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Dapagliflozin propanediol
It is crucial for patients to consult their healthcare provider before starting Dapagliflozin therapy to ensure it is appropriate for their individual health conditions.
- Risk of Dehydration: Dapagliflozin may increase the risk of dehydration, leading to dizziness, lightheadedness, and fainting, particularly when standing up suddenly. This is more common in elderly patients or those taking diuretics.
- Kidney Function: Dapagliflozin is not recommended for patients with severe renal impairment (eGFR <30 mL/min/1.73 m²) as it may cause further kidney problems. It should also be used cautiously in patients with moderate kidney impairment.
- Infections: Patients are at an increased risk of urinary tract infections (UTIs) and genital infections, particularly in women. It is important to monitor for symptoms such as pain or burning during urination, as well as unusual genital discomfort or discharge.
- Diabetic Ketoacidosis (DKA): Although rare, dapagliflozin can increase the risk of diabetic ketoacidosis, a serious condition in which the body produces high levels of ketones. Symptoms of DKA include nausea, vomiting, and abdominal pain, which require immediate medical attention.
- Amputations: There is an increased risk of lower limb amputations in patients with diabetes using dapagliflozin, so regular foot care and monitoring are advised.
Dapagliflozin is used for the treatment of several conditions, including:
- Type 2 Diabetes: It is used in conjunction with diet and exercise to improve blood sugar control in patients with type 2 diabetes.
- Heart Failure: Dapagliflozin has been shown to reduce hospitalization and the risk of death from heart failure, particularly in patients with a history of cardiovascular disease or risk factors.
- Chronic Kidney Disease: It is also indicated for slowing the progression of chronic kidney disease (CKD) in patients at risk of kidney failure, reducing the risk of worsening kidney function and cardiovascular events.
Dapagliflozin should not be used in the following cases:
- Severe Renal Impairment: It is contraindicated in patients with severe kidney dysfunction (eGFR <30 mL/min/1.73 m²) as it may worsen kidney health and is ineffective.
- Hypersensitivity: Any patient with known hypersensitivity to dapagliflozin or any of its components should avoid its use.
- Type 1 Diabetes: Dapagliflozin is not approved for use in individuals with type 1 diabetes and should not be prescribed to these patients.
- Pregnancy and Breastfeeding: The safety of dapagliflozin during pregnancy or breastfeeding has not been established. It is advised that pregnant women avoid this medication unless absolutely necessary and under strict medical supervision.
Patients taking dapagliflozin may experience common and severe side effects:
- Common Side Effects:
- Urinary tract infections (UTIs).
- Genital infections, including yeast infections, particularly in women.
- Increased urination.
- Dehydration, leading to dizziness, fainting, or lightheadedness.
- Serious Side Effects:
- Diabetic Ketoacidosis (DKA): A rare but serious side effect involving high levels of ketones in the blood, leading to symptoms like nausea, vomiting, and difficulty breathing.
- Kidney Problems: Worsening kidney function may occur in certain patients, especially those with pre-existing kidney conditions.
- Amputations: There have been reports of increased lower limb amputations, particularly in patients with diabetes.
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Dapagliflozin is a Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitor that works by:
- Reducing Glucose Reabsorption: Dapagliflozin inhibits the SGLT2 protein in the kidneys, which normally reabsorbs glucose back into the bloodstream. By blocking this process, dapagliflozin causes excess glucose to be excreted in the urine, lowering blood sugar levels.
- Cardiovascular and Kidney Benefits: Besides controlling blood sugar, dapagliflozin has shown benefits in reducing the risk of heart failure hospitalizations and slowing the progression of chronic kidney disease.
Dapagliflozin can interact with other medications, potentially affecting its effectiveness or safety:
- Diuretics: Concurrent use with diuretics may lead to increased risk of dehydration and low blood pressure, especially when standing up quickly.
- Insulin and Insulin Secretagogues: Using dapagliflozin alongside insulin or insulin secretagogues may increase the risk of hypoglycemia (low blood sugar).
- ACE Inhibitors/ARBs: Combining dapagliflozin with ACE inhibitors or angiotensin II receptor blockers (ARBs) can lead to a higher risk of kidney dysfunction.
- Rifampin: This antibiotic may reduce the effectiveness of dapagliflozin by increasing its metabolism, which could lower blood levels.
- Lithium: Dapagliflozin may reduce the effectiveness of lithium, requiring careful monitoring of lithium levels in patients on this therapy.
For adults, the typical dosage for dapagliflozin is:
- Initial Dose: 5 mg once daily, taken in the morning, with or without food.
- Dose Adjustment: In certain patients, especially those with heart failure or chronic kidney disease, the dose may be increased to 10 mg once daily depending on clinical response.
Patients should strictly follow the prescribed dosage and consult their healthcare provider if they miss a dose or experience adverse effects.
Dapagliflozin is not recommended for use in pediatric patients under the age of 18 years. The safety and efficacy in children have not been established.
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For patients with kidney impairment:
- eGFR ≥60 mL/min/1.73 m²: No dosage adjustment is necessary.
- eGFR 30-59 mL/min/1.73 m²: Dapagliflozin can be used with caution, but regular kidney function monitoring is required.
- eGFR <30 mL/min/1.73 m²: Dapagliflozin is contraindicated in patients with severe renal impairment, as it may be ineffective and can worsen kidney function.
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