Janssen Cilag (Brand)

Generic Name: Dapagliflozin
Common Brand Names: Farxiga, Forxiga

Introduction

Dapagliflozin is an SGLT2 inhibitor used primarily to treat type 2 diabetes, heart failure, and chronic kidney disease. It works by inhibiting the sodium-glucose co-transporter 2 (SGLT2) in the kidneys, leading to reduced glucose reabsorption and increased glucose excretion in urine.

Conditions of Use (Indications)

1. Type 2 Diabetes Mellitus: Helps to control blood glucose levels in patients with type 2 diabetes.
2. Heart Failure: Reduces hospitalization rates and improves outcomes in patients with heart failure with reduced ejection fraction (HFrEF).
3. Chronic Kidney Disease: Used in patients with chronic kidney disease to reduce the progression of kidney failure.

Mechanism of Action

Dapagliflozin inhibits SGLT2, a protein responsible for reabsorbing glucose from the urine back into the blood. By inhibiting this transporter, dapagliflozin reduces the reabsorption of glucose, leading to glucose excretion via the urine. It also reduces sodium reabsorption, which can help to reduce blood pressure and volume overload in heart failure and kidney disease.

Side Effects

1.Common:

• Urinary tract infections and genital mycotic infections due to increased glucose in the urine.
• Increased urination and dehydration.
• Hypotension, especially in elderly or volume-depleted patients.

2.Serious:

• Diabetic ketoacidosis, particularly in patients with type 1 diabetes (off-label use).
• Acute kidney injury or renal impairment.
• Hypoglycemia, when used with other antidiabetic agents.

Harmful Interactions

1. Diuretics: Combining with diuretics may increase the risk of dehydration and hypotension.
2. ACE Inhibitors or ARBs: Increased risk of renal dysfunction when used with dapagliflozin.
3. Insulin or Sulfonylureas: Risk of hypoglycemia may increase if used in combination with insulin or sulfonylureas.

Contraindications

1. Known hypersensitivity to dapagliflozin or any component of the formulation.
2. Severe renal impairment (eGFR < 30 mL/min/1.73 m²).
3. Active bladder cancer or a history of bladder cancer.

Latest References

1. Ponikowski, P., et al. (2023). “Dapagliflozin in Heart Failure: Recent Developments and Clinical Applications.” European Heart Journal, DOI: 10.1093/eurheartj/ehab134.
2. American Diabetes Association (ADA). (2022). “Standards of Medical Care in Diabetes.” Diabetes Care.