Background and Purpose: Sodium glucose co-transporter-2 (SGLT2) inhibitors have proven effective in reducing the risk of major adverse cardiovascular events, heart failure hospitalization, and kidney disease progression in patients with or without diabetes. The latest international consensus has expanded the indications for and prioritized the use of SGLT2 inhibitors. Yet, many patients discontinue these drugs due to genitourinary system side effects. This review intends to help clinicians manage these adverse effects. Methods: We conducted a search using the keywords "SGLT2 inhibitors," "urinary tract infection (UTI)," and/or "genital mycotic infec-tion (GMI)" in PubMed. We evaluated these papers for their relevance to the inci-dence, prevention, and treatment of adverse effects. Results: In clinical trials and cohort studies, SGLT2 inhibitors didn’t increase the risk of UTIs in people with dia-betes. However, these inhibitors did slightly but significantly raise the UTI risk in non-diabetic individuals. As for GMIs, the trials showed that SGLT2 inhibitors were associated with a 3.5 times higher risk in diabetic patients, who had an infection in-cidence rate of 5% or more. In non-diabetic individuals, these inhibitors increased the GMI risk 2.4 times, with a 1.4% incidence rate. Risk factors for genital mycotic infections among SGLT2 inhibitor users include a history of these infections, obesity, female gender, and uncircumcised male status. Conclusion: Before prescribing SGLT2 inhibitors, clinicians should provide comprehensive prevention education to patients at high risk for GMIs. If symptoms arise, prompt treatment is necessary to alleviate discomfort and ultimately improve adherence to the medication.
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