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SGLT2 Inhibitors (, , Empagliflozin, )

What does this medication do? These drugs work to lower blood sugar by causing the kidneys to remove excess sugar from the body in the urine. They also help to lower and aid weight loss. The excess sugar that is removed in the urine contains calories and over time if your calorie intake is lower than your body’s requirements you will lose weight.

How do I take this medication? You will be prescribed one tablet to take a day. Try to take it at the same time every day. If you miss a tablet and remember later on in the day you can take it. If you remember the following day, do not take two tablets together.

Who can’t take these tablets? If you have , low kidney function, are on strong water tablets or pregnant, you should not be taking this medication.

What are the common side effects? It is normal to pass urine more often when taking this tablet and because of this you should be careful not to get dehydrated. Some people also experience urinary infections, genital thrush and constipation. Taking this medication on its own should not cause hypoglycaemia (low blood sugars) but if you are taking it with other medications such as or it may cause low blood sugars. There is a very rare but important side effect to be aware of with this medication called . If you start to feel very unwell, confused, breathing fast, thirsty and nauseated you should go to A&E and tell them you are on this drug. Cases of a rare but serious and potentially life-threatening infection (Fournier’s gangrene) have been associated with the use of SGLT-2 inhibitors. If you experience severe pain, redness of the skin, swelling or tenderness in the genital or perineal area (the perineum is the space between the anus and the scrotum in the male and between the anus and the vulva in the female) along with fever or generally feeling unwell, you should seek URGENT medical attention mentioning that you have been on SGLT-2 treatment that will need stopping if Fournier’s gangrene is suspected.

Do I need to be monitored? Your doctor will monitor your kidney function whilst you are taking this medication and if it drops you may be asked to stop the medication. If you develop a foot ulcer stop taking the medication and see your GP.

Are there any sick day rules? If you are unable to eat and drink due to vomiting or nausea you should stop this medication until you are able to eat and drink again.

What about driving? You do not need to inform the DVLA if you are on this medication unless any of the following applies to you; • You have problems with vision in both eyes, or in the remaining eye if you have sight in one eye only • You develop any problems with the circulation, or sensation in your legs or feet which makes it necessary for you to drive certain types of vehicles only, for example automatic vehicles, or vehicles with a hand operated accelerator or brake. This must be shown on your driving licence. • You need laser treatment to both eyes or in the remaining eye if you have sight in one eye only. You need to notify the DVLA if you hold a Group 2 licence and are taking this medication. If you have any queries about this medication, contact your GP.

Data Protection Any personal information is kept confidential. There may be occasions where your information needs to be shared with other care professionals to ensure you receive the best care possible. In order to assist us to improve the services available, your information may be used for clinical audit, research, teaching and anonymised for National NHS Reviews and Statistics. Further information is available via Gateshead Health NHS Foundation Trust website or by contacting the Data Protection Officer by telephone on 0191 445 8418 or by email [email protected]

This leaflet can be made available in other languages and formats upon request

NoIL645 Version: 3 First Published: 05/2018 Last Reviewed: 06/2020 Review Date: 06/2022

Author: Nutrition & Dietetics 2 www.qegateshead.nhs.uk