Sodium-glucose cotransporter-2 (SGLT2) inhibitors

Sodium-glucose cotransporter-2 (SGLT2) inhibitors are a class of oral (taken by mouth) prescription medicines that are FDA-approved for use with diet and exercise to lower blood sugar in adults with type 2 diabetes.

Some SGLT2 inhibitors are also FDA-approved for use in people with chronic kidney disease (CKD) and/or heart failure to lower the risk of heart attack, stroke, and/or heart failure flare-ups, including in people who do not have diabetes. Some SGLT2 inhibitors are FDA approved to help slow the progression of kidney disease.

One type of SGLT2 inhibitor is now FDA-approved to help improve blood sugar control in children 10 years and older with type 2 diabetes. Studies are underway to see if SGLT2 inhibitors can be helpful for some kidney diseases in children who do not have diabetes.

SGLT2 inhibitors, which are also called gliflozins, are a class of drugs that lower your blood sugar levels by preventing your kidneys from reabsorbing sugar that is created by your body and the extra sugar leaves through in your urine.

Originally, SGLT2 inhibitors were developed as oral antidiabetic (blood sugar lowering) drugs. Later clinical trial data showed significant improvement in kidney health in people with heart failure and/or CKD. This benefit was even higher in people who also had albuminuria.

SGLT2 inhibitors lower blood sugar by causing the kidneys to remove sugar from the body through urine. 

Approved medicines in the SGLT2 inhibitor class include:

• Brenzavvy™ (bexaglifloxin)
• Invokana® (canagliflozin)
• Farxiga® (dapagliflozin)
• Jardiance® (empagliflozin)
• Steglatro® (ertugliflozin)

All SGLT2 inhibitors work in relatively the same way and are taken orally (by mouth).

SGLT2 inhibitors are effective at slowing the progression of kidney disease, reducing heart failure, and lowering the risk of kidney failure and death in people with CKD and type 2 diabetes. SGLT2 inhibitors also protect the kidneys in people with CKD who do not have diabetes.

Studies have shown that some medications in this drug class may also reduce the risk of heart failure in people with a history of heart disease. They have also been shown to reduce the need for hospitalization for heart failure.

Mild side effects have been reported in people using SGLT2 inhibitors, which may include:

• Urinating a lot, including at night
• Increased thirst

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

• Frequent, urgent, burning, or painful urination
• Urine that is cloudy, red, pink, or brown
• Pelvic or back pain
• Vaginal odor, yeast infection (white or yellowish vaginal discharge that may be lumpy or look like cottage cheese), and/or vaginal itching
• Redness, itching, or swelling of the penis; rash on the penis; foul-smelling discharge from the penis; or pain in the skin around the penis
• Feeling tired, weak, or uncomfortable; along with a fever and pain, tenderness, redness, and swelling of the genitals, and/or the area between the genitals and the rectum
• Flu-like symptoms
• Swelling of the legs or feet

SGLT2 inhibitors may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

This content is provided for informational use only and is not intended as medical advice or as a substitute for the medical advice of a healthcare professional.