An SGLT2 inhibitor (flozin)
Ertugliflozin
A once-daily tablet for type 2 diabetes that lowers blood sugar by removing glucose in the urine.
What is Ertugliflozin?
Ertugliflozin is a once-daily tablet used to improve blood sugar control in type 2 diabetes. It belongs to the SGLT2 inhibitor (flozin) family and works by making the kidneys pass extra sugar out in the urine. It can also help with weight and blood pressure, but increases the chance of genital thrush and urine infections.
Education and reference only. This is a plain-language guide to Ertugliflozin — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Ertugliflozin, sold as Steglatro, is a tablet for type 2 diabetes. It belongs to the SGLT2 inhibitor or 'flozin' group of medicines and is taken by mouth once a day.
How it works
It blocks a protein in the kidneys called SGLT2, which normally reabsorbs glucose back into the blood. By blocking it, more glucose is removed in the urine, which lowers blood sugar. Because sugar and some fluid leave the body this way, it can also lead to modest weight loss and a small drop in blood pressure.
Company & origin
Originated / developed by: Merck Sharp & Dohme.
What it treats
Conditions Ertugliflozin is used for
Practical use
How to take Ertugliflozin
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take one tablet by mouth once a day, in the morning.
- It can be taken with or without food.
- Drink enough fluids to avoid becoming dehydrated.
- Pause it and seek advice during illness with vomiting, diarrhoea or fever ('sick day' rules), then restart when eating and drinking normally.
- Check your feet regularly and report any new sores or changes.
- If you miss a dose, take it when you remember unless it is nearly time for the next one; do not double up.
Weighing it up
Advantages & disadvantages of Ertugliflozin
Advantages
- Simple once-daily tablet.
- Often helps with modest weight loss and a small fall in blood pressure.
- Low risk of hypos when used on its own.
Disadvantages
- Increases the chance of genital thrush and urine infections.
- Can cause dehydration and needs pausing during sick days.
- Rare but serious risk of diabetic ketoacidosis, sometimes with near-normal blood sugar.
Practical use
Good to know
Because it works by passing sugar into the urine, it can cause genital thrush and urine infections, so good genital hygiene helps. It can also cause dehydration, so it is often paused during illness with vomiting or diarrhoea ('sick day' guidance). A rare but serious risk is diabetic ketoacidosis even when blood sugar looks near normal, so feeling very unwell, breathless or sick needs urgent help.
Who should not take it / use with caution
- People who have had an allergic reaction to ertugliflozin.
- People who are dehydrated or acutely unwell until they have recovered.
- Those with a history of recurrent ketoacidosis without specialist advice.
- It is not used in type 1 diabetes except under specialist supervision.
- It is not recommended in pregnancy or breastfeeding.
Monitoring
- Blood sugar control (HbA1c) is reviewed periodically.
- Kidney function and hydration are checked.
- Be alert for ketoacidosis, genital infections and foot problems.
Side effects
- Genital thrush and urine infections.
- Passing urine more often and feeling thirsty.
- Dizziness from dehydration or low blood pressure.
- Rarely, diabetic ketoacidosis (feeling very unwell, breathless, sick or with tummy pain needs urgent help).
Key interactions
- Combining it with insulin or a sulfonylurea raises hypo risk, so those doses may be reduced.
- Water tablets (diuretics) add to the risk of dehydration.
- Tell your team about all your medicines so combinations can be checked.
Available as: Available as tablets taken by mouth.
Answers
Ertugliflozin: frequently asked questions
Why might I get thrush on this medicine?
Because ertugliflozin removes sugar through the urine, the genital area can get more thrush and urine infections. Good hygiene helps, and infections are treatable.
What are the sick day rules?
During illness with vomiting, diarrhoea or fever it is usually paused to avoid dehydration and ketoacidosis, then restarted once you are eating and drinking normally. Check with your team.
What is euglycaemic ketoacidosis?
This is a rare but serious condition where ketoacidosis develops even though blood sugar looks near normal. Feeling very unwell, sick, breathless or with tummy pain needs urgent medical attention.
Will it help me lose weight?
Many people lose a small amount of weight and may see a modest fall in blood pressure, because sugar and some fluid leave the body in the urine.
Why does foot care matter?
Good foot care and reporting any new sores is sensible in diabetes generally, and is part of staying safe on this class of medicine.
The wider class
About SGLT2 inhibitors
Ertugliflozin belongs to the sglt2 inhibitors class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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