SGLT2 Inhibitors

SGLT2 inhibitors are a group of prescription medicines that you take by mouth. They were first approved by the US Food and Drug Administration (FDA), along with diet and exercise, to lower blood sugar in adults with type 2 diabetes.^1,2

Over time, research showed that some of these medicines also protect the kidneys. Today, they are used to help slow kidney disease, including the kidney damage caused by IgA nephropathy.^1,2

How do SGLT2 inhibitors work?

SGLT2 inhibitors lower blood sugar by stopping the kidneys from reabsorbing sugar. The extra sugar then leaves your body through your urine. These medicines also lower the pressure inside the small blood vessels of your kidneys and heart. Lowering that pressure takes strain off your kidneys, which is what helps protect them and slow the disease.^1,2

Why are they used in IgA nephropathy?

A major goal in treating IgA nephropathy is to lower the amount of protein leaking into your urine and to slow the loss of kidney function. SGLT2 inhibitors help with both. They are usually used alongside other treatments, such as an ACE inhibitor or an ARB, since these medicines work in different ways to protect your kidneys.^2,3

Which SGLT2 inhibitors are FDA-approved to protect the kidneys?

Several SGLT2 inhibitors are available in the United States. Not all are approved for kidney protection, so it helps to know the differences:¹

• Dapagliflozin (Farxiga®) – Approved to slow chronic kidney disease in adults at risk of it getting worse, with or without type 2 diabetes.
• Empagliflozin (Jardiance®) – Approved to slow chronic kidney disease in adults at risk of it getting worse, with or without type 2 diabetes.
• Canagliflozin (Invokana®) – Approved to help protect the kidneys in people who have type 2 diabetes along with kidney disease.
• Ertugliflozin (Steglatro®) – Used mainly to lower blood sugar in type 2 diabetes. It is not approved specifically to protect the kidneys.

Your doctor will choose the option that best fits your health and your other medicines.^1,2

What are the possible side effects?

Side effects can vary depending on the specific drug you are taking. Possible side effects of SGLT2 inhibitors include:²

• Genital yeast infections – These can happen because of the extra sugar leaving your body in your urine.
• Dehydration – Some people lose too much fluid, which can leave you feeling lightheaded.
• Ketoacidosis – This is a dangerous build-up of acids in the blood. It is more of a risk when the body does not make enough insulin.
• Changes in potassium – These medicines can change the level of potassium in your blood, which your doctor can check.

These are not all the possible side effects of SGLT2 inhibitors. Talk to your doctor about what to expect when taking SGLT2 inhibitors. You also should call your doctor if you have any changes that concern you when taking SGLT2 inhibitors.

Other things to know

By lowering the pressure in your blood vessels, SGLT2 inhibitors also help protect your heart. This is one reason they are valuable for many people who have kidney disease.²

Before beginning treatment for IgA nephropathy, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.

Talk to your doctor

Every person’s treatment plan is different. Your doctor can explain whether an SGLT2 inhibitor is a good option for you, which one fits best, and what to watch for once you start. Do not stop or change your medicine without talking to your care team first.