ertugliflozin
Brand: Steglatro
Prototype: empagliflozin
Drug Class: SGLT-2 inhibitor
Drug Family: antidiabetic
Subclass: sodium-glucose cotransporter-2 inhibitor
Organ Systems: endocrine
Mechanism of Action
Inhibits SGLT-2 in the proximal convoluted tubule to reduce glucose reabsorption, causing glycosuria and lowering blood glucose. Produces modest weight loss and blood pressure reduction. Least clinical outcomes data among SGLT-2 inhibitors.
SGLT-2 (proximal tubule)
Indications
- type 2 diabetes mellitus
Contraindications
- type 1 diabetes
- DKA
- eGFR <30 mL/min
Adverse Effects
Common
- genital mycotic infections
- UTIs
- volume depletion
Serious
- DKA (euglycemic)
- Fournier's gangrene
- AKI
Pharmacokinetics (ADME)
| Absorption | oral bioavailability ~100% |
| Distribution | 93% protein bound |
| Metabolism | hepatic glucuronidation (UGT1A9, UGT2B7) |
| Excretion | renal (50%) and fecal (41%) |
| Half-life | 16.6 hours |
| Onset | rapid |
| Peak | 1 hour |
| Duration | 24 hours |
| Protein Binding | 93% |
| Vd | 85.5 L |
Drug Interactions
| Drug / Agent | Mechanism | Severity |
|---|---|---|
| diuretics | additive volume depletion | moderate |
Nursing Considerations
- Monitor eGFR at baseline and periodically; discontinue if eGFR <30 mL/min.
- Counsel on genital mycotic infection risk and hygiene practices.
- Hold before major surgery or prolonged fasting to reduce DKA risk.
- No proven CV or renal outcomes benefit established (VERTIS-CV trial: CV-neutral) — factor into clinical decision-making.
Clinical Pearls
- Unlike empagliflozin, dapagliflozin, and canagliflozin, ertugliflozin demonstrated only CV non-inferiority without superiority in the VERTIS-CV trial, limiting its differentiation from other SGLT-2 inhibitors.
- Available as fixed-dose combinations with metformin (Segluromet) and sitagliptin (Steglujan).
Safety Profile
Pregnancy avoid
Lactation avoid
Renal Adjustment Required
Hepatic Adjustment Not required
TDM Not required
Concordance Terms
Cross-referenced clinical concepts — click any term to see all content where it appears.