Supplements and Empagliflozin.
Empagliflozin, sold under the brand name Jardiance, is a sodium-glucose cotransporter 2 (SGLT2) inhibitor: it lowers blood glucose by increasing urinary glucose excretion.
Empagliflozin is an SGLT2 inhibitor. The full name is sodium glucose cotransporter 2. The class lowers blood glucose by increasing urinary glucose excretion. It also carries a separate cardiovascular and renal benefit shown in DAPA-HF, EMPA-REG, and the CKD trials, leading to expanded indication in heart failure and CKD even without diabetes. The supplement surface is small because SGLT2 inhibitors are minimally CYP metabolised. The clinically important issues are urinary tract and genital fungal infections (since glucose in the urine creates favourable conditions), volume depletion in heat or illness (the diuretic effect adds to dehydration risk), and the rare diabetic ketoacidosis presentation including the unusual "euglycaemic" form. Cranberry supplementation often comes up for UTI prevention. The Cochrane evidence supports modest efficacy in recurrent UTI in women. SGLT2 inhibitors tend to RAISE serum magnesium slightly, which is a class effect confirmed in meta-analyses (PMID 35582188, PMID 27628105) and the opposite of what is often assumed. They have even been studied in refractory hypomagnesaemia. Routine magnesium supplementation is not indicated simply because someone takes this drug.
Below are the 7 documented pairs we have explicitly assessed against Empagliflozin in the Distil database: 4 amber and 3 green. The pairs cluster around 2 mechanisms: Additive glucose lowering and Renal magnesium retention (drug-induced rise). Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not on this list is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by supplement, and the missing-item form at the bottom of the page routes any uncatalogued supplement into our next curation pass.
Documented interactions
Last reviewed 1 September 2026. Each interaction below lists the evidence its assessment drew on: some rest on studies of the exact pair, others on mechanism evidence, where a citation may support one part of the reasoning rather than the exact combination. The evidence line on each entry says which.
Additive glucose lowering
Amber Does Alpha Lipoic Acid interact with Empagliflozin?
Alpha lipoic acid may lower blood sugar by improving how your body responds to insulin. Empagliflozin also lowers blood sugar, so the two may add up. The combination is usually manageable because empagliflozin rarely causes low blood sugar on its own, but monitor your glucose when you start alpha lipoic acid or change the dose.
Evidence: Supported by human study data.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Garlic Extract interact with Empagliflozin?
Garlic supplements may lower blood sugar a little on their own. Empagliflozin also lowers blood sugar but rarely pushes it too low on its own, so the combination is generally manageable. Monitor your glucose when you start a garlic supplement or change the dose.
Evidence: Limited human data, from small studies or case reports.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Holy Basil interact with Empagliflozin?
Holy basil (tulsi) may lower blood sugar on its own. Empagliflozin also lowers blood sugar, so the two may add up. The combination is usually manageable because empagliflozin rarely causes low blood sugar on its own, but monitor your glucose when you start holy basil or change the dose.
Evidence: Limited human data, from small studies or case reports.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Psyllium Husk interact with Empagliflozin?
Psyllium lowers blood sugar a little on its own, which can add to empagliflozin's effect. Empagliflozin rarely causes low blood sugar by itself, so the practical risk is small, but monitor your glucose when you first add regular psyllium, especially if empagliflozin is combined with a sulfonylurea or insulin.
Evidence: Limited human data, from small studies or case reports.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Renal magnesium retention (drug-induced rise)
Green Does Magnesium interact with Empagliflozin?
Empagliflozin tends to raise your magnesium level slightly rather than lower it, which is the opposite of what water tablets like furosemide do, so it does not create a magnesium shortfall that needs correcting. Taking a magnesium supplement alongside it is generally fine, and there is no reason to start one simply because you take empagliflozin. If your kidney function is reduced, ask your kidney or diabetes team before adding magnesium, because it is the kidneys that clear any excess.
Evidence: Well established across multiple human studies or interaction references.
Green Does Magnesium Glycinate interact with Empagliflozin?
Empagliflozin tends to raise your magnesium level slightly rather than lower it, which is the opposite of what water tablets like furosemide do, so it does not create a magnesium shortfall that needs correcting. Taking magnesium glycinate alongside it is generally fine, and there is no reason to start it simply because you take empagliflozin. If your kidney function is reduced, ask your kidney or diabetes team before adding magnesium, because it is the kidneys that clear any excess.
Evidence: Well established across multiple human studies or interaction references.
Green Does Magnesium L-Threonate interact with Empagliflozin?
Empagliflozin tends to raise your magnesium level slightly rather than lower it, which is the opposite of what water tablets like furosemide do, so it does not create a magnesium shortfall that needs correcting. Taking magnesium L-threonate alongside it is generally fine, and there is no reason to start it simply because you take empagliflozin. If your kidney function is reduced, ask your kidney or diabetes team before adding magnesium, because it is the kidneys that clear any excess.
Evidence: Well established across multiple human studies or interaction references.
What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope (food-supplement interactions only; for drug-drug interactions, the BNF is authoritative). Use the checker below to surface any supplement, and submit a missing item if you take something we have not catalogued.
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How we grade severity, choose what's in scope, and what we exclude.
Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.
Read the full methodologyA full supplement review, built around you, not a generic stack.
The free checker answers one interaction question at a time. A Distil report reviews the bigger picture: your goals, diet, medications, current supplements and any blood results you provide, then shows what appears worth keeping, changing, adding or leaving out.
- what your diet already covers, so you are not adding a capsule for something food is already handling
- which evidence-graded compounds are worth considering for your goals, and which were considered but left out
- what to keep, change or stop from what you already take, plus the order to introduce anything new
- how your medications and complete supplement stack fit together, with daily timing and a clear point for reassessment
The interaction check is one section of the full report. You also get the reasoning behind each recommendation and the evidence references used.
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