Dapagliflozin Brand Name– Farxiga
What is Dapagliflozin
Dapagliflozin is an oral antidiabetic agent of the sodium-glucose co-transporter 2 (SGLT2) inhibitor class.
Dapagliflozin works by blocking the reabsorption of glucose by the kidney, which results in increased glucose excretion and reduced blood glucose concentrations.
Dapagliflozin is used to improve glycemic control in adults with type 2 diabetes mellitus (DM). Dapagliflozin is also used to reduce the risk of hospitalization for heart failure (HF) in adults with type 2 DM and established cardiovascular (CV) disease or multiple CV risk factors.
Dapagliflozin was superior to placebo in reducing the incidence of the primary composite endpoint of hospitalization for heart failure or CV death (HR 0.83 [95% CI 0.73, 0.95]), which reflected a lower rate of hospitalization for HF in subjects randomized to dapagliflozin (HR 0.73 [95% CI 0.61, 0.88]), with no change in the risk of CV death.
The drug is not recommended for use in patients with moderate to severe renal impairment, as drug efficacy is reduced in these patients, and the risk for renal-related adverse reactions may increase.
Metformin is first-line in the treatment of type 2 DM. Additional therapy with an SGLT2 inhibitor with evidence of reducing HF and/or chronic kidney disease (CKD) progression should be considered in patients with indicators of high-risk or established CKD or HF, independent of baseline A1C or individualized A1C target.
SGLT2 inhibitors with proven CV-risk reduction, like dapagliflozin, are also an alternative treatment option in DM patients with indicators of high-risk or established CV disease who cannot tolerate a glucagon-like peptide-1 receptor agonist (GLP-1 RA)
Indications
- reduction of heart failure hospitalizations
- type 2 diabetes mellitus
For the treatment of type 2 diabetes mellitus in combination with diet and exercise
Side Effects
- anaphylactoid reactions
- angioedema
- balanitis
- bone fractures
- candidiasis
- constipation
- cystitis
- dehydration
- diabetic ketoacidosis
- diuresis
- hypercholesterolemia
- hyperlipidemia
- hyperphosphatemia
- hypoglycemia
- hypotension
- hypovolemia
- increased urinary frequency
- infection
- influenza
- nausea
- necrotizing fasciitis
- orthostatic hypotension
- pharyngitis
- polyuria
- prostatitis
- rash
- renal failure (unspecified)
- tissue necrosis
- urticaria
- vaginitis
Monitoring Parameters
- blood glucose
- glycosylated hemoglobin A1c (HbA1c)
- serum cholesterol profile
- serum creatinine/BUN
Contraindications
- adrenal insufficiency
- balanitis
- breast-feeding
- children
- dehydration
- diabetic ketoacidosis
- dialysis
- fever
- geriatric
- hypercortisolism
- hyperglycemia
- hyperthyroidism
- hypoglycemia
- hypotension
- hypothyroidism
- hypovolemia
- infants
- laboratory test interference
- malnutrition
- pituitary insufficiency
- pregnancy
- pyelonephritis
- renal disease
- renal failure
- renal impairment
- surgery
- tissue necrosis
- type 1 diabetes mellitus
- urinary tract infection (UTI)
- vaginitis
Interactions
- Acebutolol
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- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
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