Indication

Type 2 Diabetes Mellitus

Administration

Take in the morning qDay, with or without food

Adult Dose

Type 2 Diabetes Mellitus\r\nIndicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus\r\n\r\nRecommended starting dose is 5 mg PO qDay in the morning\r\n\r\nIf starting dose tolerated and additional glycemic control is needed, increase dose to maximum of 15 mg qDay\r\n\r\nHepatic impairment\r\nMild-to-moderate: No dosage adjustment necessary\r\nSevere: Not recommended

Child Dose

<18 years: Safety and efficacy not established

Renal Dose

Renal impairment\r\neGFR ?60 mL/min/1.73 m²: No dosage adjustment necessary\r\neGFR <30 mL/min/1.73 m²: Contraindicated\r\nEnd-stage renal disease or dialysis: Contraindicated\r\neGFR 30-60 mL/min/1.73 m²\r\nInitiation of ertugliflozin not recommended\r\nContinued use not recommended with persistent eGFR 30-60 mL/min/1.73 m²

Contraindication

Hypersensitivity\r\n\r\nSevere renal impairment, end-stage renal disease, or dialysis

Mode of Action

Selective sodium-glucose transporter-2 (SGLT2) inhibitor\r\n\r\nSGLT-2 inhibition lowers the renal glucose threshold (ie, the plasma glucose concentration, which exceeds the maximum glucose reabsorption capacity of the kidney); lowering the renal glucose threshold results in increased urinary glucose excretion

Precaution

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Side Effect

>10%\r\nFemale genital mycotic infections (9.1-12.2%)\r\n\r\n1-10%\r\nVolume depletion adverse effects (1.9-4.4%)\r\n\r\nMale genital mycotic infections (3.7-4.2%)\r\n\r\nUrinary tract infections (4-4.1%)\r\n\r\nHeadache (2.9-3.5%)\r\n\r\nVaginal pruritus (2.4-2.8%)\r\n\r\nIncreased urination (2.4-2.7%)\r\n\r\nNasopharyngitis (2-2.5%)\r\n\r\nBack pain (1.7-2.5%)\r\n\r\nRenal adverse effects (1.3-2.5%)\r\n\r\nWeight decreased (1.2-2.4%)\r\n\r\nThirst (1.4-2.7%)

Pregnancy Category Note

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Interaction

Hypoglycemia risk increased with insulin and insulin secretagogues (eg, sulfonylureas); a lower dose of insulin or insulin secretagogue may be required\r\nMonitoring glycemic control with urine glucose tests is not recommended in patients taking SGLT2 inhibitors, as SGLT2 inhibitors, increase urinary glucose excretion and lead to positive urine glucose tests; use alternative methods to monitor glycemic control