Indications
Sotagliflozin is used in adults with heart failure, and in adults with type 2 diabetes who have chronic kidney disease and other heart risk factors, to lower the risk of dying from heart disease, being admitted to hospital for heart failure, and needing urgent visits for heart failure.
How It Works
Sotagliflozin blocks two sugar transporters called SGLT2 and SGLT1. Blocking SGLT2 in the kidneys makes the body pass more sugar and salt in the urine, which lowers blood sugar and reduces fluid load on the heart. Blocking SGLT1 in the gut slows sugar absorption after meals.
Dosage and Administration
The usual starting dose is 200 mg once daily, taken no more than 1 hour before the first meal of the day. The doctor may increase it to 400 mg once daily if it is well tolerated and the patient is stable. Take it as prescribed.
- Swallow the tablet whole.
- If you miss a dose by more than a few hours, skip it and take the next dose the following day as usual.
Interactions
Taking it with Insulin or sulfonylureas (such as Gliclazide or Glimepiride) increases the risk of low blood sugar, so their doses may need lowering. It adds to the effect of diuretics such as Furosemide, which may cause dehydration or low blood pressure. It can raise Digoxin levels, so monitoring is advised. Rifampicin and some other enzyme inducers may reduce its effect. Lithium levels may fall.
Contraindications
- Allergy to Sotagliflozin or any ingredient.
- Not for type 1 diabetes, because of the risk of ketoacidosis.
- People on dialysis.
Side Effects
Common side effects include urinary tract infections, genital fungal infections, diarrhoea, low blood sugar (mainly with Insulin or sulfonylureas), dizziness and signs of dehydration such as feeling light-headed on standing.
Get urgent medical help if you have nausea, vomiting, stomach pain, unusual tiredness or trouble breathing (possible ketoacidosis, even with normal blood sugar), pain, tenderness or swelling of the genital or anal area with fever (a rare serious infection), fainting, or signs of an allergic reaction.
Pregnancy and Lactation
Not recommended during the second and third trimesters of pregnancy because of possible effects on the baby’s kidneys; tell your doctor if you are pregnant or planning pregnancy. Breastfeeding is not recommended while taking it.
Precautions and Warnings
Kidney function should be checked before and during treatment. Drink enough fluids, especially in hot weather or illness. Your doctor may advise stopping it temporarily before surgery or during serious illness, fasting or heavy vomiting, to lower the risk of ketoacidosis. Keep the genital area clean to reduce infections. Take extra care in older people and those on diuretics.
Overdose
Overdose may cause dehydration, low blood pressure or low blood sugar. Contact a doctor or go to hospital promptly. Treatment is supportive.
Therapeutic Class
SGLT1 and SGLT2 inhibitor (sodium glucose cotransporter inhibitor).
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.