empagliflozin + rifampicin

Empagliflozin + rifampicin is a combination of two small molecule oral drugs. Empagliflozin is a selective and reversible inhibitor of sodium-glucose cotransporter 2 (SGLT2), decreasing renal glucose reabsorption and increasing urinary glucose excretion, thereby lowering blood glucose levels in patients with type 2 diabetes mellitus. Rifampicin is an antibiotic of the rifamycin class that inhibits bacterial DNA-dependent RNA polymerase, used primarily to treat tuberculosis and other bacterial infections. Pharmacokinetic studies show coadministration of rifampicin with empagliflozin increases empagliflozin exposure by about 35%, but this is not considered clinically meaningful and no dose adjustment of empagliflozin is recommended. Rifampicin’s effect is due to transporter inhibition (OATP1B1/1B3), but empagliflozin exposure is affected less than 2-fold, with good tolerability observed in healthy subjects[1][2][3]. There is no evidence this drug combination is approved or marketed as a fixed-dose product; the combination refers to the coadministration of these two drugs.