Dapagliflozin propanediol

Indications

Dapagliflozin propanediol is used for: Type 2 diabetes mellitus

Adult Dose

Diabetes Mellitus Type 2 Selective sodium-glucose transporter-2 (SGLT2) inhibitor indicated as an adjunct to diet and exercise to improve glycemic control with type 2 diabetes mellitus Initial: 5 mg PO qDay; take in am with or without food May increase to 10 mg qDay in patients tolerating 5 mg/day who have an eGFR ?60 mL/min/1.73 m² and require additional glycemic control Indicated as monotherapy, as initial therapy with metformin, or as an add-on to other oral glucose-lowering agents, including metformin, glimepiride, sitagliptin, and insulin Hepatic impairment Mild or moderate: No dosage adjustment required Severe: Not studied

Child Dose

Renal Dose

Renal impairment eGFR ?60 mL/min/1.73 m²: No dosage adjustment required eGFR <60 mL/min/1.73 m²: Do not initiate Not recommended with eGFR that declines persistently between 30 to <60 mL/min/1.73 m² eGFR <30 mL/min/1.73 m²: Contraindicated

Administration

Contra Indications

Hypersensitivity to dapagliflozin propanediol or to any of the excipients. Moderate to severe renal impairment; end-stage renal disease; active bladder cancer. Pregnancy (2nd & 3rd trimester) & lactation.

Precautions

CV disease; history of hypotension. Monitor vol status & electrolytes. UTI. Childn. Elderly. Lactation: Unknown whether distributed in human breast milk; breast feeding women should discontinue dapagliflozin or nursing taking into account the importance of the drug to the mother

Pregnancy-Lactation

Interactions

Hypoglycemia may occur w/ concomitant use w/ insulin & insulin secretagogues eg sulfonylureas. Decrease in Cmax & AUC w/ rifampin. Increase in Cmax & AUC w/ mefenamic acid. Increased thiazide & loop diuretic effects; may increase risk of dehydration & hypotension. Pioglitazone.

Adverse Effects

Side effects of Dapagliflozin propanediol : >10% Renal impairment 1-10% Female genital mycotic infections (6.9-8.4%),Urinary tract infection (4.3-5.7%),Increased urination (2.9-3.8%),Male genital mycotic infections (2.7-2.8%),Dyslipidemia (2.1-2.5%),Constipation (1.9-2.2%),Discomfort with urination (2.6-2.1%),Extremity pain (1.7-2%),Volume depletion <1% Hypersensitivity (0.3%)

Mechanism of Action

Dapagliflozin is a highly potent, selective, and reversible inhibitor of sodium-glucose cotransporter 2 (SGLT2) that improves glycemic control in patients with type 2 diabetes mellitus by reducing renal glucose reabsorption leading to urinary excretion of excess glucose (glucuresis).