Home Drug Guide Sotagliflozin

Drug Guide

Generic Name

Sotagliflozin

Brand Names Inpefa

Classification

Therapeutic: Antidiabetic agent

Pharmacological: SGLT2 and SGLT1 inhibitor

FDA Approved Indications

  • Type 1 diabetes mellitus as adjunct to insulin in adults

Mechanism of Action

Sotagliflozin inhibits sodium-glucose cotransporters 1 and 2 (SGLT1 and SGLT2), reducing glucose reabsorption in the kidneys and glucose absorption in the intestines, leading to decreased blood glucose levels.

Dosage and Administration

Adult: Start with 200 mg once daily; can increase to 400 mg based on response and tolerability.

Pediatric: Not approved for pediatric use.

Geriatric: No specific initial dose adjustment; monitor renal function closely.

Renal Impairment: Use caution; renal function should be assessed prior to initiation and periodically during treatment.

Hepatic Impairment: Data limited; use with caution and monitor patients closely.

Pharmacokinetics

Absorption: Orally absorbed; peak plasma concentrations in approximately 1.5 hours.

Distribution: Wide distribution; volume of distribution approximately 104 L.

Metabolism: Primarily metabolized by glucuronidation (UGT1A9 and UGT2B7 pathways).

Excretion: Excreted via urine and feces; renal excretion approximately 55%.

Half Life: Approximate half-life of 14 hours.

Contraindications

  • Severe renal impairment (eGFR <30 mL/min/1.73 m²)
  • End-stage renal disease
  • Dialysis

Precautions

  • Risk of diabetic ketoacidosis, especially in T1DM
  • Monitor for dehydration, hypotension, urinary tract infections, and genital mycotic infections
  • Assess renal function regularly

Adverse Reactions - Common

  • Genital mycotic infections (Common)
  • Urinary tract infections (Common)
  • Hypovolemia/dehydration (Common)

Adverse Reactions - Serious

  • Diabetic ketoacidosis (Rare but serious)
  • Kidney injury (Rare)

Drug-Drug Interactions

  • Diuretics (risk of volume depletion)
  • Insulins and other hypoglycemics (risk of hypoglycemia)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood glucose, renal function, and signs of volume depletion.

Diagnoses:

  • Risk for hypoglycemia
  • Risk for dehydration
  • Risk for urinary tract infection

Implementation: Administer with or without food at the same time daily; monitor for adverse effects.

Evaluation: Assess blood glucose control and adverse effects regularly.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Monitor blood sugar levels regularly.
  • Report signs of dehydration, genital infections, or symptoms of ketoacidosis.
  • Maintain good hygiene to prevent infections.

Special Considerations

Black Box Warnings:

  • Risk of diabetic ketoacidosis (DKA), especially in type 1 diabetes.
  • Serious urinary tract infections and genital infections.

Genetic Factors: Genetic variations may influence drug metabolism and response.

Lab Test Interference: May affect serum glucose and renal function tests.

Overdose Management

Signs/Symptoms: Hypovolemia, hypotension, hypoglycemia, ketoacidosis.

Treatment: Discontinue medication, provide supportive care including hydration, monitor metabolic parameters, and treat ketoacidosis with insulin and fluids as indicated.

Storage and Handling

Storage: Store at room temperature away from moisture and heat.

Stability: Stable until expiration date on the package.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.