Stop SGLT2 inhibitors just before surgery- FDA advises label changes
The Food and Drug Administration has approved safety changes in labeling of all sodium-glucose transporter 2 (SGLT2) inhibitors .
The new changes in labeling are that SGLT2 inhibitors namely Canagliflozin, dapagliflozin, and empagliflozin should be discontinued 3 days before scheduled surgery, and ertugliflozin should be stopped at least 4 days before the surgery.Blood sugar should be monitored after drug discontinuation and appropriately managed before surgery.
These changes have been made because surgery may put patients being treated with SGLT2 inhibitors at a higher risk of ketoacidosis.
"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.
SGLT2 inhibitors lower blood sugar by causing the kidneys to remove sugar from the body through the urine. Their safety and effectiveness 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.
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