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Ertugliflozin for Horses

Developed in collaboration with Kathleen Anderson, DVM| Founding Partner, Equine Veterinary Care

Last reviewed: 2/2/2024

What is Ertugliflozin?

Ertugliflozin is a medication prescribed by veterinarians to help control insulin (blood sugar) levels in horses and ponies with insulin dysregulation (ID), equine metabolic syndrome (EMS), refractory hyperinsulinemia (high blood sugar), and hyperinsulinemic-associated laminitis (HAL), especially for horses that don't respond to changes in diet or other accepted management practices for metabolic syndromes.

Ertugliflozin is not FDA approved for equine use. It falls into the sodium glucose co-transport-2 (SGLT2) inhibitors category and is administered orally at a dosage of 0.05 mg/kg once daily, for at least 30 days.

Ertugliflozin is also sometimes referred to in chemical terms as L-pyroglutamic acid. Other drugs in the same class include canagliflozin, dapagliflozin, velagliflozin, and empagliflozin.

Key Facts
  • Ertugliflozin is prescribed by veterinarians to help control insulin and has demonstrated lowered insulin levels when administered with veterinary oversight.
  • It works by inhibiting the protein that aids in the absorption of sugar in the kidneys.
  • Ertugliflozin is generally well tolerated, but there are some side effects, including an increased risk of renal failure.

How Ertugliflozin Works

Ertugliflozin works by inhibiting the SGLT2 protein, which aids in the reabsorption of glucose in the kidneys, leading to excretion of more glucose through urine. Once daily doses of ertugliflozin have been shown to: 

  • Lower blood sugar levels,
  • Correct insulin to normal or near-normal levels,
  • Reduce abnormal fats pads.

Possible Side Effects of Ertugliflozin

  • Weight loss
  • Urinary tract infection
  • Excessive urination
  • Excessive drinking 
  • Risk of renal failure
  • Hypertriglyceridemia (too many triglycerides, or fats, in the blood)


  • Use with caution in horses treated concurrently with nonsteroidal anti-inflammatory drugs like phenylbutazone or acetaminophen due to an increased risk of renal failure.
  • Monitor closely for signs of hyperlipidemia (elevated lipid levels) and hepatic lipidosis (fatty liver syndrome).
  • Perform routine bloodwork to follow kidney and liver parameters.

Drug Interactions

Ertugliflozin increases the risk of renal failure when administered concurrently with nonsteroidal anti-inflammatory drugs like phenylbutazone or acetaminophen. Therefore routine bloodwork is important to monitor kidney and liver parameters. Clinical trials have demonstrated clinical improvement that has eliminated the need for NSAIDS thus eliminating the drug interaction concern.

Wedgewood Pharmacy provides medication options that help ensure accurate dosing, especially for hard to medicate pets. Click below for a complete list of Wedgewood’s dosing forms and strengths.


What To Do if You Miss a Dose

If you miss giving your horse a dose, give the next dose as soon as you remember or, if it is close to the next scheduled dose, return to the regular schedule. Do not give two doses (double dose) to catch up. If you are not sure what to do, call your veterinarian and follow their directions.

What to Do in the Case of a Ertugliflozin Overdose

Ertugliflozin is generally well tolerated. 

Contact your veterinarian immediately if you suspect an overdose.

If you suspect your horse or another animal has accidentally overdosed or has eaten this medication inadvertently, immediately contact your veterinarian or the A.S.P.C.A.’s Animal Poison Control Center at 888-426-4435.

If you or someone else has ingested this medication, call the National Capital Poison Center at 800-222-1222.

Cost of Ertugliflozin

The cost of Wedgewood Pharmacy’s ertugliflozin is determined by the specific dosage based on the horse’s weight and other factors as determined by your veterinarian. 

Compounded medicines are prepared for the exact strength your veterinarian prescribes. The price of the medication will depend on the dosage and the medication form, with certain dosage forms and higher strengths generally being more expensive. 

In addition, the cost of a medication will depend upon the price of the other active pharmaceutical ingredients and may increase the cost of the finished drug.

Looking for Ertugliflozin

Looking for Ertugliflozin?

We can let your veterinarian know that you are interested in our compounded Ertugliflozin.

Frequently Asked Questions

Frequently Asked Questions for Ertugliflozin

Will ertugliflozin cure my horse’s Laminitis/Equine Metabolic Syndrome?

No, ertugliflozin does not cure Laminitis/Equine Metabolic Syndrome, but it has been proven to lower blood sugar levels and help them to get to normal or near-normal levels.

Is there any monitoring that needs to be done with ertugliflozin?

Because of the risk for renal failure, horses prescribed ertugliflozin should be closely monitored by your veterinarian for signs of elevated lipid levels (hyperlipidemia) and fatty liver syndrome (hepatic lipidosis) daily observation and routine bloodwork of kidney & liver function.

What are other benefits of ertugliflozin?

Ertugliflozin can be effective in reversing or reducing abnormal fat pads and reducing or eliminating laminitis pain in horses with refractory hyperinsulinemia and laminitis.

This article is meant to provide general and not medical advice. We strongly recommend that a veterinarian be consulted for the specific medical needs of your animal.



Kentucky Equine Research Study
National Library of Medicine
BEVA Equine Veterinary Education