Which drug class does sotagliflozin belong to?

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Sotagliflozin Drug Classification

You should tell your patient that sotagliflozin is an SGLT1/SGLT2 inhibitor—a dual sodium-glucose cotransporter inhibitor that works differently from other diabetes medications by blocking glucose reabsorption in both the kidneys and intestines. 1

What Makes Sotagliflozin Unique

Sotagliflozin is distinct from other SGLT inhibitors because it blocks two different transporters:

  • SGLT2 in the kidneys: Increases urinary glucose excretion, similar to other SGLT2 inhibitors like empagliflozin and dapagliflozin 1
  • SGLT1 in the intestines: Delays glucose absorption from food, reducing post-meal glucose spikes and increasing GLP-1 levels 2, 3

This dual mechanism differentiates sotagliflozin from selective SGLT2 inhibitors, making it the first-in-class dual SGLT1/SGLT2 inhibitor. 4, 5

FDA-Approved Indication (Critical Context)

Sotagliflozin is FDA-approved specifically to reduce cardiovascular death, heart failure hospitalization, and urgent heart failure visits in patients with heart failure or type 2 diabetes with chronic kidney disease and cardiovascular risk factors. 1

Important caveat: Sotagliflozin is NOT currently FDA-approved for glycemic management of type 1 or type 2 diabetes in the United States. 1, 6 This distinguishes it from other SGLT2 inhibitors that are primarily marketed for diabetes control.

How to Explain This to Your Patient

You can explain: "This medication helps your heart and kidneys by removing extra glucose through your urine and also slows down how quickly your body absorbs sugar from food. It's different from insulin and works independently of your body's insulin production." 3

Common Pitfall to Avoid

Do not describe sotagliflozin as simply an "SGLT2 inhibitor"—this is technically incomplete. While it does inhibit SGLT2, its dual SGLT1/SGLT2 mechanism is what defines the drug and explains its unique effects on intestinal glucose absorption and GLP-1 secretion. 2, 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Efficacy and safety of sotagliflozin in treating diabetes type 1.

Expert opinion on pharmacotherapy, 2018

Research

Combined SGLT1 and SGLT2 Inhibitors and Their Role in Diabetes Care.

Diabetes technology & therapeutics, 2018

Research

Sotagliflozin as a potential treatment for type 2 diabetes mellitus.

Expert opinion on investigational drugs, 2015

Guideline

Sotagliflozin in Type 1 Diabetes Mellitus

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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