I also have more cramps but I thought it was more statin related rather than Empagloflizin, as I started both at the same time, but it’s an interesting point to consider.
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I just ordered the higher dose Empa and would like to take a one-third dose. Is it difficult to split the tabs in thirds?
LOL not difficult, more along the lines of impossible. Snapping them in half works well enough, though.
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No. not really. It is somewhat small and I just cut them approximately in 1/3’s. Obviously maybe one portion is 7.5mg, one 9mg and the other 8.5mg but I don’t think it matters that much. I just use a sharp pocket knife. As @Davin8r mentioned above cutting it in 1/2 is more practical and I have lately started taking 1/2 after taking 1/3rd for over a year.
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I’m going to take it mostly for preservation of kidney function but also because I have been sitting on the border of pre-diabetic for a decade or more. On the other hand, I do not want to experience the possible symptoms. it isn’t worth it. Have you experienced any at the 8 mg dose?
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Do you mean side effects from empagliflozin? If so, which side effects are you concerned about? These are very well-tolerated medications, especially in men.
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Yes. I was thinking mostly about the possibility of bladder infection.
UTIs aren’t something I personally even worry about from empagliflozin.
However, certain factors increase UTI risk in SGLT2 inhibitor users. Higher doses of dapagliflozin (10 mg) showed increased UTI risk compared to placebo (RR 1.23; 95% CI 1.03-1.46).[1] A 2023 meta-analysis confirmed that dapagliflozin 10 mg/day for >24 weeks was associated with significantly higher UTI risk (OR 1.27; 95% CI 1.13-1.43).[3] Additional risk factors include age ≥65 years, eGFR ≤60 mL/min/1.73 m², proteinuria, poor glycemic control, and diabetic microvascular complications.[1]
Severe UTIs remain rare across all SGLT2 inhibitors, with incidence consistently <2% in cardiovascular outcome trials. Meta-analyses showed no difference between SGLT2 inhibitors and controls for pyelonephritis (RR 0.78; 95% CI 0.52-1.18) or urosepsis.[1][4]
Importantly, a 2025 study found that discontinuing SGLT2 inhibitors after a UTI was associated with higher cardiovascular and renal risks (HR 1.35 for both) without reducing recurrent UTI risk (HR 0.96; 95% CI 0.22-4.29), suggesting continuation is generally appropriate.
This comparative safety analysis shows that severe UTI risk is generally comparable across individual SGLT2 inhibitors, though canagliflozin demonstrates a modestly higher risk compared to empagliflozin, while dapagliflozin shows similar rates.
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I don’t believe the rates of UTI with empagliflozin in men differ from a placebo. What is slightly increased are the rates of genital fungi infections, although the rates are minimally elevated in those who do not have diabetes and are circumcised. Overall it is not a concern for me (25mg/day empa), although I have purchased a bunch of microbe testing urine strips, and use one approximately once a month to catch any possible asymptomatic infection. I’ve been on empa for over a year, and no issues so far.
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The UTI risk is much higher for women than men. I’ve been taking Empagliflozin for over a year and never a UTI.
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Smart! Which one did you go with? Any other top candidates I should look into?
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Btw., this is useful in many situations. For example, during my recent AFCD surgery, I had a catheter inserted. This abrades the urinary track, and there is some danger of infection. Before surgery I stopped taking empagliflozin, and before I resume taking it again I want to make sure my urinary track is fully healed and there are no bacteria lurking, because obviously, having glucose in your urine can result in unnecessary infections. Therefore before resuming empa in three weeks after surgery I intend to use the strips for a full week to make sure my track is likely free of any infection.
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Thanks for sharing the info about the test strips!
I didn’t know what AFCD surgery is, so I searched for it.
Is this it?
ACDF (Anterior Cervical Discectomy and Fusion) surgery is a common neck procedure to relieve pain, numbness, or weakness from pinched nerves by removing a damaged spinal disc and fusing the vertebrae together with a bone graft, spacer, and plate/screws, often with high success rates for pain relief and recovery.
Yes, I tend to agree. I’ve been on for a couple of years now and absolutely no issues or noticeable side effects.
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Sorry, yes, I meant ACDF, I have a whole thread about it, that’s what I’ll be updating soon.
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I went from 10mg to 20 mg Jardiance and started severe night time cramps. salt/electrolytes and back down to 10mg. Hopefully this corrects everything.
Our research demonstrated for the first time that EMPA reduced the incidence of ventricular arrhythmia by regulating AMPK/mTOR signaling and restored autophagic flux in DOX-treated rats and NRVCMs.
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I don’t have time to read the full paper this morning, but wanted to post this so I don’t forget.
Compared with DPP4i users, SGLT2i users had less cardiovascular events, except for increased stroke/TIA in females (HR 1.744 [1.654-1.839]). Compared with GLP1RA, SGLT2i use was associated with a decrease risk of MACE in both men and women, but higher risk for other cardiovascular and peripheral vascular events. Among SGLT2i users, those who developed erythrocytosis had increased incidence of thromboembolic events compared to those without erythrocytosis. Lastly, among SGLT2i patients treated for their erythrocytosis, the men who discontinued SGLT2i had increased risks of stroke/TIA, MI, and limb ischemia, while women had increased risk of stroke/TIA, MI, and venous thrombosis. Those who received anti-platelet therapy were associated with elevated risks of stroke/TIA, MI, venous thrombosis, and limb ischemia. In contrast, patients who receive phlebotomy had no significant difference in the outcomes. Therefore, regular monitoring of hematologic parameters is recommended for early detection and modified therapeutic strategies should be considered to reduce complication risks.
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