SGLT2 Inhibitor (Heart Failure)

Dapagliflozin is an option for treating symptomatic chronic heart failure according to NICE TA679 and NICE TA902.

Empagliflozin is an option for treating symptomatic chronic heart failure according to NICE TA773 and NICE TA929.

In order to ensure clarity for clinicians and promote equitable access, the Kent and Medway Medicines Optimisation Team recommends that:

1. SGLT2 inhibitors (Dapagliflozin & Empagliflozin as per NICE TAs), when used to treat chronic heart failure with preserved, mildly reduced, OR reduced ejection fraction, is initiated by/on the advice of a heart failure specialist, with follow on prescribing in primary care.

2. Where specialist community heart failure teams exist, SGLT2 inhibitors (Dapagliflozin &
Empagliflozin as per NICE TAs) may be initiated by the team following consultation with a
(consultant led) specialist heart failure multidisciplinary team (MDT), with a clear audit trail of
such consultation.

3. For patients with comorbidities e.g., diabetes, multi-speciality MDTs would be appropriate.

4. Monitoring requirements and discontinuation criteria should be set out at initiation and
clearly communicated to the clinician who continues with the prescribing of SGLT2 inhibitors
(Dapagliflozin & Empagliflozin as per NICE TAs).

K&M Implementation of NICE TA’s – SGLT2 inhibitors (Dapagliflozin & Empagliflozin) in the treatment of chronic heart failure