Managing the side effects of sodium-glucose cotransporter-2 inhibitors.

Kodur, Nandan; Sharew, Betemariam; Lansang, M Cecilia; Tang, W H Wilson · Cleve Clin J Med · 2025

review · Level V

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Abstract

Although sodium-glucose cotransporter-2 (SGLT2) inhibitors are widely used because of their exceptional cardiovascular and renal benefits, their side effects and corresponding management strategies have not been well characterized to date. The latest evidence suggests that class effects of SGLT2 inhibitors include volume depletion, genital fungal infections, and euglycemic diabetic ketoacidosis, while medication-specific side effects include urinary tract infections with dapagliflozin and potential increased risk of amputations with canagliflozin. Management strategies include close monitoring, adjusting medication dosages, and temporarily holding SGLT2 inhibitors when appropriate.

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