Drug Class

SGLT2 inhibitors

Blocking glucose reabsorption in the kidney, so glucose leaves in the urine.

Also called gliflozins and sodium-glucose cotransporter 2 inhibitors.

Class card

Drugs: Empagliflozin and Dapagliflozin
Used for: Type 2 diabetes
Heart failure
Chronic kidney disease
Known for: Genital yeast infections (thrush)
Ketoacidosis, even with near-normal glucose
Fournier's gangrene (perineal necrotizing fasciitis)
Name stems: -gliflozin

3 cards: the class, and each drug in it.

Mechanism of action

How do SGLT2 inhibitors work?

SGLT2 inhibitors block sodium-glucose cotransporter 2 in the proximal tubule, which normally reabsorbs about 90% of filtered glucose. Glucose and sodium pass into the urine, lowering blood glucose without relying on insulin and causing a mild osmotic diuresis. More sodium reaching the distal tubule lowers preload, afterload and glomerular pressure, which may explain their heart and kidney benefits.

The drugs

SGLT2 inhibitors with a card

Uses

What are SGLT2 inhibitors used for?

Type 2 diabetes
Heart failure
Chronic kidney disease

Side effects

Side effects of SGLT2 inhibitors

Genital yeast infections (thrush)Known for
Ketoacidosis, even with near-normal glucoseKnown forSerious
Fournier's gangrene (perineal necrotizing fasciitis)Known forSerious
Urinary tract infections, sometimes severeSerious
Dehydration and low blood pressure
Passing more urine
Acute kidney injurySerious
Higher LDL cholesterol
Hypoglycemia with insulin or a sulfonylurea
Swelling of face and throat (angioedema)Serious

What the class has in common. Each drug's card has its own, and Known for marks what an exam expects you to know.

Watch for

Cautions

Not for type 1 diabetes: they sharply raise the risk of ketoacidosis.
Pause before surgery and during acute illness or fasting; check for ketoacidosis whatever the glucose level.
Assess fluid status and kidney function first in older people and those taking loop diuretics.
Their glucose-lowering effect fades as kidney function declines.

Remember them

A way to remember them

Gliflozins make you pee sugar.

Blocking SGLT2 sends glucose into the urine. Follow the sugar: genital yeast infections and UTIs; follow the water it pulls out: dehydration; and watch for ketoacidosis while glucose still looks near normal.

Written for biofideX

Name stems

-gliflozin means SGLT2 inhibitor (gliflozin)
WHO defines it as sodium-glucose cotransporter inhibitors related to phlorizin. Empagliflozin and dapagliflozin block SGLT2 in the kidney, so more glucose leaves in the urine.
Every drug name stem

Don't mix them up

Classes easily confused with these

Sources

Checked against

Written for biofideX in plain words, after checking these references:

For learning pharmacology, not for treatment decisions: no doses are given, and a prescriber, pharmacist or the product's own label is the word on any one patient. Spotted a mistake? Tell us and we'll correct it.

Practice them

Diabetes

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