Glossary
SGLT2 Inhibitor
A class of diabetes drugs, including Invokana, Farxiga, Jardiance, and Steglatro, that lower blood sugar by making the kidneys flush sugar out through urine. Their labels warn about genital infections, including a rare flesh-eating infection called Fournier's gangrene.
SGLT2 inhibitors (sodium-glucose cotransporter-2 inhibitors) are prescription drugs for type 2 diabetes, and some are also approved for heart failure and chronic kidney disease. The class includes canagliflozin (Invokana), dapagliflozin (Farxiga), empagliflozin (Jardiance), and ertugliflozin (Steglatro), plus combination pills. As the FDA explains, they lower blood sugar by causing the kidneys to remove sugar from the body through the urine.
That mechanism, sugar in the urine, is linked to several safety warnings that drove lawsuits:
- Genital infections and Fournier's gangrene. In August 2018, the FDA warned of a rare but serious infection of the tissue around the genitals, called necrotizing fasciitis of the perineum or Fournier's gangrene, and required a warning on all SGLT2 inhibitor labels. Current labels still carry it.
- Ketoacidosis, a dangerous buildup of acids in the blood, which can occur even when blood sugar is not very high.
- Amputations with canagliflozin. FDA added a Boxed Warning about leg and foot amputation risk to Invokana in 2017, then removed it in August 2020 after reviewing newer trial data, though the risk remains described in the label.
Lawsuits over Invokana amputations and ketoacidosis, and over Fournier's gangrene with several SGLT2 drugs, were filed as individual product liability cases. Claims generally require proof of use and a diagnosed injury. Do not stop a diabetes medicine without your doctor. For how drug cases are grouped, see what is MDL, and for another diabetes drug case, see the metformin contamination lawsuit.
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