[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [SGLT2 inhibitors (gliflozins)](https://durgical.com/en/pharmacology/classes/sglt2-inhibitors/) › Ertugliflozin

# Ertugliflozin

## gliflozins?

SGLT2 inhibitors (gliflozins)

A highly selective SGLT2 inhibitor for type 2 diabetes: it makes the kidney pass glucose into the urine.

Updated Nov 1, 2026

## Quick facts

**Group**
[SGLT2 inhibitors (gliflozins)](https://durgical.com/en/pharmacology/classes/sglt2-inhibitors/)

**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.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

⇄**Sodium-glucose cotransporter 2 (SGLT2)**Ertugliflozin

ⓘ The figure shows empagliflozin bound to human SGLT2; ertugliflozin is a gliflozin that occupies the same glucose site.

**Target in 3D:** Sodium-glucose cotransporter 2 (SGLT2). PDB structure 7VSI (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/7VSI) · Drag to rotate · pinch to zoom

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 →](https://durgical.com/en/conditions/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

### Serious (rare, important)

- Diabetic ketoacidosis, which may occur with glucose not very high
- Urinary tract infections, including urosepsis and pyelonephritis
- Necrotizing fasciitis of the perineum (Fournier gangrene)
- Dehydration and low blood pressure
- Lower-limb amputation
- Hypoglycaemia with insulin or sulfonylureas

## 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.

## Memory aid

ERTUgliflozin = 'ExTRA pure SGLT2 blocker': sugar leaks into urine. Watch the 4 'S's: sex organs (yeast), sepsis (urine), starvation ketones (DKA) and sores on the feet.

## 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.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/ertugliflozin/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## Connections

## Related drugs 3

- [Empagliflozin](https://durgical.com/en/pharmacology/empagliflozin/)
- [Dapagliflozin](https://durgical.com/en/pharmacology/dapagliflozin/)
- [Canagliflozin](https://durgical.com/en/pharmacology/canagliflozin/)

## Related conditions 1

- [Type 2 diabetes mellitus](https://durgical.com/en/conditions/type-2-diabetes-mellitus/)

[← Back to the class: SGLT2 inhibitors (gliflozins)](https://durgical.com/en/pharmacology/classes/sglt2-inhibitors/)

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](https://medlineplus.gov/druginfo/meds/a618011.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [Structure of human SGLT2-MAP17 complex bound with empagliflozin](https://www.rcsb.org/structure/7VSI) (RCSB Protein Data Bank, 2021); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=A10BK04) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/ertugliflozin/