DAPAGLIFLOZIN
- It is an antidiabetic medication ,Commonly prescribed for type II Diabetic mellitus
- Based on the receptor site it works , it is grouped under the class of drugs known as SGLT-2 inhibitors
- This acts by removing excess glucose from patients body through urine
- It is one of the protective drug which can be advised for people suffering from any heart conditions
- The word DAPAGLIFLOZIN means GLI -glucose,FLOZ -flow ,IN-inhibitor .So in other words it means an sodium glucose transporter -2 inhibitor(SGLT-2)
- Upon inhibition thereby decrease the glucose reabsorption leads to increased excretion of glucose
INDICATIONS
- Mainly used in Type 2 diabetes mellitus
- To reduce further risk of heart failure or even death
- As a Alternative to improve glycemic control
- Hepatic impairment associated with diabetes mellitus
- To reduce rate of decline in GFR in chronic kidney disease
CONTRAINDICATIONS
- Dialysis or End stage renal disease
- It is not recommended in diabetes type 1 because it can cause diabetic ketoacidosis
- In case of decreased Renal function or failure with eGFR less than 60mL/min/1.73m² it should to avoided
- For treatment of CKD in patients with Polycystic kidney disease
- Recent history of immunosuppressive therapies
- Pregnant and breastfeeding women
How does it work ?
As our body contains SGLT -1 & 2 receptors in heart ,kidneys and small intestines ,whereas especially SGLT -2 receptors present in proximal convoluted tubules of kidney.Hence they tend to act on them by inhibiting the glucose reabsorption into systemic circulation
SIDE EFFECTS
Are very less common but can produce few ,they are
1.Rash
2.Nasopharyngitis
3.Back pain
4.Influenza
5.Severe infections
6.Diabetic ketoacidosis
7.dyslipidemia
8.urinary tract infections
9.increased urination or polyuria with difficulty
10.Genital Thrush
11.increased appetite
12.Nausea ,vomiting
13.dizziness due to dehydration
14.constipation
INTERACTIONS
There is no evidence of severe interactions but while usage of drugs including multiple regimens it should be closely monitored.
Drugs such as insulin ,sulfonylureas,glinides may lead to hypoglycemia
PRECAUTIONS
- There is a risk of symptomatic hypotension due to volume contraction of intravascular fluid
- Decreased body fluid depletion end up in lesser urinary volume and dry mouth
- Patients using loop diuretics careful monitoring is required or may be restricted its usage
- Elders
- There may be potential risk of genital mycotic infections such as vulvovaginitis,vulvovaginal thrush or candidiasis,Genital urinary tract infections
- On chronic use ,can result in bladder cancer and hematuria
- If patient condition is diabetic association with atherosclerosis there is a greater chance of LDL cholesterol rise leading to dyslipidemia
- With increased use the serum creatinine is raised leading to renal failure
DOSAGE
The dosage is available as 5mg and 10mg which is consumed orally
Type 2 diabetes mellitus
Just to improvise the glycemic control initially ,5 mg is recommended once daily and then the dosage can be increased to 10 mg once daily ,orally.This is only advised of the patient is well
tolerating
10 mg Once daily heart failure conditions,Renal or hepatic impairments ,Chronic kidney diseases.
BRANDS available in India
1.FARXIGA 10 mg – Astrazeneca
2.UDAPA -USV
3.OXRA-sun pharma
4.GLEDEPA-abbott
5.DAPANORM-Alkem
6.DARYL-Intas
7.DAPSONE-MSN laboratories