SGLT2 Inhibitors List: Uses, Benefits, and Side Effects

By Web Admin
Medical Disclaimer

This article is for informational purposes only and does not constitute medical advice. Always consult your physician or a qualified healthcare provider regarding any medical condition or treatment.

Key Takeaways

  • Six SGLT2 inhibitors are available in the United States — Jardiance (empagliflozin), Farxiga (dapagliflozin), Invokana (canagliflozin), Steglatro (ertugliflozin), Inpefa (sotagliflozin), and Brenzavvy (bexagliflozin).
  • All work by blocking glucose reabsorption in the kidney, lowering A1C by 0.6 to 1.0 percent and producing 2 to 4 kg of weight loss with minimal hypoglycemia.
  • Cardiovascular outcome trials separate the class — Jardiance, Farxiga, and Invokana show major adverse cardiovascular event reductions, while Steglatro showed non-inferiority only and Inpefa is approved specifically for heart failure.
  • FDA indications now extend beyond type 2 diabetes — Jardiance and Farxiga are approved for heart failure with reduced and preserved ejection fraction and for chronic kidney disease, regardless of diabetes status.
  • Combination products multiply the convenience — Synjardy, Xigduo XR, Invokamet, Segluromet pair SGLT2 with metformin, while Glyxambi, Qtern, Steglujan, and Trijardy XR pair with DPP-4 inhibitors.
Table of Contents
  1. What SGLT2 Inhibitors Are
  2. The Complete US SGLT2 Inhibitor List
  3. FDA Indications by Drug
  4. Key Cardiovascular Outcome Trials
  5. Dosing Details
  6. Combination Products
  7. Class-Wide Benefits
  8. Class-Wide Side Effects
  9. Drug-Specific Quirks
  10. Choosing Among Them
  11. Sick-Day Rules for the Whole Class
  12. Monitoring
  13. Related Reading
  14. The Bottom Line

SGLT2 inhibitors are a class of oral diabetes medications that block glucose reabsorption in the kidney, causing excess glucose to spill into the urine. Six are approved in the United States — Jardiance, Farxiga, Invokana, Steglatro, Inpefa, and Brenzavvy — plus more than a dozen fixed-dose combinations. They lower A1C by 0.6 to 1.0 percent, produce 2 to 4 kg of weight loss, and depending on the specific agent, also reduce heart failure hospitalizations, slow chronic kidney disease, and cut cardiovascular mortality.

What SGLT2 Inhibitors Are

  • Oral medications, taken once daily (twice daily for sotagliflozin and some combinations)
  • Mechanism: block SGLT2 transporters in the kidney’s proximal tubule
  • Result: 60 to 80 grams per day of glucose excreted in the urine
  • Effect: lower A1C, lower body weight, lower blood pressure, slight diuretic effect
  • Bonus: reduce heart failure hospitalizations and slow kidney disease in many patients

The Complete US SGLT2 Inhibitor List

Brand Generic Doses FDA Approval Manufacturer
Jardiance Empagliflozin 10, 25 mg 2014 Boehringer Ingelheim / Lilly
Farxiga Dapagliflozin 5, 10 mg 2014 AstraZeneca
Invokana Canagliflozin 100, 300 mg 2013 Janssen
Steglatro Ertugliflozin 5, 15 mg 2017 Merck / Pfizer
Inpefa Sotagliflozin 200, 400 mg 2023 (HF) Lexicon
Brenzavvy Bexagliflozin 20 mg 2023 TheracosBio

FDA Indications by Drug

Drug T2D HFrEF HFpEF CKD CV Risk Reduction
Jardiance Yes Yes Yes Yes Yes (CV death)
Farxiga Yes Yes Yes Yes Yes (HF + CV death)
Invokana Yes No No Yes Yes (MACE)
Steglatro Yes No No No No (non-inferior only)
Inpefa Add-on Yes Yes No HF events
Brenzavvy Yes No No No No

Key Cardiovascular Outcome Trials

Trial Drug Year Headline Result
EMPA-REG OUTCOME Empagliflozin 2015 32% reduction CV death
EMPEROR-Reduced / Preserved Empagliflozin 2020 / 2021 HF benefit irrespective of EF
EMPA-KIDNEY Empagliflozin 2022 28% reduction renal events
DECLARE-TIMI 58 Dapagliflozin 2019 17% reduction HF hospitalization
DAPA-HF Dapagliflozin 2019 26% reduction HF events in HFrEF
DAPA-CKD Dapagliflozin 2020 39% reduction renal composite
CANVAS Canagliflozin 2017 14% MACE reduction; amputation signal
CREDENCE Canagliflozin 2019 30% reduction renal composite
VERTIS CV Ertugliflozin 2020 Non-inferior MACE; HF hospitalization benefit
SOLOIST-WHF / SCORED Sotagliflozin 2021 HF events reduced in HF and CKD

Dosing Details

Drug Start Max Renal Cutoff Timing
Jardiance 10 mg daily 25 mg daily eGFR ≥ 20 Morning
Farxiga 5 mg daily 10 mg daily eGFR ≥ 25 Morning
Invokana 100 mg daily 300 mg daily eGFR ≥ 30 Before breakfast
Steglatro 5 mg daily 15 mg daily eGFR ≥ 45 Morning
Inpefa 200 mg daily 400 mg daily Any eGFR (HF) Before first meal
Brenzavvy 20 mg daily 20 mg daily eGFR ≥ 30 Morning

Combination Products

Brand Components Class Pairing
Synjardy / Synjardy XR Empagliflozin + metformin SGLT2 + biguanide
Xigduo XR Dapagliflozin + metformin SGLT2 + biguanide
Invokamet / Invokamet XR Canagliflozin + metformin SGLT2 + biguanide
Segluromet Ertugliflozin + metformin SGLT2 + biguanide
Glyxambi Empagliflozin + linagliptin SGLT2 + DPP-4
Qtern Dapagliflozin + saxagliptin SGLT2 + DPP-4
Steglujan Ertugliflozin + sitagliptin SGLT2 + DPP-4
Trijardy XR Empagliflozin + linagliptin + metformin SGLT2 + DPP-4 + biguanide

Class-Wide Benefits

  • A1C reduction of 0.6 to 1.0 percent across the class
  • Weight loss of 2 to 4 kg over 6 to 12 months
  • Blood pressure reduction of 3 to 5 mmHg systolic
  • Low hypoglycemia risk on monotherapy
  • Heart failure hospitalization reduction
  • Slowing of CKD progression in diabetic and non-diabetic kidney disease (for Jardiance and Farxiga)
  • No dosing dependency on food
  • Once-daily simplicity

Class-Wide Side Effects

  • Genital yeast infections (8 to 15 percent of women, 4 to 8 percent of men)
  • Urinary tract infections (4 to 10 percent)
  • Volume depletion, hypotension, dizziness
  • Rare euglycemic diabetic ketoacidosis
  • Very rare Fournier gangrene
  • Acute kidney injury (more likely with concurrent ACE/ARB plus diuretic)
  • Mild LDL cholesterol increase (4 to 8 percent)
  • Small expected initial eGFR drop that stabilizes

Drug-Specific Quirks

  • Invokana — CANVAS amputation signal (2× risk), fracture signal (1.5×); attenuated in CREDENCE but FDA caution remains for peripheral artery disease
  • Inpefa (sotagliflozin) — also inhibits SGLT1 in the gut, causing more diarrhea (~5 to 7 percent) than pure SGLT2 inhibitors
  • Brenzavvy (bexagliflozin) — limited cardiovascular outcome data, positioned mainly on cost
  • Jardiance — only SGLT2 inhibitor approved for HFpEF and the broadest non-diabetes CKD label
  • Farxiga — strongest evidence in heart failure with reduced ejection fraction and CKD

Choosing Among Them

Goal Preferred Agents
Type 2 diabetes alone Any in the class; cost often decides
HFrEF Jardiance, Farxiga, Inpefa
HFpEF Jardiance, Farxiga
CKD with diabetes Jardiance, Farxiga, Invokana
CKD without diabetes Jardiance, Farxiga
Post-MI / ASCVD Jardiance, Farxiga, Invokana
Budget priority Brenzavvy, generic dapagliflozin where available

Sick-Day Rules for the Whole Class

  • Hold during severe illness with vomiting or diarrhea
  • Hold during prolonged fasting or surgery (3 to 4 days before)
  • Maintain hydration aggressively
  • Watch for DKA symptoms even when glucose is normal — nausea, abdominal pain, fatigue, fruity breath
  • Resume only after eating and drinking are normal again

Monitoring

  • eGFR and creatinine at baseline, 1 month, then every 3 to 6 months
  • Potassium, especially with ACE/ARB
  • A1C every 3 months until stable, then every 6 months
  • Foot exam annually (more often with Invokana)
  • Genitourinary symptom check at every visit

For drug-specific deep dives see our pages on Jardiance for diabetes, Farxiga vs Jardiance, and Invokana (canagliflozin). Class-level side effects are covered in our SGLT2 side effects guide. For broader context see our treatment overview and is prediabetes reversible. External: the ADA Standards of Care and FDA Approved Drug Products.

The Bottom Line

Six SGLT2 inhibitors are available in the United States, with Jardiance and Farxiga leading on cardiovascular and kidney indications, Invokana strong for diabetic CKD, Steglatro a quieter glucose-only option, Inpefa specifically for heart failure, and Brenzavvy positioned on cost. All share the same mechanism, similar A1C and weight effects, and the same major side effect profile of genital infections, dehydration, and rare DKA. Drug choice usually comes down to indication beyond diabetes (heart failure, CKD), cost, and individual side effect history.

Frequently Asked Questions

How many SGLT2 inhibitors are on the US market?

Six are currently available — Jardiance (empagliflozin), Farxiga (dapagliflozin), Invokana (canagliflozin), and Steglatro (ertugliflozin) are the four mainstream agents. Two newer entries are Inpefa (sotagliflozin), a dual SGLT1 and SGLT2 inhibitor approved for heart failure, and Brenzavvy (bexagliflozin), positioned as a lower-cost option for type 2 diabetes. Plus more than a dozen fixed-dose combination products that pair these agents with metformin or DPP-4 inhibitors.

Which SGLT2 inhibitor is best?

It depends on the goal. For broad cardiovascular protection and a heart failure or CKD indication, Jardiance and Farxiga have the strongest evidence and the widest FDA labels. For diabetic kidney disease specifically, Invokana has the CREDENCE trial. For pure A1C lowering at the lowest cost, generic bexagliflozin (Brenzavvy) or budget-tier formulary options may win. Steglatro is rarely the first pick because VERTIS CV did not show MACE superiority. Inpefa is reserved for heart failure rather than diabetes.

Do all SGLT2 inhibitors have the same side effects?

The common side effects are essentially identical across the class — genital yeast infections, urinary tract infections, dehydration, and rare euglycemic diabetic ketoacidosis. The class also shares a small Fournier gangrene signal. Where they differ is drug-specific signals: Invokana showed about double the amputation risk in CANVAS and a 1.5-fold fracture risk, while Jardiance, Farxiga, and Steglatro did not show those signals in their respective trials. Sotagliflozin causes more diarrhea due to SGLT1 blockade in the gut.

Can SGLT2 inhibitors be combined with other diabetes drugs?

Yes — they combine well with metformin, DPP-4 inhibitors, GLP-1 receptor agonists, and insulin. The most popular combinations are with metformin (Synjardy, Xigduo XR, Invokamet, Segluromet) and with DPP-4 inhibitors (Glyxambi, Qtern, Steglujan, Trijardy XR). When combined with insulin or sulfonylureas, the dose of those agents usually needs reduction to avoid hypoglycemia. Combination with GLP-1 RA pairs additive A1C, weight, and CV benefit.

Sources

  1. U.S. Food and Drug Administration. Approved Drug Products Database. https://www.accessdata.fda.gov/scripts/cder/daf/
  2. American Diabetes Association. Standards of Care in Diabetes 2024. Diabetes Care 47(Suppl 1). https://diabetesjournals.org/care/issue/47/Supplement_1
  3. Zinman B, et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes (EMPA-REG OUTCOME). N Engl J Med 2015;373:2117-2128.

Related Articles

Hand holding various colorful pills and capsules.

SGLT2 Inhibitors Side Effects

A class-level guide to SGLT2 inhibitor side effects — what is common, what is rare but serious, drug-specific quirks.