Ertugliflozin Brand Name– STEGLATRO
What is Ertugliflozin
Ertugliflozin is an oral sodium-glucose co-transporter 2 (SGLT2) inhibitor.
Ertugliflozin works by blocking the reabsorption of glucose by the kidney, which results in increased glucose excretion and reduced blood glucose concentrations.
Ertugliflozin is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus (DM). Ertugliflozin monotherapy reduced A1C by 0.8 to 1% during clinical trials. The drug is not recommended for use in patients with severe renal impairment, as drug efficacy is reduced and the risk for renal-related adverse events may be increased.
SGLT2 inhibitor therapy has been shown to reduce the incidence of heart failure (HF), and some SGLT2 inhibitors have reduced overall cardiovascular (CV) risk.
Metformin is first-line in the treatment of type 2 DM.
Additional therapy with an SGLT2 inhibitor with evidence of reducing HF and/or chronic kidney disease (CKD) progression should be considered in patients with indicators of high-risk or established CKD or HF, independent of baseline A1C or individualized A1C target.
SGLT2 inhibitors with proven CV-risk reduction are also an alternative treatment option in DM patients with indicators of high-risk or established CV disease who cannot tolerate a glucagon-like peptide-1 receptor agonist (GLP-1 RA).
Indications
- type 2 diabetes mellitus
For the treatment of type 2 diabetes mellitus in combination with diet and exercise
Side Effects
- back pain
- balanitis
- candidiasis
- cystitis
- dehydration
- diabetic ketoacidosis
- diuresis
- dysuria
- headache
- hypercholesterolemia
- hyperlipidemia
- hyperphosphatemia
- hypoglycemia
- hypotension
- hypovolemia
- increased urinary frequency
- infection
- lower limb amputation
- necrotizing fasciitis
- nocturia
- orthostatic hypotension
- pharyngitis
- phimosis
- polydipsia
- polyuria
- renal failure (unspecified)
- syncope
- tissue necrosis
- urinary urgency
- vaginitis
- weight loss
Monitoring Parameters
- blood glucose
- glycosylated hemoglobin A1c (HbA1c)
- serum cholesterol profile
- serum creatinine/BUN
Contraindications
- adrenal insufficiency
- balanitis
- breast-feeding
- burns
- children
- dehydration
- diabetic ketoacidosis
- dialysis
- fever
- geriatric
- hepatic disease
- hypercholesterolemia
- hypercortisolism
- hyperglycemia
- hyperthyroidism
- hypoglycemia
- hypotension
- hypothyroidism
- hypovolemia
- infants
- infection
- lower limb amputation
- malnutrition
- pituitary insufficiency
- pregnancy
- pyelonephritis
- renal disease
- renal failure
- renal impairment
- surgery
- tissue necrosis
- trauma
- type 1 diabetes mellitus
- urinary tract infection (UTI)
- vaginitis
Interactions
- Acebutolol
- Acetazolamide
- Aliskiren; Valsartan
- Amlodipine; Benazepril
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Olmesartan
- Amlodipine; Telmisartan
- Amlodipine; Valsartan
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Androgens
- Angiotensin II receptor antagonists
- Angiotensin-converting enzyme inhibitors
- Atenolol
- Atenolol; Chlorthalidone
- atypical antipsychotic
- Azilsartan
- Azilsartan; Chlorthalidone
- Benazepril
- Benazepril; Hydrochlorothiazide, HCTZ
- Bendroflumethiazide; Nadolol
- Beta-blockers
- Betaxolol
- Bisoprolol
- Bisoprolol; Hydrochlorothiazide, HCTZ
- Bortezomib
- Brimonidine; Timolol
- Candesartan
- Candesartan; Hydrochlorothiazide, HCTZ
- Captopril
- Captopril; Hydrochlorothiazide, HCTZ
- Carbonic anhydrase inhibitors
- Carteolol
- Carvedilol
- Chloroquine
- Chlorthalidone; Clonidine
- Chromium
- Clarithromycin
- Clonidine
- Corticosteroids
- Daclatasvir
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Diazoxide
- Dorzolamide; Timolol
- Elbasvir; Grazoprevir
- Enalapril, Enalaprilat
- Enalapril; Felodipine
- Enalapril; Hydrochlorothiazide, HCTZ
- Eprosartan
- Eprosartan; Hydrochlorothiazide, HCTZ
- Esmolol
- Estrogens
- Ethanol
- Fibric acid derivatives
- Fluoxetine
- Fluoxetine; Olanzapine
- Fosinopril
- Fosinopril; Hydrochlorothiazide, HCTZ
- Garlic, Allium sativum
- Glecaprevir; Pibrentasvir
- Hydrochlorothiazide, HCTZ; Irbesartan
- Hydrochlorothiazide, HCTZ; Lisinopril
- Hydrochlorothiazide, HCTZ; Losartan
- Hydrochlorothiazide, HCTZ; Metoprolol
- Hydrochlorothiazide, HCTZ; Moexipril
- Hydrochlorothiazide, HCTZ; Olmesartan
- Hydrochlorothiazide, HCTZ; Propranolol
- Hydrochlorothiazide, HCTZ; Quinapril
- Hydrochlorothiazide, HCTZ; Telmisartan
- Hydrochlorothiazide, HCTZ; Valsartan
- Hydroxychloroquine
- Irbesartan
- Isocarboxazid
- Labetalol
- Lanreotide
- Ledipasvir; Sofosbuvir
- Levobetaxolol
- Levobunolol
- Lisinopril
- Lomefloxacin
- Losartan
- Mecasermin rinfabate
- Mecasermin, Recombinant, rh-IGF-1
- Methazolamide
- Metoprolol
- Moexipril
- Monoamine oxidase inhibitors
- Nadolol
- Nebivolol
- Nebivolol; Valsartan
- Octreotide
- Olmesartan
- Orlistat
- Pasireotide
- Pegvisomant
- Penbutolol
- Perindopril
- Perindopril; Amlodipine
- Phenelzine
- Phenothiazines
- Pindolol
- Propranolol
- Quinapril
- Quinolones
- Ramipril
- Sacubitril; Valsartan
- Selegiline
- Sofosbuvir
- Sofosbuvir; Velpatasvir
- Sofosbuvir; Velpatasvir; Voxilaprevir
- Somatropin, rh-GH
- Sotalol
- Sparfloxacin
- Sulfonamides
- Sympathomimetics
- Telmisartan
- Timolol
- tobacco
- Trandolapril
- Trandolapril; Verapamil
- Tranylcypromine
- Trovafloxacin, Alatrofloxacin
- Valsartan