TABLE 1.

Potential Adverse Effects of SGLT2 Inhibitors

Adverse Effects	Details
Polyuria, urinary frequency	A common side effect, but generally well tolerated. Prescribe cautiously in those with chronic urinary tract issues such as benign prostatic hypertrophy or urinary incontinence.
Orthostasis, dehydration	A theoretical risk, but volume-related adverse events were not increased in large CVOTs. Drug should be withheld when dehydration is a risk. Patients should be encouraged to ensure adequate oral hydration at all times.
DKA	Has occurred in patients with type 1 diabetes (do not use) or in ill, hospitalized, or postoperative patients with type 2 diabetes. Drug should be held during acute illness, when hospitalized, and at least 3 days preoperatively.
Genitourinary infections	Mostly genital mycotic infections (especially in women and uncircumcised men). There is a theoretical increased risk of bacterial urinary tract infections, so it is best to avoid use in high-risk patients (e.g., those with prior severe urinary tract infections or indwelling catheters).
Fournier’s gangrene	Mainly from post-marketing reports of drug adverse events. There is a technically conceivable, but uncertain relationship because this is a rare condition. It is best to avoid use in severely obese patients who are bedbound, especially if they have poor perineal hygiene.
Fractures	Found in the CANVAS Program only and not reproduced in trials of other agents, so this is likely not a class adverse effect.
Lower-extremity amputations	Found in the CANVAS Program and possibly VERTIS CV trials only, and was not reproduced in trials with other agents, so this is likely not a class adverse effect.