Why Medications Are Referred to by Class Names Rather Than Individual Names
Medications are referred to by their class names (such as SGLT2 inhibitors) rather than individual drug names to facilitate clinical decision-making based on established class effects while acknowledging that specific drugs within the class may have varying properties, efficacy profiles, and safety considerations. 1
Key Reasons for Using Class Names in Medical Communication
Class-wide therapeutic effects: Many medications within the same class share similar primary mechanisms of action and therapeutic benefits. For example, SGLT2 inhibitors as a class reduce cardiovascular events and heart failure hospitalizations in patients with type 2 diabetes mellitus (T2DM) 1
Simplification of clinical guidelines: Using class names helps streamline clinical recommendations and treatment algorithms, making them more accessible and easier to implement 1
Evidence-based medicine approach: Clinical trials often demonstrate class effects that apply broadly across multiple drugs within the same category, allowing clinicians to make evidence-based decisions at the class level 1
Educational efficiency: Teaching about medication classes helps clinicians understand pharmacological principles that apply across multiple drugs rather than memorizing individual drug properties 2, 3
Individual Drug Differences Within Classes
While class names are useful, important differences exist between individual medications within the same class:
Selectivity variations: Within the SGLT2 inhibitor class, dapagliflozin, empagliflozin, and ertugliflozin are highly selective for SGLT2, while canagliflozin has greater potential for inhibiting SGLT1 receptors, and sotagliflozin is considered a "dual SGLT1/SGLT2 inhibitor" 1
Clinical outcome differences: Empagliflozin demonstrated a 38% reduction in cardiovascular death in the EMPA-REG OUTCOME trial, while canagliflozin showed no significant reduction in cardiovascular death in the CANVAS Program despite similar reductions in major adverse cardiovascular events (MACE) 1
Safety profile variations: Canagliflozin has been associated with increased risk of amputation and bone fractures, which has not been observed with empagliflozin or dapagliflozin 1
When Individual Drug Names Are Preferred
Prescribing decisions: When writing prescriptions, specific drug names must be used 4, 5
Contraindications or cautions: When discussing specific contraindications, such as severe renal impairment for SGLT2 inhibitors or history of amputation risk with canagliflozin specifically 1
FDA approvals: When discussing specific FDA indications, such as empagliflozin's approval for reducing cardiovascular death in adults with T2DM and cardiovascular disease 1
Balancing Class and Individual Drug Discussions
A balanced approach to medication discussions includes:
Starting with class effects and mechanisms (e.g., SGLT2 inhibitors block glucose reabsorption in the proximal tubule) 1, 3
Following with specific drug considerations when relevant (e.g., empagliflozin's proven mortality benefit) 1
Acknowledging emerging evidence for newer drugs within established classes (e.g., newer SGLT2 inhibitors like ertugliflozin) 1, 5
Common Pitfalls to Avoid
Assuming complete class equivalence: Not recognizing important differences between drugs within the same class can lead to suboptimal treatment choices 1
Overlooking specific indications: Some medications within a class have unique FDA-approved indications that others do not 1
Ignoring safety differences: Safety profiles can vary significantly within a class, as seen with the amputation risk associated with canagliflozin but not other SGLT2 inhibitors 1