The interactions with other substances | SGLT 2 inhibitors

The interactions with other substances

SGLT2 inhibitors can increase the effect of diuretics, leading to dehydration and low blood pressure. Together with insulin or sulfonylureas, severe hypoglycemia can occur, which can also be life-threatening. Other interactions have been classified as clinically irrelevant.

Concurrent use with metformin, digoxin, warfarin, sitagliptin, carbamazepine and many other medications is unproblematic. The exact combination of medications should be monitored by the family doctor, even if he does not prescribe all of them. Interactions between SGLT2 inhibitors and the contraceptive pill have not been demonstrated.

SGLT2 inhibitors do not have a direct effect on the level of the contraceptive pill or other drugs. In case of uncertainty, the gynecologist should be contacted and an additional contraceptive method should be used. You can find more information about contraception here.

A direct interaction of alcohol and SGLT2 inhibitors is not known, but alcohol can have a diuretic effect. Persons who are prone to low blood pressure and dehydration should therefore not combine alcohol and SGLT2 inhibitors, or at least keep the amount of alcohol moderate. Chronic alcohol consumption can also damage the liver and may require a dose adjustment.

The dosage of SGLT2 inhibitors

The normal dosage of SGLT2 inhibitors is one tablet daily. The tablets contain five to ten milligrams of active ingredient. In combination therapy with other oral antidiabetics or insulin, the amount of active ingredient can be reduced to avoid severe hypoglycaemia. In the case of severe liver damage, a lower dose should be started because the active ingredient is broken down by the liver. The exact dosage should be discussed with your family doctor or diabetologist.

How much do SGLT 2 inhibitors cost?

SGLT2 inhibitors are prescription drugs that are paid for by all health insurance companies. Dapagliflozine, Forxiga, costs 69 euros per month for a daily intake of 10mg. SGLT2 inhibitors are thus many times more expensive than, for example, the oral anti-diabetic metformin. However, as there are now several manufacturers and various preparations from the group of SGLT2 inhibitors, the price will continue to fall.