Sodium-Glucose Cotransporter 2 Inhibitors: An Overview

Essie Samuel, PharmD, BCPS; Jiehyun Lee, PharmD, BCACP, CACP


US Pharmacist. 2017;42(10):42-47. 

In This Article


SGLT2 inhibitors used in the treatment of T2DM have a unique mechanism that specifically targets the kidneys. The safety profile of this drug class is well documented in the literature and is mostly consistent with these medications' mechanism of action. The most common adverse effects include genital mycotic infections, UTIs, and effects of intravascular volume depletion. Hypoglycemia, the most common side effect of antidiabetic agents, is fairly uncommon with SGLT2 inhibitors given as monotherapy. Serious safety issues are not commonly reported, although new problems are still being recognized. In addition to glycemic efficacy, empagliflozin and canagliflozin recently demonstrated CV benefits in T2DM patients. The use of SGLT2 inhibitors is becoming more prominent in the treatment of T2DM because of additional benefits such as low hypoglycemia risk, decreased mortality secondary to CV events, and efficacy in lowering BG concentrations, body weight, and BP. However, recent safety warnings raise concerns about the use of SGLT2 inhibitors in T2DM management. Risks and benefits must be closely evaluated in order to appropriately use SGLT2 inhibitors in patients with T2DM.