Dehydration from SGLT2 Inhibitors: Risks, Signs, and What to Do

When you take an SGLT2 inhibitor, a class of diabetes medications that lower blood sugar by making your kidneys flush out excess glucose through urine. Also known as gliflozins, these drugs include empagliflozin, dapagliflozin, and canagliflozin. They’re effective for blood sugar control and heart protection—but they also pull water out of your body with every trip to the bathroom. This isn’t just increased urination. It’s a real risk for dehydration, a condition where your body loses more fluid than it takes in, leading to dizziness, low blood pressure, and even kidney damage. Many people don’t realize this side effect until they feel awful—sometimes after just a few days on the drug.

Dehydration from SGLT2 inhibitors doesn’t happen the same way for everyone. It’s worse if you’re older, already on a water pill like hydrochlorothiazide, have kidney issues, or skip fluids because you’re not thirsty. You might not even feel thirsty, because these drugs mess with your body’s normal signals. That’s why the warning signs are sneaky: dry mouth, fatigue, dark urine, confusion, or a sudden drop in blood pressure when standing up. In serious cases, it can trigger acute kidney injury or dangerously low blood volume. The FDA has issued multiple safety alerts about this, especially for people with type 1 diabetes or those who cut carbs too hard while on these meds.

It’s not just about drinking more water. You need to watch your electrolyte balance, the levels of sodium, potassium, and other minerals that help your nerves and muscles work properly. SGLT2 inhibitors can lower sodium and sometimes spike potassium, especially if you’re also taking blood pressure meds like ACE inhibitors or ARBs. That’s why labs matter—your doctor should check your kidney function and electrolytes within the first few weeks of starting the drug. If you’re sick, fasting, or exercising hard, you may need to pause the medication temporarily. Talk to your provider before making any changes.

The posts below give you real, practical advice on how to spot early signs of trouble, what to do if you feel dizzy or weak, how to balance fluid intake without overdoing it, and which other drugs make dehydration riskier. You’ll also find stories from people who’ve been through it—and how they learned to manage it safely. This isn’t theoretical. It’s about staying out of the ER and keeping your body in balance while taking a drug that’s supposed to help you live longer.

SGLT2 Inhibitor Side Effects: Dehydration, Dizziness, and Blood Pressure Changes Explained

Medications and Treatments

18 Nov 2025
by Michael Brown
2 Comments

SGLT2 Inhibitor Side Effects: Dehydration, Dizziness, and Blood Pressure Changes Explained

SGLT2 inhibitors help lower blood sugar and protect the heart and kidneys, but they can cause dehydration, dizziness, and low blood pressure. Learn how these side effects happen, who’s at risk, and how to manage them safely.