Key Safety Changes for Diabetes Therapies
Jennifer D. Smith, PharmD, BCACP, BC-ADM, CDCES, a clinical pharmacy specialist for the US Department of Veterans Affairs, highlighted recent safety changes for diabetes treatments that pharmacists should know:
- Canagliflozin has lost its black box warning for lower-limb amputation. However, an increased risk of lower-limb amputation remains in the label warning and precautions section.
- An FDA safety communication recommends stopping canagliflozin, dapagliflozin, and empagliflozin at least 3 days prior to scheduled therapy. Ertugliflozin should be stopped at least 4 days before surgery. All 4 agents can be restarted after surgery.
- New data also suggest stopping sodium-glucose cotransporter 2 inhibitor therapy before scheduled surgery to lessen the risk for ketoacidosis.