SGLT2 Inhibitors - Pharmacology Summary

Mechanisms of Action: Inhibits SGLT2 (sodium/glucose cotransporter 2) in the proximal tubule, blocking reabsorption of filtered glucose (leading to osmotic diuresis)

Examples (_gliflozin):

 • Empagliflozin (Jardiance) - Best risk/benefit ratio of the three

 • Dapagliflozin (Forxiga)

 • Canagliflozin (Invokana)

Major Advantages:

 • Weight loss (~2-3kg)

 • Empagliflozin and canagliflozin ↓ CV mortality in high risk patients with T2D + atherosclerotic heart disease

 • All 3 heart failure hospitalizations and progression of nephropathy

Contraindications: eGFR < 30 mL/minute/1.73 m2 (for first initiation of use)

Common Side Effects and Toxicities:

 • AKI (likely from hypovolemia)

 • GU infections (e.g. UT Is, vulvovaginal candidiasis)

 • Euglycemic diabetic ketoacidosis (DKA)

 • Canagliflozin ↑ risk of lower limb amputation and bone fractures



- Dr. Eric Strong @DrEricStrong - Strong Medicine https://www.youtube.com/c/EricsMedicalLectures/featured



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