Dapaglip 5

Indications

Dapaglip is prescribed as a supplementary treatment alongside diet and exercise to enhance glycemic control in adults diagnosed with type 2 diabetes mellitus.
Consult a registered healthcare professional before using this medication.

Pharmacology

Dapagliflozin acts as an inhibitor of Sodium-glucose co-transporter 2 (SGLT2), primarily located in the proximal renal tubules. SGLT2 plays a crucial role in reabsorbing glucose filtered from the tubular lumen. By inhibiting SGLT2, Dapagliflozin decreases the reabsorption of filtered glucose, lowers the renal threshold for glucose (RTG), and consequently increases glucose excretion in urine.

Dosage & Administration

Adults: The recommended initial dose of Dapagliflozin is 5 mg taken once daily in the morning, with or without food. For patients who tolerate the 5 mg dose and need 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 and monitored periodically. Dapagliflozin should not be initiated in individuals with an eGFR below 60 mL/min/1.73 m². No adjustment is required for patients with mild renal impairment (eGFR ≥ 60 mL/min/1.73 m²). Discontinue Dapagliflozin if eGFR remains persistently below 60 mL/min/1.73 m².
Children: The safety and effectiveness of Dapagliflozin in children and adolescents under 18 years have not been established.
Consult a registered healthcare professional before using this medication.

Interactions

Dapaglip may interact with diuretics (thiazide and loop), potentially heightening the risk of dehydration and hypotension. When used alongside insulin or insulin secretagogues like sulphonylureas, there is an increased risk of hypoglycemia; therefore, a lower dose of insulin or secretagogue may be necessary. Interactions may also occur with antihypertensives, pioglitazone, agents affecting renal function (such as ACE inhibitors and angiotensin II antagonists), GLP-1 agonists, valsartan, rifampin, and mefenamic acid.

Contraindications

Dapagliflozin is contraindicated in individuals with a known hypersensitivity to the drug or any of its components. It is also not suitable for those with severe renal impairment, end-stage renal disease, or patients on dialysis.

Side Effects

Common side effects associated with Dapaglip include hypotension, ketoacidosis, acute kidney injury, renal impairment, urosepsis, pyelonephritis, and hypoglycemia (particularly when used with insulin or secretagogues). Other side effects may include genital fungal infections, increased levels of low-density lipoprotein cholesterol (LDL-C), nasopharyngitis, urinary tract infections, and bladder cancer.

Pregnancy & Lactation

Dapagliflozin is classified as pregnancy category C. Limited controlled studies on its use during pregnancy exist, so it should only be prescribed if the benefits outweigh potential risks to the fetus. It is unknown if Dapagliflozin passes into human breast milk; thus, its use during lactation is not recommended.

Precautions & Warnings

• Hypotension: Evaluate volume status and correct any hypovolemia prior to initiating Dapaglip, especially in the elderly, those with renal impairment, or patients on diuretics. Monitor for signs and symptoms during treatment.
• Renal Function: Regularly monitor renal function while on Dapaglip.
• Hypoglycemia: For patients using insulin or insulin secretagogues with Dapaglip, consider reducing the insulin dose to mitigate hypoglycemia risk.
• Bladder Cancer: An increased incidence of bladder cancer was noted in clinical trials. Dapaglip should not be prescribed to patients with active bladder cancer and should be used cautiously in those with a history of the condition.
• Macrovascular Outcomes: No clinical studies have demonstrated a clear macrovascular risk reduction with Dapaglip or any other antidiabetic medications.

Therapeutic Class

Sodium-glucose Cotransporter-2 (SGLT2) Inhibitors

Storage Conditions

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