SGLT2 inhibitors are a type of medication you might need to take if you have type 2 diabetes. They are also known as gliflozins.
- What are SGLT2 inhibitors?
- How do SGLT2 inhibitors work?
- Who can take SGLT2 inhibitors?
- Different types of SGLT2 inhibitors
- How to take SGLT2 inhibitors
- Your prescription
- SGLT2 inhibitors side effects
- More information and support
What are SGLT2 inhibitors?
Sodium-glucose co-transporter-2 inhibitors, often called SGLT2 inhibitors, are used to manage blood sugar levels.
They can be taken on their own or with other diabetes medications such as metformin, sulphonylureas or insulin.
How do SGLT2 inhibitors work?
SGLT2 inhibitors reduce blood sugar levels as they help the kidneys to remove excess glucose or sugar, which is passed out through your urine.
For someone with heart failure, some SGLT2 inhibitors can also improve the symptoms, such as breathlessness, and reduce the risk of your heart becoming weaker.
They can also slow down chronic kidney disease, or CKD, by reducing pressure and swelling in the kidneys.
Who can take SGLT2 inhibitors?
Adults over the age of 18 years with type 2 diabetes can take SGLT2 inhibitors.
Children aged 10 years or older who have type 2 diabetes can take one SGLT2 inhibitor called dapagliflozin.
Your healthcare professional should prescribe you an SGLT2 if metformin is not suitable for you, and if you have chronic heart failure or heart disease, or you are at high risk of developing heart failure or heart disease.
Some SGLT2 inhibitors can also be used to treat chronic kidney disease, depending on how well your kidneys are working.
You should tell your healthcare professional if you have chronic kidney disease before taking an SGLT2 inhibitor.
Who can’t take SGT2 inhibitors?
Some medications might not be suitable for some people, which might be because of medical conditions or other reasons:
- Your doctor will tell you to stop taking an SGLT2 inhibitor if you develop diabetic ketoacidosis, or DKA;
- If you have kidney disease you might not be able to take an SGLT2 inhibitor, but this will depend on the stage of your kidney disease;
- If you have severe liver disease you might need a reduced dose;
- You should not take an SGLT2 inhibitor if you are pregnant of breastfeeding. If you’re planning a pregnancy speak with a healthcare professional if you are using this medication;
- You might need to temporarily stop taking an SGLT2 inhibitor if you’re going to have an operation.
When you start a new medication always check with your healthcare team that it’s suitable for you to take.
Different types of SGLT2 inhibitors
There are four SGLT2 inhibitors available in the UK, which are all taken as a once-daily tablet that you swallow.
| Generic name | Brand name |
|---|---|
| Dapagliflozin | Forxiga |
| Canagliflozin | Invokana |
| Empagliflozin | Jardiance |
| Ertugliflozin | Steglatro |
There are three medications that have an SGLT2 inhibitor and metformin in one tablet, which decreases the amount of glucose produced by the body. They are:
| Generic name | Brand name |
|---|---|
| Dapagliflozin + metformin | Xigduo |
| Canagliflozin + metformin | Vokanamet |
| Empagliflozin + metformin | Synjardy |
And there are two medications that have an SGLT2 inhibitors and a DDP-4 inhibitor in one tablet. They are:
| Generic name | Brand name |
|---|---|
| Empagliflozin + linagliptin | Glyxambi |
| Dapagliflozin + saxagliptin | Qtern |
If you have been prescribed one of these medications and you would like more information, then be sure to ask your healthcare professional.
How to take SGLT2 inhibitors
SGLT2 inhibitors are tablets that you swallow. They can be taken with or without food.
If you take the tablet that has an SGLT2 and metformin in it, you must take it with food, to reduce the risk of having a poorly tummy.
Always take your SGLT2 exactly as your healthcare professional has told you. The Patient Information Leaflet inside the box will tell you how to take it but always check with a doctor or pharmacist if you are not sure.
Your prescription
Your healthcare team should explain your prescription to you but it's important to make sure you ask if you don't feel you know enough.
And make sure you talk to your GP or your diabetes team if you struggle to take your SGLT2 inhibitor. They might be able to help by giving you a different dose.
In England, if you need to take any medication to manage your diabetes, your prescriptions will be free. Ask your healthcare team about a prescription exemption certificate if you don't have one, to make sure you don't get charged for your medication. Prescriptions are already free for everybody in the rest of the UK, so you shouldn't pay for your SGLT2.
SGLT2 inhibitors side effects
Like all medicines, SGLT2 inhibitors can cause side effects. But when side effects are listed as common in the Patient Information Leaflet, it doesn’t mean that everyone who takes the medication will get them.
The information about side effects is based on the likelihood of people having them. For example, if a side effect is very common then it can affect more than one in ten people, and if a side effect is very rare then it affects fewer than one in 10,000 people.
Because medicines can affect people differently, your healthcare team will speak to you about what’s best for you and discuss any side effects.
Common side effects can include being really thirsty and going to the toilet to wee more often.
Risk of low blood sugar
SGLT2 inhibitors do not usually cause low blood sugar, also known as hypoglycaemia or hypos, when taken on their own. However, hypos can happen when you take an SGLT2 inhibitor with other diabetes medications such as insulin or a sulphonylurea.
Your healthcare team may advise reducing the dose of your sulphonylurea or insulin medicine when you start taking an SGLT2 inhibitor to reduce the risk of hypos.
Risk of high blood sugar
There have been reports of some people developing diabetic ketoacidosis, also called DKA, if they take SGLT2 inhibitors, although this is a rare side effect.
The risk of DKA is higher if:
- you have had DKA before
- you’re unwell
- you’re having surgery
- your insulin doses are reduced too quickly
- you’re following a low carbohydrate diet or a ketogenic diet.
If you take an SGLT2 inhibitor and become unwell, you should temporarily stop taking it. You need to check your ketones and your blood sugars (if you've been told to do this and have the kit) and speak to your healthcare team. Taking this medication when you're not very well could increase your risk of developing DKA so you need to know the symptoms to look out for.
These are not all the side effects. You'll find the full list of known side effects in the Patient Information Leaflet. This comes in the medication box.
It's also important that you get individual advice from your healthcare team before starting SGLT2 inhibitor treatment and report any side effects to your healthcare professionals, if you have any.
You can also report these side effects to the Yellow Card Scheme, which is the government system used for recording side effects with medicines in the UK.
More information and support
Still have more questions? Or is there anything you're not sure about SGLT2 inhibitors after reading this page? Contact our helpline on 0345 123 2399.
You can visit the NHS website for more information on SGLT2 inhibitors.
