At the same time that the FDA announced it was strengthening existing warnings about the risk of acute kidney injury in patients with type 2 diabetes treated with the sodium-glucose co-transporter 2 (SGLT2) inhibitors canagliflozin (Invokana, and others) and dapagliflozin (Farxiga, and others),1 a study was published showing that the third SGLT2 inhibitor, empagliflozin (Jardiance, and others), slowed the progression of renal dysfunction in patients with type 2 diabetes.2

SGLT2 INHIBITION — SGLT2, a membrane protein expressed mainly in the kidney, transports filtered glucose from the proximal renal tubule into tubular epithelial cells. SGLT2 inhibitors decrease renal glucose and sodium reabsorption and increase urinary glucose excretion, resulting in lower blood glucose levels and a modest reduction in HbA1c. These drugs also increase urinary sodium excretion, cause...  Continue reading

The FDA has approved Onzetra Xsail (Avanir), a nasal powder formulation of sumatriptan, for acute treatment of migraine in adults. Nasal spray formulations of sumatriptan (Imitrex) and zolmitriptan (Zomig) have been available for many years.

SUMATRIPTAN FORMULATIONS — Subcutaneously administered sumatriptan relieves pain faster (in about 10 minutes) and more effectively than other triptan formulations, but it causes more adverse effects.1,2 With oral sumatriptan, onset of pain relief generally ... Continue reading