What is dapagliflozin?

What is dapagliflozin (Forxiga®)?

  • Type of drug: Dapagliflozin (Forxiga®) is a sodium-glucose cotransporter 2 (SGLT-2) inhibitor
  • Use: type 2 diabetes; CKD with protein in urine; chronic heart failure (CHF)
  • Dose: 10 mg once a day (including CKD patients)
  • Side-effects: 
    • Initial decrease (<10%) in GFR (increases later); low blood glucose (sugar)
    • UTIs; vulvovaginal disorders; DKA.
  • Monitor: creatinine/GFR; glucose.

Note 1. Its anti-proteinuric effect is augmented if the patient is also on an ACE or ARB
Note 2. Do NOT use in DM1
Note 3. Indicated in proteinuric CKD (uACR >25 mg/mmol) with GFR <60 and >25 ml/min (with or without DM). But do not initiate in Stage 5 CKD (GFR < 15 ml/min).

How does dapagliflozin work in chronic kidney disease (CKD)?
Reducing protein loss reduces kidney damage by reducing pressure and inflammation in the kidneys. It also reduces blood pressure and body weight, which helps the kidneys.

Other resources

CKD drug side-effects
CKD referral advice (GP Gateway)
CKD patient information (CKD Explained’s 30+ core articles about CKD)
Dapagliflozin (BNF)
This is a review article: Young, 2023

 

 

Last Reviewed on 26 April 2024

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