SGLT2 Inhibitor: Jardiance, Farxiga and Their Warnings
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SGLT2 inhibitor

Also called gliflozin, SGLT-2 inhibitor, empagliflozin, dapagliflozin · Reviewed

Definition: An SGLT2 inhibitor is a class of oral drugs that includes empagliflozin (Jardiance), dapagliflozin (Farxiga) and canagliflozin (Invokana). Their labels approve them for blood sugar control in type 2 diabetes, and Jardiance and Farxiga are also approved to lower risks in heart failure and chronic kidney disease.

What the labels approve

Jardiance and Farxiga labels list uses beyond blood sugar: lowering the risk of cardiovascular death and heart failure hospitalization in adults with heart failure, and lowering the risk of kidney decline in adults with chronic kidney disease. Invokana is approved for blood sugar control in adults and children 10 and older with type 2 diabetes, and to lower heart and kidney risks in some adults with type 2 diabetes. Each label sets its own uses, so the class name alone does not tell you what a given product is approved for.

Warnings on the Jardiance label

Jardiance has no boxed warning. Its warnings section lists:

  • Ketoacidosis: life-threatening, and possible with blood sugar under 250 mg/dL, which can make it easy to miss.
  • Fluid loss and low blood pressure, with kidney checks before starting (see eGFR).
  • Urinary and genital infections, including rare serious ones.
  • Low blood sugar when combined with insulin or a sulfonylurea.
  • Lower limb amputation, an imbalance seen with the class.

Why it matters for your log

SGLT2 inhibitors are often taken alongside a GLP-1 receptor agonist or other diabetes drugs. Logging every medicine together shows which combinations raise the risk of hypoglycemia on the labels. The Jardiance label also says it is not recommended in the second and third trimesters of pregnancy or while breastfeeding.

Read more on Dose Track: Jardiance side effects · Farxiga side effects · Jardiance vs Farxiga · Metformin vs Jardiance

General education drawn from labels and published studies, not personal medical advice. Your prescriber, pharmacist and the label that came with your product are the final word.
DPP-4 inhibitorA DPP-4 inhibitor is a class of oral type 2 diabetes drugs that includes sitagliptin (Januvia) and… SulfonylureaA sulfonylurea is an older class of oral type 2 diabetes drugs that includes glimepiride and glipizide… HypoglycemiaHypoglycemia means low blood glucose (blood sugar). MedlinePlus says that for many people with diabetes… GLP-1 receptor agonistA GLP-1 receptor agonist is a drug that switches on the same receptor as GLP-1 (glucagon-like peptide-1),… eGFR (estimated glomerular filtration rate)eGFR (estimated glomerular filtration rate) is a number that estimates how well your kidneys filter waste… HbA1c (hemoglobin A1C)HbA1c , or A1C, is a blood test that shows your average blood sugar over the past two to three months.…

Frequently asked questions

Does Jardiance have a boxed warning?+
No. Ketoacidosis is the first serious risk in its warnings section.
Can an SGLT2 inhibitor cause low blood sugar?+
The Jardiance label says the risk is higher when it is combined with insulin or a sulfonylurea, whose dose may be lowered.

Sources

  1. Jardiance (empagliflozin) US prescribing information, DailyMed
  2. Farxiga (dapagliflozin) US prescribing information, DailyMed

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