Ertugliflozin
gliflozins
SGLT2 inhibitors (gliflozins)
A highly selective SGLT2 inhibitor for type 2 diabetes: it makes the kidney pass glucose into the urine.
Quick facts
- Group
- SGLT2 inhibitors (gliflozins)
- Target
- Sodium-glucose cotransporter 2 (SGLT2)
- Used for
- Type 2 diabetes in adults
- Key effects
- Genital yeast infections · Frequent urination
- Monitor
- HbA1c and blood glucose · Kidney function
- ATC
- A10BK04
No doses: the clinician sets them by the current guideline.
Mechanism of action
The figure shows empagliflozin bound to human SGLT2; ertugliflozin is a gliflozin that occupies the same glucose site.
SGLT2 in the early proximal tubule reabsorbs most filtered glucose together with sodium. Ertugliflozin, one of the most SGLT2-selective gliflozins, blocks it so glucose and some sodium and water are lost in the urine. Blood glucose falls independently of insulin, with calorie loss and mild diuresis.
- Blocks SGLT2 in the proximal tubule
- Filtered glucose and sodium are not reabsorbed
- Glucose, calories and some water leave in urine
- Blood glucose falls without extra insulin
Indications
- Type 2 diabetes in adults, with diet and exercise, to improve glucose control Type 2 diabetes mellitus →
Adverse effects
Common
- Genital yeast infections
- Frequent urination, including at night; thirst
- Dry mouth, headache
- Dizziness on standing from fluid loss
Contraindications
- Not used for type 1 diabetes or diabetic ketoacidosis
- Hypersensitivity to ertugliflozin
Key interactions
- Insulin or sulfonylureas
- Higher risk of hypoglycaemia; their dose may be lowered.
- Diuretics
- More fluid loss and low blood pressure.
- Alcohol
- Alters glucose and worsens side effects; binge drinking raises ketoacidosis risk.
What is monitored
- HbA1c and blood glucose
- Kidney function
- Hydration and blood pressure
- Ketones when unwell, even with near-normal glucose
- Feet and legs (sores, infection)
Administration and safety
- Oral tablet, once a day in the morning, with or without food.
- Usually stopped at least four days before planned surgery to prevent ketoacidosis.
- Fluid status is checked and corrected before starting.
Pregnancy and breastfeeding
Not recommended, especially in the second and third trimesters; insulin is the usual treatment for diabetes in pregnancy.
Nursing care
- Before: kidney function, volume status, foot examination, history of amputation or genital infections.
- During: signs of ketoacidosis (nausea, vomiting, abdominal pain, fast breathing) even with near-normal glucose.
- Teach genital hygiene and to report genital or perineal pain with fever.
- Teach foot care and to report leg or foot sores.
Pharmacokinetics
- Absorption
- Oral, with or without food.
- Elimination
- Its glucose-lowering effect depends on kidney function and falls as eGFR falls.
Test yourself
Think of the answer, then tap the question to see it.
Why is ertugliflozin stopped before planned surgery?
Fasting and surgical stress raise the risk of ketoacidosis, which SGLT2 inhibitors increase, sometimes with near-normal glucose.
Which serious foot and leg warning appears for ertugliflozin?
Lower-limb amputation; feet are checked and sores reported early.
Why do genital yeast infections occur with gliflozins?
Glucose in the urine feeds yeast in the genital area.
Connections
← Back to the class: SGLT2 inhibitors (gliflozins)
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Ertugliflozin: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); Structure of human SGLT2-MAP17 complex bound with empagliflozin (RCSB Protein Data Bank, 2021); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.