Ertugliflozin is a sodium-glucose cotransporter 2 (SGLT2) inhibitor. It works by blocking the reabsorption of glucose in the kidneys, causing excess glucose to be excreted in the urine. This mechanism not only lowers blood sugar but also induces a mild, persistent ketogenic state, which may activate longevity pathways like AMPK, mimicking some metabolic benefits of caloric restriction.
Verdict
A promising metabolic modulator with strong evidence, but requires medical supervision.
HEALTHSPAN IMPACT
High Value
RISK LEVEL
Moderate
EVIDENCE GRADE
A
MONTHLY COST
$150 - $550
Protocol
- A typical off-label protocol involves taking the lowest effective dose, 5 mg, once daily in the morning.
Flags
- Increased risk of genital mycotic infections (yeast infections) and urinary tract infections.
- Carries a risk of euglycemic ketoacidosis, a serious metabolic state requiring immediate medical attention.
- May cause dehydration and hypotension (low blood pressure), especially in older adults or those on diuretics.
- A rare but severe risk of Fournier's gangrene (necrotizing fasciitis of the perineum) is associated with SGLT2 inhibitors.
- Contraindicated for individuals with severe kidney impairment (low eGFR).