The 'gliflozins' - new safety information about rare side effects

[John Gray]

I've just received a notification from my doctor as above, linking to a 12-page Sheffield Teaching Hospital leaflet on the subject issued in June 2022 (attached as pil5170_1_.pdf below).

"Why have I been given this leaflet?
You have been given this leaflet because you are taking, or about to take, one of tablets in the list below:
• Empagliflozin (Jardiance®)
• Canagliflozin (Invokana®)
• Dapagliflozin (Forxiga®)
• Ertugliflozin (Steglatro®)
These tablets are called Sodium-glucose co-transporter-2 inhibitors or SGLT2 inhibitors."

The "Rare Side-Effects' (1 in 1,000 to 1 in 10,000 people that take the medication) to which the doctor referred appear to be:
• Necrotising fasciitis of the perineum (Fournier’s gangrene)
• Diabetic ketoacidosis (DKA)

I'm not sure why the sudden fuss/warning - can anyone elucidate?

 

[grovesy]

I have just started one of these last week, and the Diabetic Nurse was very strong of the dos and don't on them.

 

[MikeyBikey]

When I read about SGLT2 Inhibitors a few years ago I did wonder if they were a drug worth risking as they seemed IMHO potentially very nasty!

 

[everydayupsanddowns]

No idea about the timings @John Gray (the DKA risk was being flagged 8 years ago or more - https://www.gov.uk/drug-safety-upda...d-advice-on-the-risk-of-diabetic-ketoacidosis )

Not sure of there has been some extra announcement, research published, or other shift in recommendations, or simply that it can take an inordinate amount of time for organisations to get things reviewed, checked, edited, tweaked, rechecked, amended again, reviewed by stakeholders, re-edited again, and finally ultimately published.

 

[Lucyr]

Not new announcements, as Mike says the DKA risk was flagged many years ago. I’d already had DKA from starting the tablets by the time the clinic letter advising DKA was a risk arrived. Lucky I’d read the leaflet. It should all be covered on there already.

 

[Cheyne]

Hi,
I had to stop Empagliflozin 6 months ago as it was knocking me out 3 hours after taking and giving me anaphylaxis. Usually lost 2 hours each time. Never had another occurance since stopping them.
Cheers

 

[snowball12]

So glad I couldn't tolerate these drugs!!!!

 

[John Gray]

With regard to why I have suddenly been sent the Awful Warning mentioned in my first post, it appears that this is scheduled to happen every year. (I have been on empagliflozin for five months.)
The Community Pharmacist who rang me back says that if I had got the symptoms of DKA I would know about it!

 

[wantonnoodle]

With regard to why I have suddenly been sent the Awful Warning mentioned in my first post, it appears that this is scheduled to happen every year. (I have been on empagliflozin for five months.)

This makes sense. I started on them last May, and had the leaflet re-issued to me from my GP a couple of weeks back.

Not had any issues with them to be honest though. If anything, I prefer them to the Metformin that I'm still on as well; asked if could reduce Metformin given much bigger reduction of HbA1c on Empagliflozin, but told numbers need to come down further.

Given I was given the choice of Trulicity or Empagliflozin in May last year, I'm glad that I picked the Empagliflozin as I think I would not have been on Trulicity very long given the shortages.