Empagliflozin is increasingly used in patients with heart failure, with or without diabetes.
Pharmac criteria for Empagliflozin for heart failure is in short include
Heart failure - NYHA II, III, IV
On optimal standard HF treatment
Echo - LVEF <= 40%; or if not practical
Ketoacidosis risk is real, however, and sick day plan may be useful
Sick day plan trigger =
feel unwell (e.g. fever or stomach bug)
cannot eat or drink normally
Sick day plan =
Stop taking Empagliflozin
Watch for sign of dehydration
Restart after feeling better and eating/drinking normally for 2 days
We have a role in communicating such plan to patients on Empagliflozin, and is unique to the standard mix of heart failure patients.