Glyxambi (Empagliflozin and Linagliptin) - Oral

What Is Glyxambi?

Glyxambi (empagliflozin and linagliptin) is a prescription drug used along with diet and exercise to control blood sugar in adults with type 2 diabetes. It also lowers the risk of heart-related death in adults with type 2 diabetes and heart disease.

Glyxambi contains two drugs: empagliflozin and linagliptin. Empagliflozin is in a drug class called sodium-glucose cotransporter 2 (SGLT2) inhibitors. Linagliptin is in a drug class called dipeptidyl peptidase 4 (DPP-4) inhibitors, also known as gliptins.

Combining these two medications lowers blood sugar levels and helps the body eliminate sugar. It also allows the body to produce more insulin (which lowers blood sugar levels) and decreases glucagon. Since glucagon increases blood sugar, blood sugar levels are better controlled by decreasing glucagon.

Glyxambi is available as an oral tablet that is taken by mouth.

Drug Facts

Generic Name: Empagliflozin and linagliptin

Brand Name(s): Glyxambi

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Hypoglycemic

Available Generically: No

Controlled Substance: N/A

Active Ingredient: Empagliflozin and linagliptin

Dosage Form(s): Tablets

What Is Glyxambi Used For?

The Food and Drug Administration (FDA) approved Glyxambi to:

  • Improve blood sugar levels (in combination with diet and exercise) in adults with type 2 diabetes.  
  • Lower the risk of cardiovascular (heart-related) death in adults with both type 2 diabetes and established heart disease.

Glyxambi is not indicated for use in type 1 diabetes due to its ability to increase the risk of diabetic ketoacidosis (DKA) when used in this population. DKA is a life-threatening complication of diabetes that can occur when the body makes high levels of blood acids (ketones). DKA more commonly occurs in people with type 1 diabetes than in people with type 2 diabetes.

Glyxambi has not been studied in people who have a history of pancreatitis (inflammation of the pancreas).

How to Take Glyxambi

Before taking Glyxambi, read the information leaflet that comes with your prescription. Consult your healthcare provider with any questions or concerns. Take Glyxambi exactly as your healthcare provider instructed, usually once daily in the morning, with or without food. Do not skip doses or change the amount taken unless required.

Your healthcare provider may prescribe Glyxambi with or without other diabetes medications. Low blood sugar episodes are more likely when taking Glyxambi with certain other diabetes drugs, so ask about testing blood sugar and ketones, hypoglycemia (low blood sugar), and how to treat it.

Moreover, empagliflozin, one of the ingredients in Glyxambi, can cause life-threatening ketoacidosis. Your healthcare provider may order blood work to test your kidney function before and during Glyxambi treatment. While on treatment, notify your healthcare provider if you become sick with diarrhea or vomiting, are dehydrated, experience trauma, or have an upcoming surgery—all factors which can affect blood sugar.

And while taking your medication, follow the general guidelines for a healthy lifestyle, including eatomg a well-balanced diet and exercising.

Storage

Store Glyxambi at room temperature (68–77 degrees Fahrenheit), away from heat, direct light, and moisture. Do not keep this medication in the bathroom; store it in its original labeled container and keep it out of reach of children and pets. Make sure the lid is tightly closed when not in use.

How Long Does Glyxambi Take to Work?

In clinical studies, Glyxambi started to work quickly to lower blood sugar. However, information is not available on exactly how long it will take to become effective. Monitoring your blood sugar regularly will give you an idea of how well Glyxambi is working. A hemoglobin A1C measurement taken three months after starting Glyxambi will show your blood sugar control over this time.

What Are the Side Effects of Glyxambi?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

The most common side effects of Glyxambi are:

The most common lab abnormalities associated with taking Glyxambi include:

  • Hyperuricemia (increased uric acid levels in the blood)
  • Hyperlipasemia (increased levels of the pancreatic enzyme lipase in the blood, which could signal a problem with the pancreas)
  • Increased levels of creatinine, which could indicate kidney problems
  • Increased hematocrit (excess red blood cells)

Severe Side Effects

Call your healthcare provider immediately if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Hypersensitivity reaction or anaphylaxis: Symptoms can include rash, hives, difficulty breathing, and swelling around the lips, tongue, and face. An allergic reaction may require emergency medical attention. 
  • Angioedema: Characterized by swelling under the skin, this adverse effect also requires emergency medical attention.
  • Hypoglycemia
  • Heart failure: Call your healthcare provider right away if you have symptoms of swelling, shortness of breath, or rapid weight gain.
  • Pancreatitis (an inflamed pancreas, which can be life-threatening): Call your healthcare provider right away if you have pain in the upper stomach area that may spread to the back, with or without vomiting.
  • Severe joint pain: Call your healthcare provider right away if you have joint pain that is severe or ongoing.
  • Rhabdomyolysis (muscle breakdown which can cause kidney damage)
  • Bullous pemphigoid (a rare skin condition that can cause blisters filled with fluid): Call your healthcare provider right away if you have itching, blisters, or a breakdown of the outer layer of the skin. 
  • Serious UTI: Consult your healthcare provider if you have symptoms of a serious UTI, which can include pain or burning when you urinate, blood in the urine, and/or stomach or back pain.
  • Ketoacidosis: Get medical help right away if you have nausea, vomiting, stomach pain, confusion, extreme drowsiness, or difficulty breathing.
  • Kidney injury
  • Orthostatic hypotension (a drop in blood pressure when you stand up from a sitting or lying down position): Consult your healthcare provider if you feel light-headed.
  • Fournier’s gangrene: Get medical attention right away if you have pain/tenderness, redness, or swelling of the genitals or the area from the genitals to the rectum, fever, or discomfort. These symptoms can worsen quickly and can become life-threatening.

Long-Term Side Effects

Long-term or delayed side effects are possible. Some long-term or delayed side effects can be mild, such as:

  • Weight loss
  • Cough
  • Joint pain
  • Sore throat
  • Infection

Moderate long-term or delayed side effects may include:

  • High cholesterol
  • Fungal infections (including genital fungal infections)
  • UTI
  • Dehydration
  • Orthostatic hypotension
  • Mouth sores/ulcers

Severe long-term or delayed side effects may include:

  • Kidney failure
  • Pancreatitis
  • Severe skin reactions
  • Diabetic ketoacidosis
  • Heart failure
  • Muscle breakdown which can lead to kidney damage
  • Necrotizing fasciitis of the perineum: This necrotizing fasciitis is also called Fournier’s gangrene and can be life-threatening, causing symptoms such as pain, redness, and swelling in the genital and perianal area. Severe side effects require immediate medical attention.

Report Side Effects

Glyxambi may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Glyxambi Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For type 2 diabetes:
      • Adults—1 tablet once a day, taken in the morning. Each tablet contains 10 milligrams (mg) empagliflozin and 5 mg linagliptin. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 25 mg of empagliflozin and 5 mg of linagliptin per day.
      • Children—Use and dose must be determined by your doctor.

Modifications

Due to the possible effects of this medication, there may be changes to how it is used. Therefore, it is important for users to be aware of the following when taking Glyxambi.

Pregnancy: Glyxambi should not be used in the second and third trimesters of pregnancy due to the potential risk to the fetus. Glyxambi is generally not used during the first trimester. If you already take Glyxambi and find out you are pregnant, consult your healthcare provider.

Breastfeeding: Glyxambi is generally not recommended while breastfeeding. Consult your healthcare provider for advice. 

Older adults: Adults age 65 and older (as well as adults with kidney problems or who take medications called loop diuretics) are at higher risk for dehydration or low blood pressure from Glyxambi.

People with liver problems: No dosage adjustment is required for adults with liver problems.

People with kidney problems: People with kidney problems are at higher risk of dehydration or low blood pressure, as well as UTIs when taking Glyxambi. Glyxambi should not be used in people who are on dialysis or who have an eGFR of less than 30 (eGFR is a measure of kidney function that stands for estimated glomerular filtration rate).

Missed Dose

Take Glyxambi as prescribed by your healthcare provider. If you miss a dose, take it as soon as you can. If it is almost time for the next dose, skip the missed dose. Do not take two doses together.

Overdose: What Happens If I Take Too Much Glyxambi?

Contact your healthcare provider or the Poison Control Center if you think you may have overdosed on Glyxambi. Call 911 if someone collapses, has a seizure or difficulty speaking, or can't breathe or wake up after taking their medication.

What Happens If I Overdose on Glyxambi?

If you think you or someone else may have overdosed on Glyxambi, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Glyxambi, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your progress at regular visits, especially during the first few weeks that you take this medicine. Blood and urine tests may be needed to check for unwanted effects.

Tell your doctor if you are pregnant or planning to become pregnant. It is not safe to take this medicine during the second and third trimester of pregnancy. It could harm an unborn baby.

Pancreatitis (swelling of the pancreas) may occur while you are using this medicine. Check with your doctor right away if you have a sudden and severe stomach pain, chills, constipation, nausea, vomiting, loss of appetite, fever, or lightheadedness.

Check with your doctor right away if you have chest pain or tightness, decreased urine output, dilated neck veins, extreme fatigue, irregular breathing, irregular heartbeat, swelling of the face, fingers, feet, or lower legs, trouble breathing, or weight gain. These may be signs of heart failure.

Dizziness, lightheadedness, or fainting may occur with this medicine. This is more common if you have kidney disease, low blood pressure, or if you are taking a diuretic (water pill). Taking plenty of fluids each day may help. Drink plenty of water during exercise or in hot weather. Check with your doctor if you have severe nausea, vomiting, or diarrhea that does not stop. This may cause you to lose too much water.

Ketoacidosis (high ketones and acid in the blood) may occur while you are using this medicine. This can be life-threatening and requires immediate medical attention. Your doctor may give you insulin, fluid, and carbohydrate replacement to treat this condition. Tell your doctor right away if you have nausea, vomiting, trouble breathing, increased thirst or urination.

This medicine may increase your risk of having kidney problems, including acute kidney injury or damaged kidney function. Check with your doctor right away if you have blood in the urine, decreased urine output, muscle twitching, nausea, rapid weight gain, seizures, stupor, swelling of the face, ankles, or hands, or unusual tiredness or weakness.

This medicine may cause hypoglycemia (low blood sugar). This is more common when this medicine is taken together with other diabetes medicines (eg, insulin, glipizide, or glyburide). The symptoms of low blood sugar must be treated before they cause you to pass out. People feel different symptoms with low blood sugar. It is important that you learn which symptoms you usually have so you can treat it quickly. Some symptoms of low blood sugar include: behavior changes that are similar to being drunk, blurred vision, cold sweats, confusion, cool, pale skin, difficulty with thinking, drowsiness, excessive hunger, a fast heartbeat, headaches that continue, nausea, shakiness, slurred speech, or unusual tiredness or weakness. Talk to your doctor about how to treat low blood sugar.

Hyperglycemia (high blood sugar) may occur if you do not take enough or skip a dose of your medicine, overeat or do not follow your meal plan, have a fever or infection, or do not exercise as much as usual. High blood sugar can be very serious and must be treated right away. It is important that you learn which symptoms you have in order to treat it quickly. Talk to your doctor about the best way to treat high blood sugar.

This medicine may cause vaginal yeast infections in women and yeast infections of the penis in men. This is more common in patients who have a history of genital yeast infections or in men who are not circumcised. Women may have a vaginal discharge, itching, or odor. Men may have redness, itching, swelling, or pain around the penis, or a discharge with a strong odor from the penis. Check with your doctor right away if you have any of these symptoms.

This medicine may increase risk of having urinary tract infections, including pyelonephritis or urosepsis. Check with your doctor right away if you have bladder pain, bloody or cloudy urine, difficult, burning, or painful urination, or lower back or side pain.

This medicine may cause a rare but serious bacterial infection, called necrotizing fasciitis of the perineum or Fournier's gangrene, which can cause damage to the tissue under the skin in the area between and around the anus and genitals (perineum). Fournier's gangrene may lead to hospitalization, multiple surgeries, or death. Check with your doctor right away if you have fever, unusual tiredness or weakness, or pain, tenderness, redness, or swelling of the area between and around your anus and genitals.

This medicine may cause serious allergic reactions, including anaphylaxis, angioedema, and other skin conditions, which can be life-threatening and require immediate medical attention. Call your doctor right away if you have a chest tightness, cough, difficulty swallowing, dizziness, rash, itching, trouble breathing, trouble swallowing, or puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue while you are using this medicine.

This medicine may cause severe and disabling joint pain. Call your doctor right away if you have severe joint pain while using this medicine.

This medicine may cause bullous pemphigoid. Tell your doctor if you have large, hard skin blisters while using this medicine.

Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests (eg, urine glucose tests may not be accurate). Also, you may need to stop taking this medicine at least 3 days before you have a surgery.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Glyxambi?

Glyxambi is not appropriate for everyone. There are certain reasons your healthcare provider may not prescribe this medication for you.

You should not take this medication if you are allergic to empagliflozin, linagliptin, any inactive ingredients in Glyxambi, or any drug in the SGLT2 inhibitor or DPP-4 inhibitor drug class.

You may not be prescribed Glyxambi if any of the following apply to you:

  • Allergy to empagliflozin, linagliptin, inactive ingredients in Glyxambi, or any drug in the SGLT2 inhibitor or DPP-4 inhibitor drug class. Let your healthcare provider know if you have had an allergic reaction to any of these drugs previously.
  • Second or third trimester of pregnancy
  • Type 1 diabetes
  • Volume depletion or dehydration
  • An eGFR less than 30

Glyxambi may be prescribed with caution in some people only if their healthcare provider determines it is safe. These populations include:

  • People with an eGFR between 30 and 59
  • People who take medications that may harm the kidneys
  • People with low blood pressure 
  • Older adults
  • People at risk for heart failure, pancreatitis, or ketoacidosis
  • People with insulin deficiency
  • People who have fasted for a prolonged time
  • People with alcohol use disorder or who misuse alcohol
  • People with a history of UTIs or genital fungal infections
  • Uncircumcised males

What Other Medications May Interact With Glyxambi?

Tell your healthcare provider about all of the medicines you take, including prescription and over-the-counter (OTC) medicines, and vitamins or supplements.

Glyxambi can interact with:

Other drug interactions may occur with Glyxambi. Consult your healthcare provider for a full list of drug interactions.

What Medications Are Similar?

Glyxambi contains two drugs: empagliflozin and linagliptin.

Empagliflozin is an SGLT2 inhibitor. It is also available as the single-ingredient drug Jardiance, which has only empagliflozin. Other SGLT2 inhibitors include:

Empagliflozin is also available as part of other combination products in addition to Glyxambi, such as:

Linagliptin, the second ingredient in Glyxambi, is a DPP-4 inhibitor. It is available as the single-ingredient drug Tradjenta, which contains linagliptin only. Other drugs in this class include:

Linagliptin is also available as part of a combination product in the following drugs, in addition to Glyxambi:

Other oral medications are available to help control blood sugar in adults with type 2 diabetes, such as:

  • Glinides: Repaglinide, nateglinide
  • Glucophage (metformin)
  • Sulfonylureas: Amaryl (glimepiride), Glucotrol (glipizide), and glyburide
  • Thiazolidinediones: Actos (pioglitazone)

Some people with type 2 diabetes use injectable medications that are not insulin but that also help control blood glucose levels. These drugs are part of a class called glucagon-like peptide-1 (GLP-1) agonists. Examples of these drugs are:

There is also one oral GLP-1 agonist available, called Rybelsus (semaglutide).

People with type 2 diabetes may also need injectable insulin to help control blood glucose. There are different types of short-acting insulin and long-acting insulin. Examples of short-acting insulin include Humalog (insulin lispro) and Novolog (insulin aspart). Examples of long-acting insulin include Lantus (insulin glargine) and Levemir (insulin detemir).

The above is a list of drugs also prescribed for type 2 diabetes. It is not necessarily a list of drugs recommended to take with Glyxambi. Your healthcare team will work with you to find the best treatment regimen for controlling your blood sugar.

Frequently Asked Questions

  • What is Glyxambi used for?

    Glyxambi is a prescription drug used in combination with diet and exercise to control blood sugar in adults with type 2 diabetes. Glyxambi also helps to lower the risk of heart-related death in adults who have both type 2 diabetes and heart disease.

  • How does Glyxambi work?

    Glyxambi lowers blood sugar levels and helps the body eliminate sugar (glucose). It also helps the body produce more insulin and decreases glucagon, thereby reducing blood sugar levels. Insulin and glucagon are hormones produced by the pancreas that help regulate blood glucose levels in the body.

  • What drugs should not be taken with Glyxambi?

    Glyxambi interacts with various drugs and supplements. These include diuretics, insulin, some diabetes medications, Saint-John’s-wort, and certain seizure medications. Before taking Glyxambi, tell your healthcare provider about all of the medications you take, including prescription and OTC drugs, vitamins, and supplements.

  • How long does it take for Glyxambi to work?

    Glyxambi may start lowering blood sugar very quickly. Check your blood sugar regularly to monitor how well Glyxambi is working. Also, your healthcare provider will likely order a hemoglobin A1C blood test after several months of taking Glyxambi. The A1C measures your blood sugar control over three months.

  • What are the side effects of Glyxambi?

    The most common side effects of Glyxambi include urinary tract infections, upper respiratory tract infections, and nasopharyngitis (common cold). Other side effects may include low blood sugar, high cholesterol, nausea, diarrhea, fungal infections of the genitals, and joint pain.

    Serious side effects have been linked to Glyxambi too. These include heart failure, pancreas problems, kidney failure, and severe genital infections. Discuss all potential side effects with your healthcare provider before starting Glyxambi.

How Can I Stay Healthy While Taking Glyxambi?

Before taking Glyxambi, discuss your medical history and medications with your healthcare provider. When taking Glyxambi, follow your healthcare provider’s instructions for use. Read the patient information that comes with your prescription. Consult your healthcare provider if you have any questions.

Ask your healthcare provider if you should carry glucagon with you. Glucagon can raise blood sugar in a severely low blood sugar emergency (when you are unable to eat or drink). Glucagon is available by injection or as a nasal spray called Baqsimi. Ensure your loved ones, friends, or caregivers know how to use it in an emergency.

Glyxambi is meant to be used along with a diet and exercise plan for controlling your blood sugar. Work with your healthcare team to devise the best plan for your needs. A registered dietitian may be a helpful resource for this.

Your healthcare provider will advise you on how often to check your blood sugar levels. Check to see if your provider's office has a certified diabetes care and education specialist who can teach you how to use your meter and answer questions about disease management.

Another helpful tip for people with diabetes is to purchase a medical alert device and wear it at all times. This will alert emergency responders that you have type 2 diabetes. Additionally, keep a few essential items on hand at all times. Pack these in a diabetes kit or supplies bag:

  • Blood glucose testing meter and extra supplies such as strips, lancing device, lancets, alcohol wipes, and batteries
  • Emergency contact information
  • Glucagon (injection or nasal spray) 
  • Low blood sugar treatments such as juice boxes, glucose tablets, honey sticks, and Smarties

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. DailyMed. Label: Glyxambi- empagliflozin and linagliptin tablet, film coated.

  2. Raedler LA. Glyxambi (empagliflozin/linagliptin): a dual-acting oral medication approved for the treatment of patients with type 2 diabetes. Am Health Drug Benefits. 2015;8(Spec Feature):171-5. PMID: 26629285; PMCID: PMC4665058.

  3. Centers for Disease Control and Prevention. Diabetic ketoacidosis.

  4. Epocrates. Glyxambi.

  5. Prescribers’ Digital Reference. Empagliflozin/linagliptin - drug summary.

  6. Boehringer Ingelheim. Jardiance label.

  7. Boehringer Ingelheim. Tradjenta.

  8. Marín-Peñalver JJ, Martín-Timón I, Sevillano-Collantes C, Del Cañizo-Gómez FJ. Update on the treatment of type 2 diabetes mellitus. World J Diabetes. 2016;7(17):354-95. doi: 0.4239/wjd.v7.i17.354

  9. Dungan K, DeSantis A. Glucagon-like peptide 1-based therapies for the treatment of type 2 diabetes mellitus. UpToDate.

  10. Silver B, Ramaiya K, Andrew SB, et al. EADSG guidelines: insulin therapy in diabetes. Diabetes Ther. 2018;9(2):449-492. doi:10.1007/s13300-018-0384-6

  11. Endocrine Society. Pancreas hormones.

By Karen Berger, PharmD
Karen Berger, PharmD, is a community pharmacist and medical writer/reviewer.