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Nov 13, 2023


Heart Health

Inpefa For Diabetes and Heart Failure

What is Inpefa?

Inpefa, known as Sotagliflozin, is a prescription medication classified under the drug category of sodium-glucose co-transporter 1 and 2 inhibitors (SGLT1/SGLT2 inhibitors). It helps manage type 2 diabetes by regulating blood glucose levels.

Mechanism of Action: Inpefa targets two key areas:

  1. Intestinal Absorption: By inhibiting SGLT-1 in the intestines, Inpefa reduces the absorption of glucose from the diet, thereby lowering blood glucose levels.
  2. Renal Excretion: Inpefa inhibits SGLT-2 in the kidneys, which leads to increased excretion of glucose in the urine.
Cardiovascular Benefits

Clinical trials have suggested that Inpefa also offers cardiovascular advantages. These studies have shown a significant reduction in the risk of death and hospitalizations related to heart failure, highlighting its potential in managing cardiovascular aspects of diabetes. On May 26, 2023, Inpefa was approved by the FDA specifically for the treatment of heart failure.

Dosage and Administration

Inpefa is available in tablet form, with dosages of 200 mg and 400 mg. It’s taken by mouth, approximately 1 hour before breakfast or the first meal of the day. Starting with a dosage of 200 mg, healthcare providers may increase the dose to 400 mg per day after a few weeks, based on the patient's response and tolerance.

Side Effects of Inpefa

Common side effects
  • Yeast infection in both men and women
  • Urinary tract infection (UTI)
  • Diarrhea
  • Low blood sugar
  • Dizziness
  • Dehydration
Common side effects
  • Having too much acid in your blood (ketone), also known as ketoacidosis. Symptoms of this may include nausea, vomiting, stomach pain, confusion, or having difficulty breathing.
  • Genital fungal infections (may become serious and lead to hospitalization).
  • Low blood pressure, which may include symptoms such as dizziness, lightheadedness, tiredness, and/or blurred vision.
  • Low blood sugar, which may include symptoms such as headache, sleepiness, hunger, dizziness, sweating, shakiness, and/or increased heartbeat.
  • Low fluids in your body, which may result in low blood pressure or dehydration. Note that individuals aged 65 or older have an elevated risk of developing this condition. The likelihood of being at risk is also increased if you have pre-existing kidney issues or are prescribed loop diuretics, commonly referred to as water pills.
  • Developing a flesh-eating bacterial infection of the genitals, also known as Fournier's gangrene. Symptoms of this may include fever, pain, tenderness, redness, or swelling in your genital area.
  • Severe allergic reaction, including experiencing symptoms such as swelling in the face, throat, tongue, or mouth; rash; trouble breathing.

Pregnancy and Inpefa

Insufficient data exists to determine the safety of Inpefa for use by pregnant women. While animal studies revealed adverse effects on unborn babies in the second and third trimesters, this doesn't necessarily predict the same outcomes in humans. Inpefa is also not recommended while breastfeeding.

If you are pregnant or considering pregnancy, speak with your healthcare provider to explore the most appropriate heart failure treatment for you.


Inpefa, like many medications, has the potential to interact with a variety of other substances. Understanding these interactions is crucial for safe and effective medication use. Here are key considerations:

  • Digoxin: Used for heart conditions, its interaction with Inpefa may lead to increased side effects.
  • Rifampin: Commonly used for treating infections, it may alter the effectiveness of Inpefa.
  • Lithium: Used for mental health conditions, its combination with Inpefa could enhance side effects.
  • Alcohol can exacerbate dizziness, lead to dehydration, and when combined with Inpefa, may increase the risk of low blood pressure and other adverse effects.

Overpaying for Inpefa?

Managing diabetes effectively often involves finding the right medication, but for many, the high cost of drugs like Inpefa can pose a significant barrier. Inpefa, known for its efficacy in treating type 2 diabetes, comes with a price tag that may be prohibitive for patients without extensive insurance coverage.

Recognizing this challenge, Marley Drug offers an alternative that blends efficacy with affordability. By providing access to cost-effective options like Brenzavvy, which belongs to the same drug class as Inpefa and delivers comparable therapeutic benefits, Marley Drug is committed to ensuring that effective diabetes management is more accessible. This initiative not only supports better health outcomes for patients but also aligns with the growing need for more financially sustainable healthcare solutions.

Learn more about BRENZAVVY (bexagliflozin) and how to access it through Marley Drug.

Speak With Your Doctor

You should consult with your doctor about Inpefa for heart failure because it allows for a personalized assessment of its suitability for their unique condition. This conversation may help you understand the potential benefits and risks, consider any interactions with existing medications, and ensure that Inpefa aligns with your medical history and specific health needs.