and Fournier's gangrene, which are rare but serious adverse effects associated with SGLT-2 inhibitors. If a patient experiences severe abdominal pain while taking empagliflozin, they should seek medical attention, but this would not typically be attributed to the medication itself. Key points to consider when prescribing empagliflozin include:
- Monitoring for signs and symptoms of urinary tract infections and genital mycotic infections
- Counseling patients on the risks of diabetic ketoacidosis, acute kidney injury, and Fournier's gangrene
- Encouraging patients to seek medical attention if they experience severe abdominal pain
- Weighing the benefits and risks of empagliflozin in individual patients, particularly those with a history of pancreatitis or other risk factors for pancreatic disease.