The FDA has recommended new safety changes in the labelling of sodium-glucose transporter 2 (SGLT2) inhibitors requiring its usage to be discontinued before surgery due to a higher risk of ketoacidosis post-surgery.
The SGLT-2 drugs namely canagliflozin, dapagliflozin, and empagliflozin require to be discontinued 3 days before a scheduled surgery, and ertugliflozin should be stopped at least 4 days before the surgery, said the agency.
SGLT2 inhibitors lower blood sugar by causing the kidneys to remove sugar from the body through the urine. Hence, blood sugar should be monitored after drug discontinuation and appropriately managed before surgery.
“The SGLT2 inhibitor may be restarted once the patient’s oral intake is back to baseline and any other risk factors for ketoacidosis are resolved,” the agency added.
The safety and efficacy of SGLT-2 drugs have not been established to treat diabetic ketoacidosis or to treat patients with type 1 diabetes.
These medications are available as single-ingredient therapies and also in combination with other diabetes medicines.