Why have I been given this information?
You have been sent this information because you are taking or are about to take a drug called an SGLT-2 inhibitor, for the treatment of Diabetes, kidney disease, or heart disease.
Research has found that there are very rare, but important side effects, which appear to be associated with taking this medication. It is important to note that these side effects do not outweigh the benefits to using this medication. You should be aware of these potential side effects as if they are not identified early on, they can be extremely dangerous.
The name of these drugs end with ‘gliflozin’. Examples include:
- Empagliflozin (Jardiance)
- Dapagliflozin (Forxiga)
- Canagliflozin (lnvokana)
What are these side effects?
Diabetic ketoacidosis is a condition in which there is too much acid in the blood, as a result of changes in blood sugar. This can very rarely happen in some people with type 2 diabetes and these drugs can increase this risk even when the blood glucose concentration is normal. If left untreated, this can be life threatening, and require urgent treatment in hospital.
Fournier’s gangrene is a very rare and severe skin infection in the genital or groin area, which can lead to abscesses and skin destruction. If treatment is delayed, this condition can be fatal.
How common are these side effects?
Diabetic ketoacidosis is estimated to occur in between 1 in 1000 and 1 in 10,000 patients treated with an SGLT-2 inhibitor.
Fournier’s gangrene can occur in people who do not have diabetes but is more common in people with diabetes. It is estimated to occur in approximately 1 in 100,000 patients treated with an SGLT-2 inhibitor. This appears to be approximately 12 times more common than in patients treated with other diabetes drugs. Most cases of Fournier’s gangrene occur in men, but there have been reports of Fournier’s Gangrene in women taking SGLT2 inhibitors.
What should I look out for?
The following symptoms might indicate diabetic ketoacidosis: nausea, vomiting, fast breathing, abdominal pains, unusual drowsiness, or fever.
The following symptoms might indicate Fournier’s gangrene: severe pain, tenderness, redness, or swelling in the genital or groin area accompanied by fever or generally feeling unwell.
If you have or suspect any of these symptoms, stop this medication and seek help immediately, even if your blood sugars are near normal.
If we are closed, please dial 111 or 999 if you are severely unwell. Explain that you are worried about one of the conditions above, and include any symptoms you are experiencing. Stop this medication until you receive further medical advice.
More information on Diabetic ketoacidosis can be found on the NHS website.