Dapaglip 10

Indications

Dapaglip is prescribed as a supplementary treatment alongside diet and exercise to aid in better glycemic control in adults diagnosed with type 2 diabetes mellitus.
Always use the medication as directed by a registered healthcare provider.

Pharmacology

Dapagliflozin is a Sodium-glucose Co-transporter 2 (SGLT2) inhibitor. This enzyme, located in the proximal renal tubules, plays a key role in reabsorbing glucose from the filtrate back into the bloodstream. By blocking SGLT2, Dapagliflozin reduces glucose reabsorption and lowers the renal threshold for glucose (RTG), thereby increasing glucose excretion in urine.

Dosage & Administration

• Adults: The usual starting dose for Dapagliflozin is 5 mg once daily, preferably taken in the morning, with or without food. For patients who are tolerating the 5 mg dose but require further glycemic control, the dose may be increased to 10 mg once daily.
• Patients with Renal Impairment: Renal function should be assessed before starting Dapagliflozin therapy and periodically during treatment. It is contraindicated in individuals with an eGFR lower than 60 mL/min/1.73 m². For patients with mild renal impairment (eGFR ≥60 mL/min/1.73 m²), no dosage adjustment is necessary. Dapagliflozin should be discontinued if eGFR falls persistently below 60 mL/min/1.73 m².
• Children: The safety and efficacy of Dapagliflozin in individuals under 18 years of age have not been established.
  Always follow the guidance of a registered healthcare professional when using this medication.

Drug Interactions

Dapaglip may interact with diuretics such as thiazide and loop diuretics, increasing the risk of dehydration and hypotension. When combined with insulin or insulin secretagogues (e.g., sulfonylureas), there is a higher risk of hypoglycemia, which may require dose adjustments. Other potential interactions include antihypertensive drugs, pioglitazone, medications affecting renal function (e.g., ACE inhibitors, angiotensin II blockers), GLP-1 agonists, valsartan, rifampin, and mefenamic acid.

Contraindications

Dapaglip is not suitable for patients with known hypersensitivity to Dapagliflozin or any of its ingredients. It is also contraindicated in those with severe renal impairment, end-stage renal disease, or patients undergoing dialysis.

Side Effects

Common side effects of Dapaglip include hypotension, ketoacidosis, acute kidney injury, worsening renal function, urosepsis, pyelonephritis, hypoglycemia (particularly with insulin or insulin secretagogues), genital mycotic infections, elevated LDL-C cholesterol, nasopharyngitis, urinary tract infections, and in some cases, bladder cancer.

Pregnancy & Lactation

Dapagliflozin falls under pregnancy category C. There is insufficient data on the safety of Dapagliflozin during pregnancy. It should only be used if the potential benefits outweigh the risks to the fetus. It is not known whether Dapagliflozin is excreted in breast milk, but it is not recommended for use during breastfeeding.

Precautions & Warnings

• Hypotension: Prior to starting Dapaglip, evaluate volume status, especially in the elderly, patients with renal issues, low systolic blood pressure, or those on diuretics. Continue monitoring throughout the treatment.
• Renal Function: Regular monitoring of renal function is recommended during therapy.
• Hypoglycemia: For patients using insulin or insulin secretagogues, adjust the dose of these medications to minimize the risk of hypoglycemia when combined with Dapaglip.
• Bladder Cancer: Clinical trials have shown an imbalance in bladder cancer incidence. Dapaglip is contraindicated in patients with active bladder cancer and should be used cautiously in those with a history of bladder cancer.
• Macrovascular Outcomes: No clinical studies have demonstrated a definitive benefit of Dapaglip in reducing macrovascular risks compared to other antidiabetic therapies.

Therapeutic Class

Sodium-glucose Co-Transporter-2 (SGLT2) Inhibitors

Storage Conditions

Store Dapaglip in a cool, dry place, below 30°C, and away from direct light. Keep out of reach of children.