Sodium-glucose Co-transporter 2 (SGLT2) Inhibitors

This information is important for patients prescribed a SGLT2 inhibitor. If you are prescribed one of the following medications, you are taking a SGLT-2 inhibitor:

• Dapagliflozin
• Canagliflozin
• Empagliflozin
• Ertugliflozin

You should take this medication according to the instructions from your prescriber. Please make sure you understand how to take the medicine and ask if you have any questions. 
This is an effective treatment for several conditions, diabetes, heart failure or chronic kidney disease.  As with all medications, it can have some side effects.  These can include:

• Hypoglycaemia (low blood glucose) – This usually only occurs if taken in combination with other diabetes medicines and your prescriber may therefore need to alter the dose.
• Dehydration – This medicine increases your urine volume so may cause dehydration. To prevent dehydration, you must drink at least two litres of non-sugary drinks a day, unless directed otherwise. 
• Genital infections – As this medicine increases the glucose (sugar) in your urine, there is an increased risk of infection, such as genital thrush.  Wash your genital area with warm water using non-perfumed soap and avoid wearing tight underwear to reduce the risk of infection.  

In rare cases, SGLT2 Inhibitors can cause more serious side effects or complications, including diabetic ketoacidosis (DKA), Fournier’s gangrene and lower-limb amputation. Please seek medical advice immediately if you have any of the following:

• Rapid weight loss
• Feeling or being sick, or stomach pain
• Fast and deep breathing
• Sweet or metallic taste in the mouth
• Different odour to your breath, urine or sweat.
• Severe pain, tenderness, redness, or swelling in the genital area, accompanied by fever or feeling unwell.

If you are taking canagliflozin, or are diabetic, it is important you attend for regular foot checks whilst taking this medication. 

If you become unwell and have vomiting, diarrhoea, or fever, you should stop this medication. You can restart when you are better (eating and drinking normally), however if you remain unwell after 48 hours seek medical advice from your GP, Pharmacist or NHS 111.

The following blood tests are required to monitor your treatment, at least once a year. If you haven’t had one in the last year, please book a blood test with your GP practice.