Medicine & USMLE

SGLT2 Inhibitors

Diabetes Drugs
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  2. Rapid Acting Insulin
  3. Short Acting Insulin
  4. Intermediate Acting Insulin
  5. Long Acting Insulin
  6. Metformin
  7. Sulfonylureas
  8. Meglitinides
  9. Thiazolidinediones (TZDs)
  10. DPP-4 Inhibitors
  11. Incretin Mimetics
  12. SGLT2 Inhibitors
  13. Alpha Glucosidase Inhibitors
  14. Pramlintide


SGLT2 Inhibitors, short for sodium-glucose co-transporter 2 inhibitors, are a class of drugs with names that end in -gliflozin, such as canagliflozin, empagliflozin, and dapagliflozin. These drugs are used to lower blood sugar levels in order to treat type 2 diabetes mellitus. By inhibiting the SGLT2 cotransporters, these drugs decrease the reabsorption of glucose in the kidneys, especially in the proximal convoluted tubules of the kidney. Decreased reabsorption of glucose in the kidney causes increased glucose in the urine.

Side effects of taking SGLT2 inhibitors include dizziness, hypotension, and weight loss. Patients taking SGLT2 inhibitors are at an increased risk of developing urinary tract infections. Since these drugs require some kidney function in order to work, they should be used with caution in patients with kidney damage. Last but not least, SGLT2 inhibitors can cause vaginal candidiasis.

Key Points

  • Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors
    • Drug Name
      • -gliflozin Ending
        • Canagliflozin
        • Dapagliflozin
        • Empagliflozin
    • Mechanism
      • Blocks Glucose Reabsorption in the Kidney
        • Acts on the proximal convoluted tubule
          • Inside the nephron of the kidney, glucose is filtered out of the bloodstream and into the urine. Normally, the glucose is then reabsorbed back into the blood at the proximal tubule. SGLT2 Inhibitors block that reabsorption, leading to lower blood glucose levels
      • Increase glucose excretion in urine
        • Due to the blocked glucose reabsorption in the kidney, higher levels of glucose are found in the urine.
        • Called glycosuria
    • Clinical Use
      • Treats Type 2 Diabetes Mellitus (DM)
        • The end result of SGLT2 inhibitors is a decrease of blood glucose levels in patients with type 2 diabetes mellitus
    • Side Effects
      • Causes weight loss
      • Causes hypotension
        • SGLT2 inhibitors have a slight diuretic effect that lowers blood pressure
      • Causes dizziness (orthostatic hypotension)
        • Blood pressure that decreases with sudden movements, like standing up too quickly
        • Causes a feeling of dizziness
        • Instruct the patient to rise slowly to avoid dizziness and falls
      • Causes urinary tract infections (UTIs)
        • Due to an increase in glucose in the urine
      • Causes vaginal candidiasis
        • An infection in the vulvovaginal region caused by the bacteria candida
        • Due to an increase in glucose in the urine
      • Use with caution in patients with kidney damage