§ Sodium glucose cotransporter 2 (SGLT2) inhibitors are
antidiabetic drugs.
§ SGLT2 inhibitors include
Canagliflozin, Dapagliflozin, Empagliflozin,
Ertugliflozin and other Gliflozins.
§ SGLT2 inhibitors prevent the reabsorption of glucose
and facilitate its excretion through urine by inhibiting Sodium-glucose
co-transporter-2 in the proximal convoluted tubule, which results in decrease
in blood sugar.
§ SGLT2
inhibitors such as Dapagliflozin, Canagliflozin and Ipragliflozin are metabolised by
glucuronidation predominantly by UGT1A9 enzyme.
§ The drugs inhibiting UGT1A9 such as Mefenamic acid and
Probenecid slightly increased the plasma exposure of Dapagliflozin and
Canagliflozin respectively.
§ Rifampicin
and other UGT inducers such as Phenytoin, Phenobarbital and Ritonavir were observed to
decrease the plasma levels of Canagliflozin, insignificantly.
§ The pharmacokinetics parameters
of Warfarin, Digoxin, Simvastatin, Valsartan, Oral
contraceptives containing Ethinyl estradiol and Levonorgestrel and Thiazide diuretics (Hydrochlorothiazide)
were not altered significantly by the concomitant administration of
Canagliflozin or Dapagliflozin.
§ Coadministration of SGLT2 inhibitors
such as Canagliflozin, Dapagliflozin and Ipragliflozin with other oral
antidiabetic drugs did not result in any clinically significant interactions.
§ SGLT2 inhibitors could be
coadministered with any medicines without dosage adjustments except
Canagliflozin which needs higher dosage while using along with UGT enzyme
inducers.
§ Healthcare professionals through the screening, education, and
follow up on suspected drug interactions could reduce the risk of adverse
effects.
§ The patients are encouraged to ask their doctor or pharmacist to
look over their list for any potentially dangerous combinations.
§ It is recommended that people fill all their prescriptions at one
pharmacy, if possible.
