Rankings / Longevity — Supplements

SGLT2 inhibitors (canagliflozin / empagliflozin / dapagliflozin)

Longevity · SGLT2 inhibitor / glucoretic

Also known as: Invokana ·Jardiance ·Farxiga ·gliflozin ·flozin ·empagliflozin ·dapagliflozin ·canagliflozin

Tier C+

Reviewed by Read Off Label · Last reviewed · How we grade

geroprotectorsenolyticmetabolicrepurposed-drug
5.5 / 10
Tier C+
Ev 6 Bn 5 Sf 5

Bottom line

Read Off Label grades SGLT2 inhibitors (canagliflozin / empagliflozin / dapagliflozin) as C+ (5.5/10) based on moderate evidence, med benefit magnitude, and a med-risk safety profile.

The strongest repurposed-drug geroscience case after rapamycin and metformin.

Studied, labeled, or reported-use context: Oral once daily (empagliflozin 10-25 mg, dapagliflozin 10 mg, canagliflozin 100-300 mg) — Rx; not individualized guidance.

What the evidence says

The strongest repurposed-drug geroscience case after rapamycin and metformin. NIA Interventions Testing Program: canagliflozin extended median male-mouse lifespan ~14% (males only; Miller et al., JCI Insight 2020). Katsuumi (Nature Aging 2024): canagliflozin works as an indirect senolytic — clearing senescent cells by restoring immune surveillance — and extended lifespan in progeroid mice even when started in middle age. In humans, SGLT2 inhibitors cut all-cause mortality and heart-failure/kidney events across DECLARE-TIMI 58, EMPA-REG OUTCOME, DAPA-HF and the CKD trials, including in the very old (AGING-HF, mean age 90: mortality HR 0.67). The healthy-longevity benefit is extrapolated from disease populations and mice — no healthspan RCT yet; the male-only mouse lifespan effect is unexplained.

Mechanism

Block sodium-glucose cotransporter 2 in the kidney's proximal tubule, spilling glucose into urine; beyond glucose-lowering they shift fuel use toward ketones, lower inflammation, and act as an indirect senolytic — enhancing immune clearance of senescent cells

Studied, labeled, or reported dose & route

Oral once daily (empagliflozin 10-25 mg, dapagliflozin 10 mg, canagliflozin 100-300 mg)

This records doses and routes described in studies, approved labeling, clinical practice, or documented use. It is not individualized guidance and does not establish safety; context changes with indication, formulation, health history, monitoring, and other medicines.

Citations

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Common questions

What does the evidence show about SGLT2 inhibitors (canagliflozin / empagliflozin / dapagliflozin)'s effects?
Read Off Label rates the evidence for SGLT2 inhibitors (canagliflozin / empagliflozin / dapagliflozin) as Moderate and the benefit magnitude as med, producing an overall grade of C+ (5.5/10). The strongest repurposed-drug geroscience case after rapamycin and metformin.
What safety findings are reported for SGLT2 inhibitors (canagliflozin / empagliflozin / dapagliflozin)?
SGLT2 inhibitors (canagliflozin / empagliflozin / dapagliflozin) has a med risk profile in the database. Med (genital/urinary infections, euglycemic ketoacidosis, volume depletion; well-characterized) Legal status: Rx (FDA-approved for T2D, heart failure, CKD — Invokana / Jardiance / Farxiga; off-label as a geroprotector).
What doses or routes are reported for SGLT2 inhibitors (canagliflozin / empagliflozin / dapagliflozin)?
Oral once daily (empagliflozin 10-25 mg, dapagliflozin 10 mg, canagliflozin 100-300 mg) This is context from studies, approved labeling, clinical practice, or documented use; it is not individualized guidance and does not establish safety.
How does SGLT2 inhibitors (canagliflozin / empagliflozin / dapagliflozin) work?
Block sodium-glucose cotransporter 2 in the kidney's proximal tubule, spilling glucose into urine; beyond glucose-lowering they shift fuel use toward ketones, lower inflammation, and act as an indirect senolytic — enhancing immune clearance of senescent cells

This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.