What are the names of SGLT-2 (Sodium-Glucose Linked Transporter-2) inhibitors?

SGLT-2 Inhibitors: Names and Classification

SGLT-2 inhibitors currently available include canagliflozin, dapagliflozin, empagliflozin, ertugliflozin, and sotagliflozin, with the first three being the most commonly used for chronic kidney disease and cardiovascular risk reduction. 1

Main SGLT-2 Inhibitors

Primary SGLT-2 Inhibitors

• Dapagliflozin - Highly selective for SGLT-2 1
• Empagliflozin - Highly selective for SGLT-2 1
• Canagliflozin - Has greater potential for inhibiting SGLT-1 receptors in addition to SGLT-2 1
• Ertugliflozin - Highly selective for SGLT-2 1

Dual SGLT Inhibitor

• Sotagliflozin - Referred to as a "dual SGLT1/SGLT2 inhibitor" due to its higher affinity for SGLT-1 receptors 1

Selectivity Characteristics

SGLT-2 inhibitors vary in their selectivity for the SGLT-2 co-transporter:

• Most selective for SGLT-2: Dapagliflozin, empagliflozin, and ertugliflozin 1
• Less selective with SGLT-1 inhibition: Canagliflozin (has reported inhibition of intestinal glucose absorption) 1
• Dual action: Sotagliflozin (has the most affinity to SGLT-1 receptors) 1

Clinical Applications

SGLT-2 inhibitors are primarily used for:

1. Type 2 diabetes management 1
2. Chronic kidney disease - Particularly for patients with eGFR ≥20 mL/min/1.73 m² 1, 2
3. Cardiovascular risk reduction - Especially in patients with established cardiovascular disease 1
4. Heart failure - Particularly heart failure with reduced ejection fraction 1

Mechanism of Action

SGLT-2 inhibitors work by:

• Blocking renal glucose reabsorption in the proximal convoluted tubule 1
• Increasing urinary glucose excretion 1
• Reducing the renal glucose threshold 1
• Promoting glycosuria in diabetic patients 1

Important Clinical Considerations

When prescribing SGLT-2 inhibitors, be aware that:

• They can be used in patients with eGFR ≥20 mL/min/1.73 m² 1, 2
• They should be used with caution in patients with renal insufficiency (GFR < 45 mL/min/1.73 m²) 1
• Common adverse effects include genitourinary tract infections 1
• Rare but serious adverse effects include euglycemic ketoacidosis 1
• They provide significant cardiovascular and renal benefits beyond glucose control 1

SGLT-2 inhibitors represent an important class of medications that extend beyond glycemic control to provide significant cardiovascular and renal protection, making them increasingly important in the management of type 2 diabetes and its complications.