From the Guidelines
The treatment of SGLT2 inhibitor-associated balanitis involves both immediate management with topical antifungal medications and preventive measures, including meticulous genital hygiene and consideration of temporarily discontinuing the SGLT2 inhibitor in severe cases. When managing SGLT2 inhibitor-associated balanitis, it is essential to consider the potential for increased risk of genital mycotic infections, especially in women, as noted in the 2025 standards of care in diabetes 1. The use of SGLT2 inhibitors may need to be discontinued if the effect of genital mycotic infections becomes burdensome. Key considerations in the treatment of SGLT2 inhibitor-associated balanitis include:
- Immediate management with topical antifungal medications such as clotrimazole 1% cream applied twice daily for 7-14 days
- In more severe cases, oral fluconazole 150mg as a single dose may be necessary
- Temporarily discontinuing the SGLT2 inhibitor in consultation with the prescribing physician
- Preventive measures, including meticulous genital hygiene with gentle cleansing using water, thorough drying after washing, wearing loose cotton underwear, and avoiding tight clothing
- Educating patients about the importance of glycemic control as high blood glucose levels promote fungal growth The increased risk of genital mycotic infections associated with SGLT2 inhibitors, as reported in the 2025 standards of care in diabetes 1, highlights the need for careful consideration and management of this potential side effect.
From the Research
SGLT2 Inhibitor-Associated Balanitis Treatment
There are no specific studies provided that directly address the treatment for Sodium-Glucose Linked Transporter 2 (SGLT2) inhibitor-associated balanitis. However, the following information can be gathered from the available studies:
- The studies 2, 3, 4 mention that SGLT2 inhibitors are associated with an increased risk of genital infections, including balanitis, but do not provide specific treatment options.
- The study 2 found that the risk of genital infections, including balanitis, was approximately 3-fold higher in patients taking SGLT2 inhibitors compared to those taking dipeptidyl peptidase-4 inhibitors.
- The study 3 reported that urinary tract infections and worsening of renal function were common causes of discontinuation of SGLT2 inhibitors, but did not provide specific information on the treatment of balanitis.
- The study 4 mentioned that genital infections, including balanitis, were more frequent in patients taking dapagliflozin, an SGLT2 inhibitor, but did not provide treatment options.
Key Points
- SGLT2 inhibitors are associated with an increased risk of genital infections, including balanitis.
- The risk of genital infections is higher in patients taking SGLT2 inhibitors compared to those taking other antidiabetic medications.
- There is no specific information available on the treatment of SGLT2 inhibitor-associated balanitis in the provided studies.