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SGLT2 Inhibitors

Fournier's gangrene and DKA

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If you have been prescribed an SGLT inhibitor such as

  • Dapagliflozin (Forxiga), Empagliflozin (Jardiance),

  • Canagliflozin (Invokana), Ertugliflozin (Steglatro)

This information is to help support you in using your medication safely.

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These drugs work by helping the kidneys to pass excess sugar out of the body in urine. This can help to lower glucose (sugar) levels in your blood. If your urine is tested with a dipstick, it would show that glucose is present, which is normal. These medications can also be used to treat a condition called Heart Failure (HF), which is sometimes called Congestive Cardiac Failure (CCF).

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How to take this medication

You should take this tablet in the morning and at the same time each day. Swallow the tablet whole with some water, preferably before the first meal of the day.

If you miss a dose, you should take it as soon as you remember; however, never take a double dose on the same day.

Potential side effects

Very common (may affect more than 1 in 10 people)

  • Thrush (more common in females), Low blood sugar

Common (may affect up to 1 in 10 people)

  • Urine infection, Dizziness, Increased urination, Dehydration, Thirst, Low blood pressure

Rare (may affect up to 1 in 1000 people)

  • Diabetes Ketoacidosis (DKA) This is a serious and potentially left threatening complication.

Rare (Unknown frequency)

  • Fournier's gangene

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Fournier’s Gangrene- this is a serious infection of the genital area, Seek urgent medical attention if you experience a combination of pain, tenderness, swelling or redness of the genitals or perineal area. 

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Diabetic Ketoacidosis (DKA)

This side effect is rare, affecting up to one in 1,000 people who take SGLT2 inhibitors. However, it is serious and potentially life threatening.

Signs and symptoms of Diabetic Ketoacidosis (DKA)

You, your family, friends, and carers should know these signs so you can take immediate action.

  • Feeling or being sick,, Feeling drowsy, Abdominal (stomach) pain, Fast and deep breathing

  • Sweet smelling breath (like pear drops or acetone)

If you experience any of these, you must seek immediate medical attention.

 

What to do if you are unwell

There is a higher risk of diabetic ketoacidosis when you are unwell. Therefore, it is very important that you follow the SICK DAY RULES If you become unwell and are not eating and drinking normally.

If you become unwell, for example, with an infection, diarrhoea and vomiting, flu, severe cold, pneumonia, COVID-19 or are not eating and drinking normally you should take the following steps in line with Sick Day Rules:

  • You should temporarily stop taking your SGLT2 inhibitor until you are feeling better.

  • Drink plenty of fluids to avoid dehydration.

  • Contact your GP or out of hours service or A+E if you are concerned or not improving

 

YOU MUST NOT FOLLOW A LOW CALORIE OR KETO TYPE DIET WHEN TAKING THIS MEDICATION

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