- Type 2 Diabetes: Learn the Warning Signs
- Diabetes Friendly Dining
- Type 2 Diabetes: Test Your Medical IQ
- What are SGLT2 inhibitors?
- How do SGLT2 inhibitors work?
- What are the uses for SGLT2 inhibitors?
- What are the side effects of SGLT2 inhibitors?
- What are the dosages for SGLT2 inhibitors?
- Which drugs or supplements interact with SGLT2 inhibitors?
- Are SGLT2 inhibitors safe to take during pregnancy or while breastfeeding?
What are SGLT2 inhibitors?
SGLT2 (sodium-glucose co-transporter 2) inhibitors are prescription oral medications used to treat type 2 diabetes.
What generic and brand names of SGLT2 inhibitors are available in the US?
Brand and generic names of SGLT2 inhibitors and combination products that contain SGLT2 inhibitors include:
- canagliflozin (Invokana)
- canagliflozin/metformin (Invokamet)
- canagliflozin/metformin extended release (Invokamet XR)
- dapagliflozin (Farxiga)
- dapagliflozin/metformin extended release (Xigduo XR)
- dapagliflozin/saxagliptin (Qtern)
- empagliflozin (Jardiance)
- empagliflozin/linagliptin (Glyxambi)
- empagliflozin/metformin (Synjardy)
- empagliflozin/metformin extended release (Synjardy XR)
- ertugliflozin (Steglatro)
- ertugliflozin/metformin (Segluromet)
- ertugliflozin/sitagliptin (Steglujan)
Do I need a prescription for SGLT2 inhibitors?
How do SGLT2 inhibitors work?
- SGLT2 inhibitors reduce blood glucose by blocking the action of a protein called sodium-glucose co-transporter-2 (SGLT2) in the kidney. This protein is responsible for reabsorbing sugar back into the body from urine. Blocking this protein prevents the kidney from reabsorbing glucose from urine and causes glucose to be removed from the body through urine. This lowers the level of glucose in the blood.
- SGLT2 inhibitors also reduce blood pressure and cause weight loss. In one study, empagliflozin (Jardiance) significantly reduced the risk of death from cardiovascular causes, death from any cause, and the risk of hospitalization for heart failure in people with type 2 diabetes.
- The FDA approved the first SGLT2 inhibitor, canagliflozin (Invokana), in 2013.
What are the uses for SGLT2 inhibitors?
- SGLT2 inhibitors are used alone or in combination with metformin or other diabetic medications and with exercise and diet to reduce blood glucose in adults with type 2 diabetes.
- SGLT2 inhibitors are not for treating people with type 1 diabetes or for treating diabetic ketoacidosis.
- SGLT2 inhibitors are not prescribed for patients with kidney disease including those on dialysis.
Latest Diabetes News
Daily Health News
What are the side effects of SGLT2 inhibitors?
On Aug. 29, 2018, the FDA issued a warning that cases of a rare but serious infection of the genitals and area around the genitals have been reported with the class of type 2 diabetes medicines called SGLT2 inhibitors. This serious rare infection, called necrotizing fasciitis of the perineum, is also referred to as Fournier’s gangrene.
SGLT2 inhibitors are FDA-approved for use with diet and exercise to lower blood sugar in adults with type 2 diabetes. SGLT2 inhibitors lower blood sugar by causing the kidneys to remove sugar from the body through the urine. First approved in 2013, medicines in the SGLT2 inhibitor class include canagliflozin, dapagliflozin, empagliflozin, and ertugliflozin. In addition, empagliflozin is approved to lower the risk of death from heart attack and stroke in adults with type 2 diabetes and heart disease. Untreated, type 2 diabetes can lead to serious problems, including blindness, nerve and kidney damage, and heart disease.
Seek medical attention immediately if you experience any symptoms of tenderness, redness, or swelling of the genitals or the area from the genitals back to the rectum, and have a fever above 100.4 F or a general feeling of being unwell. These symptoms can worsen quickly, so it is important to seek treatment right away.
On May 15, 2015, the FDA informed the public that SGLT2 inhibitors have been associated with increased risk of ketoacidosis in people with diabetes.
Common side effects
The most common side effect of SGLT2 inhibitors include:
- Genital yeast infections in men and women
- Urinary tract infections (UTIs)
- Increased urination
- Kidney problems
- Flu like symptoms
- Nasal congestion
- Urinary discomfort
- Back pain
Serious side effects of SGLT2 inhibitors include:
- Kidney failure
- Hyperkalemia (high levels of potassium in the blood)
- Hypotension (low blood pressure)
- Increased cholesterol levels
- Serious urinary tract infections
- Increased bladder cancer risk
- Serious allergic reactions
- Low blood glucose (hypoglycemia) when combined with insulin or drugs that increase insulin production
What are the dosages for SGLT2 inhibitors?
SGLT2 inhibitors are available as tablets.
- canagliflozin (Invokana): 100, 300 mg tablets
- dapagliflozin (Farxiga): 5, 10 mg tablets
- empagliflozin (Jardiance): 10, 25 mg tablets
Which drugs or supplements interact with SGLT2 inhibitors?
- Combining SGLT2 inhibitors with insulin or drugs that increase insulin secretion increases the risk of hypoglycemia.
- Combining SGLT2 inhibitors with diuretics increases the frequency of urination and the risk of dehydration.
- Rifampin, phenytoin, phenobarbital, ritonavir (Norvir) increase the removal of canagliflozin from the body by increasing the action of UDP glucuronosyl transferases (UGT) enzymes. UGT are enzymes that convert chemicals in the body to other types of chemicals that dissolve better in water and are easier to remove from the body. This interaction may reduce the efficacy of canagliflozin. Therefore, the dose of canagliflozin may need to be increased when it is combined with drugs that increase its removal form the body.
- Canagliflozin increases blood levels and the effect of digoxin.
- The prescribing information for dapagliflozin does not list any drug interactions.
Are SGLT2 inhibitors safe to take during pregnancy or while breastfeeding?
SGLT2 inhibitors have not been adequately evaluated in pregnant women. SGLT2 inhibitors affected kidney development and maturation in animals.
SGLT2 (sodium-glucose co-transporter 2) inhibitors is a class of drugs prescribed to treat type 2 diabetes in conjunction with diet and exercise. Review side effects, drug interactions, preparations, and pregnancy and breastfeeding safety information prior to taking any medication.
Multimedia: Slideshows, Images & Quizzes
Sugar Quiz: Facts on Diet & Sugar
Sugar lurks in surprising places. Take the Sugar Quiz to learn of the many ways sugar sneaks into your diet and see what you know...
Type 2 Diabetes: Test Your Medical IQ
What causes type 2 diabetes? Can it be prevented? Take this online quiz and challenge your knowledge of this common condition....
Salt Quiz: Test Your Diet IQ
Do you love salt? Take the online Salt Quiz to get the facts about dietary salts and sodium in fruits, vegetables, processed...
Diet and Nutrition Quiz: Plans & Facts
Even if you think you're getting enough fruits and vegetables per day, how can you be sure? Take the Diet & Nutrition Quiz to...
Diabetes Quiz: Test Your Medical IQ
Take the Diabetes Quiz and learn the causes, signs, symptoms, and types of this growing epidemic. What does diabetes have to do...
Exercise and Fitness Quiz: Test Your IQ
Take our Exercise and Fitness Quiz and learn to maximize your fitness level with simple exercises that do not require major...
Top Diets: The Best Dieting Tips Ever for Weight Loss
What separates good diets from the best diets? These weight loss strategies--like drink more water, eat breakfast, sleep...
Pictures of the 7 Most Effective Exercises to Do at the Gym or Home (and Tips to Improve Form)
These seven exercises deliver fitness results at home or in the gym. Start your training to better physical health with the most...
Pictures of the 7 Riskiest Workout Moves, and How to Improve Them
Working out is supposed to make you healthier--but some exercises can leave your body at risk of pain or injury. Some exercises...
The 30-Minute Fitness Routine in Pictures
This quick, high-intensity 30-minute workout routine can make you look better and feel better. Discover the right way to do...
How Diabetes Can Affect Your Feet
Learn more about diabetes related foot problems. For people with diabetes, too much glucose in the blood can cause serious foot...
High Protein Diets: Good or Bad?
Low-carb, high-protein diets are quite popular. High protein diets let you snack on protein-rich foods you love, but what are the...
Diet for Stress Management: Carbs, Nuts, and Other Stress-Relief Foods
While there are many ways to cope with stress, one strategy is to eat stress-fighting foods. Find out which foods to eat as part...
Vegetarian Diet: Tasty, Basic Choices in Pictures
Thinking about becoming a vegetarian? Compared to the general population, the typical vegetarian has a lower body mass index...
Type 2 Diabetes Diagnosis, Treatment, Medication
Learn about type 2 diabetes warning signs, symptoms, diagnosis, and treatment options. Read how diet and exercise can help manage...
Diet Mistake Pictures: Crash Diets, High-Calorie Drinks, and More
Discover 10 common diet mistakes that may be preventing you from losing weight. Learn to avoid these diet blunders and watch the...
Pictures of Famous People With Diabetes
See pictures of celebrities that have been diagnosed with type 1 or type 2 diabetes including Mary Tyler Moore, Salma Hayek, and...
Exercise Tips for Kids and the Whole Family
Exercise is great for kids, and fun activities for the whole family are there if you know how to find them. Learn how to lose...
Grocery Smarts: 'Healthy Fat' Foods for Fitness in Pictures
A healthy diet starts at the grocery store. See which fat foods to avoid and which fit foods to choose....
Portion Control Tips: Lose Weight and Stick to Your Diet
Portion control can help with weight loss and help you stick to a healthy diet. But how much is too much? This photo guide will...
10 Tips for a Healthier Fast Food Diet
Losing weight is tough on the road. Fast food can't compare to the health of a well-planned, balanced diet. But if you must eat...
Tips to Eat Healthy When You Dine Out in Pictures
Recognize the dangers of eating out and stay on your healthy diet at restaurants. Learn about healthy eating at restaurants,...
Diet-Wrecking Foods: Smoothies, Lattes, Popcorn, and More in Pictures
It may seem healthy, but is it really? Many food frauds masquerade as diet food. See 23 foods that seem healthy but can be...
Benefits of Exercise: Fitness Facts Prove the Benefits of Working Out
These fitness facts explain why to get in shape. Check out these health facts on the benefits of exercise....
No-Gym Workout in Pictures: Equipment, Routines, and More
Learn about this no-gym, at home quick workout. It can get you into great shape at home and shows the best moves for flat abs and...
Exercise and Fitness: 10 Budget-Friendly Exercise Gadgets
There are plenty of cheap and free ways to exercise. Learn about inexpensive ways to get in shape with the use of jump ropes,...
17 Must-Try Fitness Workouts in Pictures
Learn the latest exercise crazes such as TRX, pole dancing, Zumba, Kangoo jumps, boot camps, exergames and more that are designed...
Diabetes Diet: Healthy Meal Plans for Diabetes-Friendly Eating
Discover the best and worst meals for diabetes-savvy dining. See how to avoid carbs and control your blood sugar with healthier...
Healthy Dieting Myths and Facts
Learn about healthy dieting myths and facts. Can't tell fact from fiction about weight loss and healthy eating? Discover the...
Food Cravings Slideshow: Chocolate, Carbs, Salt, Sugar
Learn which food cravings can wreck your diet. Whether your craving something creamy or crunchy, sweet or salty, food cravings...
Blood Sugar Swings: Tips for Managing Diabetes & Glucose Levels
Learn to better control your glucose levels by preventing blood sugar swings. Beware of caffeine, sugary foods, spices, exercise,...
Diabetes Management Tips and Preventing Complications
Learn 10 simple ways to better manage your diabetes. See tips for controlling blood sugar, diet and exercise and other helpful...
Diabetic Peripheral Neuropathy: Improve Diabetes Nerve Pain
Read about diabetic peripheral neuropathy and exercises to manage nerve pain. Learn how to cope with the symptoms of diabetic...
Pictures of 10 Muscle-Building Exercises for Diabetes
Watch this slideshow on Diabetes and Exercise. If you have diabetes, see how strengthening your muscles with these 10 weight...
12 Reasons to Love the Mediterranean Diet in Pictures
The Mediterranean diet is a delicious way to eat healthy. We show you how to get the most from this diet with foods like olive...
Food Swaps for Meals and Snacks for Heart Health in Pictures
Explore 10 food swaps for heart-wise dining. Learn what food to buy and how to cook in order to make a big difference for your...
Travel Tips for Better Diabetes Control
Traveling with diabetes can be intimidating, but it shouldn't stop you! Learn tips for packing your diabetic supplies, how to...
Healthy Seeds: 11 Edible Super Seeds for Better Nutrition
Are pumpkin seeds good for your health? What's the nutritional value of chia seeds? Find out how to easily incorporate more...
Diabetes Diet: 11 Low-Sugar Drink Ideas
Searching for low-sugar drink ideas? This pictures slideshow has eleven beverages ideal for people with diabetes and those...
Related Disease Conditions
Diabetes (Type 1 and Type 2)
Diabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are...
Low Blood Sugar (Hypoglycemia)
Low blood sugar, or hypoglycemia, is a syndrome in which a person's blood sugar is dangerously low. People with type 1 and type 2...
Tips for Managing Type 1 and 2 Diabetes at Home
Managing your diabetes is a full time commitment. The goal of diabetic therapy is to control blood glucose levels and prevent the...
Diabetes and Eye Problems
Diabetes and eye problems are generally caused by high blood sugar levels over an extended period of time. Types of eye problems...
Diabetes and Foot Problems (Treatment)
Diabetes related foot problems can affect your health with two problems: diabetic neuropathy, where diabetes affects the nerves,...
Type 2 Diabetes
Type 2 diabetes is a condition in which a person's pancreas does not produce enough insulin to meet the needs of the body....
Diabetic Neuropathy (Symptoms, Causes, Diagnosis, Treatment)
Diabetic neuropathy a condition in which nerve damage has occurred as a complication of diabetes. The pain from the nerve...
Type 2 Diabetes Medications (Side Effects, Differences)
Type 2 diabetes oral medications are prescribed to treat type 2 diabetes in conjuction with lifestyle changes like diet and...
A diabetic diet, or diabetes diet helps keep blood glucose levels in the target range for patients. Exercise and medication may...
Sex, Urinary, and Bladder Problems of Diabetes
Having diabetes can mean early onset and increased severity of bladder symptoms (urinary incontinence and urinary tract...
Diabetes Treatment (Type 1 and Type 2 Medications and Diet)
The major goal in treating diabetes is controlling elevated blood sugar without causing abnormally low levels of blood sugar....
High Blood Sugar (Glucose, Hyperglycemia)
Hyperglycemia or high blood sugar is a serious health problem for diabetics. There are two types of hyperglycemia, 1) fasting,...
Diabetes and Kidney Disease
In the United States diabetes is the most common cause of kidney failure. High blood pressure and high levels of blood glucose...
Diabetes: Caring for Your Diabetes at Special Times
Taking care of a disease such as diabetes is a life-long process. Learn how to care for yourself or loved one with diabetes in...
Diabetes Diet for Type 2 Diabetes, List of Foods
A type 2 diabetes diet or a type 2 diabetic diet is important for blood sugar (glucose) control in people with diabetes to...
Diabetic Ketoacidosis (Causes, Symptoms, Treatment, Complications)
Diabetic ketoacidosis (DKA) is a complication of type 1 diabetes that is life threatening. If a person thinks they may have...
Treatment & Diagnosis
Medications & Supplements
Prevention & Wellness
Health Solutions From Our Sponsors
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
U.S. Food and Drug Administration. "FDA approves Invokana to treat type 2 diabetes First in a new class of diabetes drugs."
U.S. Food and Drug Administration. "FDA warns about rare occurrences of a serious infection of the genital area with SGLT2 inhibitors for diabetes."
Zinman, B. et al. "Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes — NEJM." New England Journal of Medicine. N.p., 17 Sept. 2015. Web. 27 Apr. 2016.