Sotagliflozin
gliflozins
SGLT2 inhibitors (gliflozins)
A gliflozin approved to reduce cardiovascular death and heart failure events in heart failure and in type 2 diabetes with kidney disease and risk factors.
Quick facts
- Group
- SGLT2 inhibitors (gliflozins)
- Target
- Sodium-glucose cotransporter 2 (SGLT2)
- Used for
- Heart failure · Type 2 diabetes
- Key effects
- Diarrhoea · Increased thirst · Dizziness on standing
- Monitor
- Volume status · Ketones when unwell
- ATC
- A10BK06
No doses: the clinician sets them by the current guideline.
Mechanism of action
The figure shows sotagliflozin bound to human SGLT2 (with its partner protein MAP17).
Sotagliflozin blocks the sodium-glucose cotransporter in the proximal tubule, so glucose, sodium and water are lost in the urine. Lower blood volume and preload, natriuresis and metabolic effects are thought to explain the reduction in heart failure events, as with other gliflozins.
- Blocks SGLT2 in the proximal tubule
- Glucose, sodium and water leave in the urine
- Preload and congestion fall
- Fewer heart failure admissions and urgent visits
Indications
- Heart failure, to reduce cardiovascular death, hospitalization and urgent visits for heart failure Heart failure →
- Type 2 diabetes with chronic kidney disease and other cardiovascular risk factors, for the same outcomes Type 2 diabetes mellitus →
Adverse effects
Common
- Diarrhoea
- Increased thirst, dry mouth
- Genital yeast infections
- Dizziness on standing
Contraindications
- Hypersensitivity to sotagliflozin
- Not used in type 1 diabetes or diabetic ketoacidosis
Key interactions
- Insulin or sulfonylureas
- Higher risk of hypoglycaemia.
- Diuretics
- More fluid loss and low blood pressure.
- Alcohol
- Worsens side effects; binge drinking raises ketoacidosis risk.
What is monitored
- Volume status, blood pressure and kidney function
- Ketones when unwell
- Signs of urinary or genital infection
- Glucose in people with diabetes
Administration and safety
- Oral tablet, once a day before the first meal.
- Started low and increased after about two weeks if tolerated.
- Usually stopped at least three days before planned surgery to prevent ketoacidosis.
Pregnancy and breastfeeding
Not recommended in the second and third trimesters; other treatments are preferred in pregnancy.
Nursing care
- Before: volume status, kidney function, type of diabetes.
- During: dizziness, dehydration, signs of ketoacidosis (nausea, vomiting, abdominal pain, fruity breath, fast breathing).
- Teach adequate fluid intake and genital hygiene.
- Teach sick-day rules: report vomiting, fasting or infection.
Pharmacokinetics
- Absorption
- Oral tablet, taken before the first meal of the day.
Test yourself
Think of the answer, then tap the question to see it.
For what outcome is sotagliflozin approved?
To reduce cardiovascular death and hospitalization or urgent visits for heart failure.
Why is sotagliflozin stopped before planned surgery?
To prevent ketoacidosis triggered by fasting and surgical stress.
Which common gastrointestinal adverse effect is listed for sotagliflozin?
Diarrhoea.
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: Sotagliflozin: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); Structure of human SGLT2-MAP17 complex with Sotagliflozin (RCSB Protein Data Bank, 2023); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.