Name Brand SGLT2 Inhibitors
The four FDA-approved SGLT2 inhibitors available in the United States are Jardiance (empagliflozin), Invokana (canagliflozin), Farxiga (dapagliflozin), and Steglatro (ertugliflozin). 1
Available Brand Names and Generic Equivalents
- Jardiance contains empagliflozin and is available in 10 mg and 25 mg oral tablets 2
- Invokana contains canagliflozin and is available in 100 mg and 300 mg oral tablets 3
- Farxiga (also marketed as Forxiga in some regions) contains dapagliflozin and is available in 10 mg oral tablets 4, 5
- Steglatro contains ertugliflozin 1
Mechanism of Action
All four agents work through the same mechanism: blocking sodium-glucose cotransporter 2 (SGLT2) in the proximal renal tubule, which increases urinary glucose excretion and reduces blood glucose levels independently of insulin 1, 6. This insulin-independent mechanism allows these medications to provide complementary therapy when combined with other antidiabetic agents 6.
Clinical Distinctions Between Agents
Cardiovascular Indications
- Empagliflozin (Jardiance) is FDA-approved to reduce cardiovascular death in adults with type 2 diabetes and established cardiovascular disease 1
- Canagliflozin (Invokana) is FDA-approved to reduce the risk of MI, stroke, or CV death in adults with T2D and CV disease 7
- Dapagliflozin (Farxiga) is FDA-approved to reduce the risk of hospitalization for heart failure in adults with T2D and established CV disease or multiple CV risk factors, and also to reduce CV death and hospitalization for HF in adults with HFrEF regardless of diabetes status 7, 8
Renal Protection
Canagliflozin is FDA-approved to reduce the risk of end-stage kidney disease, doubling of serum creatinine, CV death, and hospitalization for HF in patients with T2D and diabetic nephropathy with albuminuria 7. All three major agents (empagliflozin, canagliflozin, dapagliflozin) have demonstrated renal benefits in cardiovascular outcomes trials 7.
Important Safety Distinctions
Canagliflozin has been associated with increased amputation risk and bone fractures in some trials, while empagliflozin and dapagliflozin have not shown these signals 1. This represents a clinically meaningful difference when selecting among agents for patients with peripheral vascular disease or osteoporosis risk factors.