NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

Which SGLT2 inhibitor is not recommended for use if eGFR is less than 30 unless there is significant albuminuria?

1. Canagliflozin

2. Dapagliflozin

3. Empagliflozin

4. All of the above

The correct answer is: Canagliflozin

SGLT2 inhibitors are a class of drugs commonly used to treat type 2 diabetes. However, as with any medication, there are certain precautions and contraindications that must be considered before use. One such precaution is the level of kidney function, as impaired kidney function can affect the metabolism and elimination of these drugs. In particular, Canagliflozin, also known as Invokana, is not recommended for use if eGFR (estimated glomerular filtration rate) is less than 30 unless there is significant albuminuria (excessive levels of protein in the urine). This is because Canagliflozin is primarily eliminated through the kidneys and can cause further damage if used in patients with severe kidney impairment. The other SGLT2 inhibitors, Dapagliflozin (Farxiga) and Empagliflozin (Jardiance), are also eliminated through the kidneys but have less of an impact on kidney function and can still be used in patients with eGFR less than 30. Therefore, the correct answer is A as it is the only SGLT2 inhibitor that is not recommended for use in patients with severe kidney impairment.