Dapagliflozin Saxagliptin

Dapagliflozin Saxagliptin Brand Name– QTERN

What is Dapagliflozin Saxagliptin

Dapagliflozin saxagliptin is a combination of 2 oral antidiabetic agents. Dapagliflozin is a sodium-glucose co-transporter 2 (SGLT2) inhibitor.

Saxagliptin is a dipeptidyl-peptidase-4 (DPP-4) inhibitor. The product used to improve glycemic control in adults with type 2 diabetes mellitus (DM).

In clinical trials, when saxagliptin was added to dapagliflozin and metformin therapy, patients experienced a mean A1C reduction of 0.5% over baseline, a significant difference vs. dapagliflozin-metformin therapy.

Such reductions may allow more patients to achieve A1C target goals. Dapagliflozin has been shown to reduce the risk of hospitalization for heart failure (HF) compared with placebo.

Dapagliflozin saxagliptin should not be used if the eGFR is less than 45 mL/minute/1.73 m² due to the reduced efficacy of dapagliflozin.

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). DPP-4 inhibitors, like saxagliptin, are therapeutic options that are generally well tolerated, have a neutral effect on weight and minimal risk of hypoglycemia.

Indications

• type 2 diabetes mellitus

For the treatment of type 2 diabetes mellitus in combination with diet and exercise

Side Effects

1. abdominal pain
2. anaphylactoid reactions
3. angioedema
4. arthralgia
5. back pain
6. balanitis
7. bone fractures
8. bullous rash
9. candidiasis
10. constipation
11. cystitis
12. dehydration
13. diabetic ketoacidosis
14. diarrhea
15. diuresis
16. exfoliative dermatitis
17. headache
18. heart failure
19. hypercholesterolemia
20. hyperlipidemia
21. hyperphosphatemia
22. hypoglycemia
23. hypotension
24. hypovolemia
25. increased urinary frequency
26. infection
27. influenza
28. lymphopenia
29. nausea
30. necrotizing fasciitis
31. new primary malignancy
32. orthostatic hypotension
33. pancreatitis
34. pemphigus
35. pharyngitis
36. polyuria
37. prostatitis
38. rash
39. renal failure (unspecified)
40. rhabdomyolysis
41. sinusitis
42. thrombocytopenia
43. tissue necrosis
44. urticaria
45. vaginitis
46. vomiting

Monitoring Parameters

• blood glucose
• glycosylated hemoglobin A1c (HbA1c)
• serum cholesterol profile
• serum creatinine/BUN

Contraindications

• adrenal insufficiency
• arthralgia
• balanitis
• bladder cancer
• breast-feeding
• children
• dehydration
• diabetic ketoacidosis
• dialysis
• exfoliative dermatitis
• fever
• geriatric
• heart failure
• history of angioedema
• hypercholesterolemia
• hypercortisolism
• hyperglycemia
• hyperthyroidism
• hypoglycemia
• hypotension
• hypothyroidism
• hypovolemia
• infants
• laboratory test interference
• malnutrition
• pancreatitis
• pituitary insufficiency
• pregnancy
• pyelonephritis
• renal disease
• renal failure
• renal impairment
• serious rash
• surgery
• tissue necrosis
• type 1 diabetes mellitus
• urinary tract infection (UTI)
• vaginitis

Interactions

• Acebutolol
• Acetaminophen; Aspirin, ASA; Caffeine
• Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
• Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
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• Acetaminophen; Dextromethorphan; Phenylephrine
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