— Product
DAPACROSS-5MG TAB
DAPAGLIFLOZIN 5MG
DAPACROSS-5MG TAB is a tablet of dapagliflozin 5 mg, an SGLT2 inhibitor. It is used in type 2 diabetes mellitus to improve glycaemic control, at the lower starting strength, and works by increasing the excretion of glucose in the urine rather than by acting on insulin.
01
Benefits
- Lowers blood glucose by blocking renal glucose reabsorption, a mechanism independent of insulin secretion or sensitivity.
- Carries a low risk of hypoglycaemia when used alone, because its action is glucose-dependent.
- Produces modest weight loss, which is an advantage over several other glucose-lowering agents.
- Lowers blood pressure modestly through its mild diuretic effect.
- SGLT2 inhibitors have established cardiovascular and renal protective effects in appropriate patients.
- Once-daily dosing, taken with or without food.
02
Side effects
Not everyone gets these. Most are mild and settle as the course finishes.
Common
- Genital fungal infection — thrush in women, balanitis in men
- Urinary tract infection
- Increased urine output and thirst
- Dizziness on standing
Less common
- Dehydration and a fall in blood pressure
- Rise in serum creatinine on starting, usually settling
- Constipation or nausea
- Back pain
Stop and get medical help if any of these occur
- Nausea, vomiting, abdominal pain, deep rapid breathing or confusion — this may be ketoacidosis even with a near-normal blood glucose
- Severe pain, redness, swelling or blackening of the skin between the genitals and anus, with fever
- Fever with loin pain, or blood in the urine
- Marked dizziness, fainting or a very reduced urine output
- Signs of severe dehydration
03
Precautions
- Dapagliflozin can cause euglycaemic diabetic ketoacidosis — ketoacidosis with a blood glucose that is only mildly raised or normal. Patients must know the symptoms and that a normal glucose reading does not exclude it.
- Stop before major surgery, during acute serious illness, and during prolonged fasting or a very low carbohydrate diet, all of which precipitate ketoacidosis.
- Contraindicated in type 1 diabetes and in a history of diabetic ketoacidosis.
- Genital fungal infection is common. Counsel on genital hygiene and adequate fluid intake before starting.
- Fournier's gangrene, a rare but life-threatening perineal infection, has been reported. Any perineal pain, redness or swelling with fever needs emergency assessment.
- Efficacy depends on renal function and falls as it declines; check renal function before starting and periodically.
- Use with caution alongside diuretics and in the elderly, where volume depletion and hypotension are more likely.
- Contraindicated in pregnancy and breastfeeding.