What should you know about SGLT2 inhibitors in heart failure?

Medicines in this group include dapagliflozin and empagliflozin. They were first used for diabetes, but heart failure treatment may benefit from their effects even when a person does not have diabetes. They can reduce fluid pressure on the heart and may help protect kidney function. They are used alongside, rather than as a replacement for, the rest of an agreed heart failure plan.

Your clinician may review kidney blood tests, blood pressure, hydration and other medicines before starting or continuing treatment. Passing urine more often, thirst or genital irritation can occur. Tell the prescriber about repeated infections, vomiting, diarrhoea or difficulty drinking.

Take it exactly as prescribed and do not double a missed dose. Keep drinking normally unless your heart-failure team has given you a fluid limit. Ask for advice before a planned operation or during an illness that stops you eating and drinking, because a temporary pause may be needed. Do not stop long-term heart medicines on your own.

Track breathlessness, energy, ankle swelling and weight changes in the way your clinician recommends. A chronic disease review can bring these observations, kidney checks and medication questions together.

Seek urgent help for severe breathlessness at rest, chest pressure, fainting, confusion, or rapidly worsening swelling. Contact a clinician promptly for very little urine, persistent vomiting, marked weakness, painful urination, or new abdominal pain with nausea and deep or rapid breathing.

Ask why this medicine suits your type of heart failure, which kidney tests are needed, what to do during vomiting or fasting, and whether your other medicines could increase dehydration or low blood pressure.