SGLT2 Inhibitors

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Mon, 01/25/2016 - 11:16
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Lisa Patel
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Joined: 07/30/2014 - 12:53
SGLT2 Inhibitors

I wanted to ask how organizations are handling orders for SGLT2 Inhibitors for inpatient use in light of the drug safety communication from May 2015 regarding the risk of ketoacidosis that can present atypically. The agents are non-formulary at our institution. However, should an MD order an SGLT2 inhibitor, we are encouraging pharmacists to have a discussion with prescribers about alternatives and use clinical discretion. This includes discontinuing the mediation if a patient presents with DKA symptoms.
Specifically, I was curious if any of your institutions have specific recommendations or have implemented any safeguards regarding the use of SGLT2 inhibitors in the pre-operative setting. Are you all recommending to hold the SGLT2 inhibitors prior to elective surgery. If so for what period of time. We have seen varying recommendations – i.e. hold for 24h vs. do not hold.

Thank you.
Lisa Patel

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