Practical guide to prescribing sodium-glucose cotransporter 2 inhibitors for cardiologists

Orly Vardeny
Muthiah Vaduganathan

The sodium-glucose cotransporter 2 (SGLT2) inhibitors are a class of glucose-lowering therapies that have been shown to reduce risks of heart failure (HF) events in patients with type 2 diabetes mellitus (T2DM) at high-risk for or with cardiovascular disease. The United States Food and Drug Administration has expanded the regulatory label for empagliflozin and canagliflozin for use to lower cardiovascular risk in patients with T2DM and cardiovascular disease. SGLT2 inhibitors are being actively studied in the treatment of patients with HF, including in those without diabetes mellitus. Despite the accumulating data supporting this class of therapies in HF prevention, cardiologists infrequently prescribe SGLT2 inhibitors, potentially due to lack of familiarity with their use. We provide an up-to-date practical guide highlighting important elements for treatment initiation, dosing, anticipated adverse effects, and barriers to uptake.

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JACC Heart Fail. 2019;7:169-172