Dapagliflozin and Metformin

Hypoglycaemic excluding Insulin · Biguanide/Reversible inhibitor of sodium-glucose co-transporter 2 (SGLT2)

Indications

Type 2 diabetes mellitus inadequately controlled by diet and exercise; when metformin alone is inadequate; in patients currently receiving the combination as separate tabs, or with other hypoglycaemic agents, including insulin, when these plus metformin are inadequate.

Dosage

Adults: On the basis of current metformin dose, 1 tab twice daily with food. Combination therapy: Consider lower dose of insulin or sulfonylurea. Children: Not recommended.

Adverse Effects

Genital infection, dyslipidaemia, increased haematocrit, back pain, dysgeusia, UTI, dysuria, polyuria, GI upset. Combination therapy: Also, hypoglycaemia.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Hepatic or moderate to severe renal impairment (eGFR <60 mL/min/1.73 m2), acute conditions predisposing to renal impairment. Diabetic ketoacidosis, or pre-coma. Cardiac or respiratory failure, recent MI. Acute alcohol intoxication, alcoholism. Discontinue for 48 hrs before and after surgery; confirm normal renal function before resuming. Elderly (= 75 yrs).

Interactions

Diuretics, glucocorticoids, antihypertensive agents that affect renal functions (e.g. NSAIDs), GLP-1 agonists, beta-2 agonists, alcohol, iodinated contrast agents, pioglitazone, cimetidine.

Pharmacokinetics

DAPAGLIFLOZIN: Absorption: Rapid. Metabolism: Hepatic. Renal. Bioavailability: 78%. Half-life elimination: 13 hrs. Time to peak, plasma: Oral: 2-3 hrs. After high fat-meal: 2 hrs. Excretion: Urine (75%). Faeces (21%). METFORMIN: Onset of action: Within days, max effects up to 2 wks. Metabolism: Not metabolized by the liver. Bioavailability: Absolute: Fasting: 50%-60%. Half-life elimination: Plasma: 4-9 hrs. Blood: Approx. 17.6 hrs. Time to peak, serum: Immediate release: 2-3 hrs. Extended release: 7 hrs. (Range: 4-8 hrs). Excretion: Urine.

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.