dapagliflozin

Dapagliflozin is an oral medication in the class of sodium-glucose cotransporter 2 (SGLT2) inhibitors. It is marketed under the brand name Farxiga and works by blocking SGLT2 in the proximal tubules of the kidneys. By inhibiting glucose reabsorption, dapagliflozin increases urinary glucose excretion and lowers blood glucose levels. The drug can also have modest effects on body weight and blood pressure.

Indications and approved use vary by region. In adults with type 2 diabetes, dapagliflozin is used to improve glycemic control as an adjunct to diet and exercise. It has been approved for use in adults with heart failure with reduced ejection fraction, with or without diabetes, to reduce the risk of cardiovascular death and hospitalization for heart failure. It is also approved in adults with chronic kidney disease to reduce the risk of sustained eGFR decline, end-stage kidney disease, cardiovascular death, and hospitalization for heart failure.

Dosing generally starts at 10 mg once daily, taken with or without food. The maximum approved dose is typically 10 mg daily; dosing may be adjusted or avoided in patients with significant renal impairment, and use should be guided by renal function and clinical status. The medication should be used with caution in patients at risk for volume depletion or hypotension.

Common adverse effects include genital mycotic infections and urinary tract infections. Other risks associated with SGLT2 inhibitors, such as dehydration, ketoacidosis (including in patients with near-normal blood glucose), and, rarely, severe infections of the perineum have been described. Dapagliflozin is generally avoided in pregnancy due to limited safety data. As with any medicine, interactions with other drugs and comorbid conditions should be considered, particularly diuretics and agents affecting renal function.