✓ Medically reviewed by · Last reviewed: May 2026
Pharmacy Researcher · 8 years experience
Pharmacy researcher with 8 years reviewing clinical drug information, generic formulation equivalence, and international pharmaceutical standards. Focuses on patient-facing accuracy in medication education.
Key Takeaways — Steglatro (Ertugliflozin)
- Steglatro is ertugliflozin, an SGLT2 inhibitor for type 2 diabetes — one of the newest in its class, co-developed by Pfizer and Merck.
- SGLT2 inhibitors block glucose reabsorption in the kidney, causing excess glucose to be excreted in urine, lowering blood sugar and body weight.
- Key weakness: Steglatro failed its cardiovascular outcomes trial (VERTIS CV) — it did NOT reduce the risk of major cardiovascular events. Jardiance (empagliflozin) and Forxiga (dapagliflozin) both did, and carry FDA-approved heart failure and CKD indications that ertugliflozin lacks.
- No generic ertugliflozin exists — Steglatro costs $400–$600/month in the US. Alternatives with stronger evidence are available at a fraction of the price.
- MedsBase stocks: Jardiance (empagliflozin) from $33, Forxiga (dapagliflozin) from $33, Invokana (canagliflozin) from $29.
What Is Steglatro?
Steglatro is the brand name for ertugliflozin, an oral SGLT2 (sodium-glucose cotransporter 2) inhibitor approved by the FDA in December 2017 for adults with type 2 diabetes mellitus, as an adjunct to diet and exercise to improve glycaemic control. It is available as 5 mg and 15 mg tablets, taken once daily in the morning, with or without food. Steglatro is also available in combination tablets: Segluromet (ertugliflozin + metformin) and Steglujan (ertugliflozin + sitagliptin).
Ertugliflozin was co-developed by Pfizer and Merck (MSD) and is the newest of the four SGLT2 inhibitors to reach the US market — following canagliflozin (Invokana, 2013), dapagliflozin (Farxiga/Forxiga, 2014), and empagliflozin (Jardiance, 2014).
How Steglatro Works
In the kidneys, glucose filtered by the glomerulus is normally reabsorbed back into the bloodstream — primarily via SGLT2 transporters in the proximal tubule. Ertugliflozin selectively inhibits SGLT2, blocking approximately 90% of filtered glucose reabsorption. This forces the excess glucose to be excreted in urine (glycosuria), lowering blood glucose levels independently of insulin.
Secondary effects of the osmotic diuresis include:
- Mild blood pressure reduction (3–5 mmHg systolic)
- Weight loss (1.5–3 kg average over 26 weeks)
- Modest reduction in serum uric acid
Steglatro Dosing
| Dose | HbA1c Reduction | Notes |
|---|---|---|
| 5 mg once daily (starting dose) | ~0.7–0.9% | Starting dose; titrate if tolerated |
| 15 mg once daily (max dose) | ~0.9–1.1% | Assess eGFR before uptitrating; not effective if eGFR <45 |
Take in the morning, with or without food. Avoid in type 1 diabetes, severe renal impairment (eGFR <30), or on dialysis. Hold before major surgery or prolonged fasting (risk of euglycaemic ketoacidosis).
Steglatro Side Effects
- Genital mycotic infections (thrush) — most common SGLT2 class effect; ~10–14% incidence, more in women
- UTIs — increased urinary glucose creates a favourable environment for bacteria; 5–6% incidence
- Polyuria / increased urination — osmotic effect; self-limiting
- Volume depletion / hypotension — particularly in elderly or those on diuretics; start cautiously
- Diabetic ketoacidosis (DKA) — rare but serious; risk rises if used off-label in T1DM or with caloric restriction
- Fournier’s gangrene (necrotising fasciitis of the perineum) — class warning; rare (<1 in 1,000 patient-years)
- Lower limb amputation — a class concern that emerged with canagliflozin (CANVAS); ertugliflozin data show numerical increase (not statistically significant in VERTIS CV)
The Critical Issue: Steglatro Failed Its Cardiovascular Trial
The VERTIS CV trial (N=8,246, ~3.5-year follow-up) tested ertugliflozin in patients with type 2 diabetes and established cardiovascular disease. Result: ertugliflozin was non-inferior to placebo for MACE (major adverse cardiovascular events) — but it did NOT show superiority. It showed no statistically significant reduction in heart failure hospitalisation (primary HF endpoint p=0.11) and no benefit on renal progression in the primary analysis.
Contrast this with Jardiance (EMPA-REG OUTCOME): 14% reduction in MACE, 35% reduction in cardiovascular death, 35% reduction in HF hospitalisation — results so strong that empagliflozin gained a heart failure indication. And Forxiga (DECLARE-TIMI 58 + DAPA-HF + DAPA-CKD): HF hospitalisation and CKD progression benefits so compelling it now has FDA approvals for heart failure and CKD regardless of diabetes status.
This evidence gap matters clinically. Most guidelines (ADA, ESC) recommend SGLT2 inhibitors with proven cardiovascular outcome benefit — specifically empagliflozin or dapagliflozin — as the preferred SGLT2 choice in patients with established CVD, heart failure, or CKD. Ertugliflozin is rarely the first-choice SGLT2 inhibitor in these settings.
SGLT2 Inhibitors Compared — Steglatro vs Alternatives
| Drug | CV Outcome | HF Indication | CKD Indication | MedsBase Price |
|---|---|---|---|---|
| Steglatro (Ertugliflozin) | Non-inferior only (VERTIS CV) | No | No | Not stocked |
| Jardiance (Empagliflozin) | Superior — EMPA-REG | Yes (HFrEF + HFpEF) | Yes (CKD) | From $33 |
| Forxiga (Dapagliflozin) | Superior — DECLARE | Yes (HFrEF + HFpEF) | Yes (CKD) | From $33 |
| Invokana (Canagliflozin) | Superior — CANVAS | Yes | Yes (CKD — CREDENCE) | From $29 |
Better-Evidenced Alternatives at MedsBase
SGLT2 Inhibitors With Proven CV & Renal Benefits
- Jardiance (Empagliflozin) — from $33 — 10 mg or 25 mg once daily. First SGLT2 inhibitor to show CV mortality reduction; now FDA-approved for HFrEF, HFpEF, and CKD. The most prescribed SGLT2 inhibitor globally.
- Forxiga (Dapagliflozin) — from $33 — 10 mg once daily. DAPA-HF and DAPA-CKD trials established benefits in heart failure and CKD independent of diabetes. Strong renal protective profile.
- Invokana (Canagliflozin) — from $29 — 100 mg or 300 mg once daily. CREDENCE trial showed 30% reduction in renal endpoints in diabetic nephropathy. Lower limb amputation risk signal; not preferred in patients with peripheral arterial disease.
- Glyxambi (Empagliflozin + Linagliptin) — from $35 — Combination SGLT2 inhibitor + DPP-4 inhibitor for dual glucose-lowering with a single tablet.
Frequently Asked Questions
Why would a doctor choose Steglatro over Jardiance or Forxiga?
In most clinical settings, they wouldn’t — and guidelines increasingly don’t recommend ertugliflozin as the first-choice SGLT2 inhibitor. Steglatro might be prescribed when a patient has already tried empagliflozin or dapagliflozin and not tolerated them, or in straightforward glucose-lowering-only settings where CV and renal benefits are not a primary concern. In practice, ertugliflozin prescriptions have declined significantly since the VERTIS CV results.
Does Steglatro cause weight loss?
Yes — ertugliflozin causes average weight loss of approximately 1.5–3 kg over 26 weeks, primarily through osmotic calorie loss (glucose excreted in urine) and modest fluid volume reduction. This is comparable to other SGLT2 inhibitors.
Can Steglatro be used in chronic kidney disease?
Ertugliflozin’s efficacy depends on kidney function — it is not effective if eGFR <45, and is contraindicated if eGFR <30 or in dialysis patients. Importantly, it has no FDA-approved CKD indication (unlike dapagliflozin and empagliflozin). For patients with CKD and type 2 diabetes, Forxiga (dapagliflozin) or Jardiance (empagliflozin) are the evidence-supported choices.
What is the risk of genital thrush with Steglatro?
Approximately 10–14% of patients (higher in women, lower in men) develop genital mycotic infections on ertugliflozin — a class-wide SGLT2 effect caused by increased urinary glucose providing substrate for Candida species. Most cases are mild and respond to standard antifungal treatment. Good genital hygiene reduces recurrence risk.
Is ertugliflozin approved for heart failure?
No. Ertugliflozin does not have an FDA-approved heart failure indication. Empagliflozin (Jardiance) and dapagliflozin (Forxiga) are both FDA-approved for HFrEF and HFpEF — including in patients without diabetes. This is a meaningful clinical distinction.
Where can I order SGLT2 inhibitor alternatives online?
MedsBase stocks Jardiance (empagliflozin), Forxiga (dapagliflozin), and Invokana (canagliflozin) — all sourced from WHO-GMP certified manufacturers and shipped worldwide with discreet packaging. All orders are covered by our Reshipment Assurance Policy.
Medical Disclaimer: SGLT2 inhibitors are prescription medications for type 2 diabetes requiring medical supervision. Do not start, stop, or change your diabetes medication without consulting your doctor. Blood glucose, HbA1c, kidney function, and blood pressure should be monitored regularly during therapy.
Written by
Sophie ChenPharmaceutical Content Researcher · 8 years experience
Sophie Chen is a pharmaceutical content researcher with 8 years covering generic medication access and clinical pharmacology. She specialises in international regulatory frameworks, bioequivalence standards, and patient-facing education on therapeutic drug classes. She is not a clinician.