SGLT2 Inhibitors - Patient Information Leaflet

 

You have been given this leaflet because you are taking, or are about to take a SGLT-2 inhibitor. They are used to treatment diabetes, chronic kidney disease or heart failure. The name of these drugs end with ‘gliflozin’. Examples include, empagliflozin (Jardiance®), canagliflozin (lnvokana®), dapagliflozin (Forxiga®) and ertugliflozin (Steglatro®).

What are the possible side effects of SGLT2 inhibitors?

Very common (≥1/10)
An increase in the risk of hypoglycaemia when used in combination with other diabetes medication (insulin/sulfonylurea).

Common (≥1/100 to <1/10)

  • Developing genital or urinary tract infections.
  • Passing more urine more often.
  • Increased thirst.
  • Itching/rash.

Rare (≥1/10,000 to <1/1,100)

  • Diabetic ketoacidosis (rare but serious side effect).
  • Necrotising fasciitis of the perineum (Fournier’s gangrene) [pain, tenderness, erythema, or swelling in the genital or perineal area, with fever or malaise].
 

What is Fournier’s Gangrene?

Fournier’s gangrene is a rare, life-threatening bacterial infection of your scrotum, penis or perineum (the area between your genitals and rectum). It’s an infection that worsens quickly and requires emergency care. Go to the emergency department if your genitals or perineum are red, tender, or swollen, and you have either a fever or you feel unwell in general.

Although very rare (incidence of approximately 1 in 100,000 patients) it is a serious and potentially life threatening condition and should be viewed as a medical emergency.

 

What is diabetic ketoacidosis (DKA)?

  • DKA is rare but serious condition that can develop in people taking SGLT 2 inhibitors. It is a serious condition which requires urgent medical treatment.
  • It is an increase in certain acids (ketones) building up in the blood.
 

What are the symptoms of DKA?

  • Nausea and vomiting.
  • Abdominal/stomach pain.
  • Rapid breathing.
  • Dehydration e.g. dizziness and excessive thirst, a sweet or metallic taste in the mouth or a different odour to urine or sweat.
  • Drowsiness or tiredness.
  • Confusion.
  • In some cases of DKA blood glucose levels maybe in the normal range in people using SGLT2 inhibitors.

If you experience any of these symptoms, even if your blood glucose levels are not high, you should contact your doctor or go to the nearest hospital and tell the emergency doctor that you are taking a SGLT2 inhibitor.

See your doctor urgently:

  • If you have a severe illness.
  • If you are very dehydrated.
  • If you have had significant weight loss and have poor appetite.
  • If there is excess alcohol use.
  • If you are on insulin treatment and there is a sudden reduction in insulin doses
 

Sick day guidance

If you are unwell (i.e. too unwell to go to work or carry out normal daily activities), you should temporarily stop taking this medicine, especially if you have:

  • vomiting
  • diarrhoea
  • fever

You can restart them when you are better.

If you remain unwell after 48 hours seek medical advice from your GP, Pharmacist or NHS 111. If you have diabetes, you must increase the number of times you check your blood glucose levels. If they run too high or low, please seek medical advice.

For further advice please contact your community pharmacist, GP, or specialist (if under one). If you are acutely unwell and need urgent medical attention, please contact NHS 111, or attend your local Emergency department