Sotagliflozin

Sotagliflozin is used to lower the risk of stroke, heart attack, death, hospitalization for heart failure, or urgent heart failure-related visits in adults with heart failure, type 2 diabetes, or chronic kidney disease accompanied by cardiovascular disease. It belongs to a group of medications known as SGLT2 inhibitors, which help lower blood sugar by causing the kidneys to remove glucose through the urine. It was approved by the USFDA in the year 2023.

BRAND NAME:

Inpefa- Inpefa is available as oral tablets containing sotagliflozin as the main active ingredient with strengths 200mg and 400mg.

MECHANISM OF ACTION:

Sotagliflozin is a dual inhibitor of the sodium-glucose co-transporters SGLT1 and SGLT2, working through complementary mechanisms to lower blood glucose and provide cardiovascular and renal benefits. By inhibiting SGLT2 in the kidneys, sotagliflozin reduces the reabsorption of glucose from the renal tubules, leading to increased urinary glucose excretion and subsequently lower blood sugar levels. In addition, by inhibiting SGLT1 in the small intestine, it slows the absorption of glucose from the gut, helping to reduce postprandial blood glucose spikes. Beyond its glucose-lowering effects, sotagliflozin also promotes osmotic diuresis and natriuresis, which can lower blood pressure, reduce cardiac preload and afterload, and improve overall heart function. These effects contribute to its ability to reduce the risk of heart failure-related events and progression of kidney disease, particularly in individuals with type 2 diabetes, chronic kidney disease, or established cardiovascular disease.

PHARMACOKINETICS:

Absorption: After oral administration, sotagliflozin is quickly absorbed, with peak plasma levels (Tmax) usually occurring within 1 to 2 hours.

Distribution: Sotagliflozin is highly bound to plasma proteins, with about 98–99% of the drug primarily attached to albumin.

Metabolism: Sotagliflozin is extensively metabolized in the liver, primarily through the process of glucuronidation. The involvement of cytochrome P450 (CYP) enzymes in its metabolism is minimal, which reduces the potential for significant drug-drug interactions commonly associated with CYP-mediated pathways.

Excretion: Sotagliflozin is mainly eliminated through the feces as metabolites, indicating that it undergoes extensive metabolism in the liver. A smaller portion of the drug is eliminated through the urine, indicating limited renal excretion.

PHARMACODYNAMICS:

Sotagliflozin is a dual inhibitor of sodium-glucose co-transporters SGLT1 and SGLT2, which are responsible for glucose reabsorption in the kidneys and glucose absorption in the intestines, respectively. Its pharmacodynamics effects are primarily related to improved glycemic control and cardiovascular-renal protection.

DOSAGE AND ADMINISTRATION:

Sotagliflozin are available as oral tablets with strengths 200mg and 400mg. The dosage is prescribed basing on the patients health condition and age.

Startingdose:
Usually, 200 mg once daily taken orally, with or without food.
Maintenancedose:
The dose may be increased to 400 mg once daily, depending on the patient’s response to treatment and ability to tolerate the medication.

DRUG INTERACTIONS:

While taking sotagliflozin it is necessary to discuss with the doctor if the patient is taking any other medication for other health issues. Some medications can occur serious adverse effects while interacting with sotagliflozin. Below are some medication that are should be avoid while taking sotagliflozin.

Carbamazepine
Ritonavir
Phenytoin
Phenobarbital
Rifampin

FOOD INTERACTIONS:

Avoid taking alcohol.

CONTRAINDICATIONS:

Sotagliflozin is contraindicated in patients with hypersensitive to its components, and also should avoid patients suffering with diabetic ketoacidosis.

ADVERSE EFFECTS: