From the Guidelines
Dapagliflozin (Forxiga) is indicated for adults with type 2 diabetes mellitus and heart failure to reduce the risk of cardiovascular death and hospitalization for heart failure, with a recommended dosage of 10 mg once daily, as supported by the most recent and highest quality study 1.
Indication and Dosage
The medication is used to improve glycemic control in adults with type 2 diabetes as an adjunct to diet and exercise, and to reduce the risk of hospitalization for heart failure in adults with type 2 diabetes and established cardiovascular disease or multiple cardiovascular risk factors.
- The recommended dose is 10 mg once daily, taken orally in the morning with or without food.
- For patients with type 2 diabetes and heart failure with reduced ejection fraction (HFrEF), dapagliflozin provides dual benefits by improving both glycemic control and heart failure outcomes.
Renal Impairment Considerations
- No dose adjustment is needed for mild to moderate renal impairment.
- However, it's not recommended for patients with severe renal impairment (eGFR <30 mL/min/1.73m²) 1.
Mechanism of Action and Benefits
Dapagliflozin works as an SGLT2 inhibitor, reducing glucose reabsorption in the kidneys and increasing urinary glucose excretion, which lowers blood glucose levels.
- It also provides cardiovascular benefits through multiple mechanisms including reduced preload and afterload, improved cardiac metabolism, and anti-inflammatory effects 1.
Side Effects and Monitoring
Common side effects include genital mycotic infections and urinary tract infections.
- Patients should be monitored for volume depletion, especially if they are on diuretics or have renal impairment 1.
From the FDA Drug Label
To reduce the risk of hospitalization for heart failure in adults with type 2 diabetes mellitus and either established cardiovascular disease or multiple cardiovascular risk factors The recommended dosage of DAPAGLIFLOZIN TABLETS is 10 mg orally once daily in adults for the following indications: • To reduce the risk of sustained eGFR decline, end stage kidney disease (ESKD), cardiovascular (CV) death, and hospitalization for heart failure (hHF) in patients with chronic kidney disease at risk of progression • To reduce the risk of CV death, hHF, and urgent heart failure visit in patients with heart failure. • To reduce the risk of hHF in patients with type 2 diabetes mellitus and either established CV disease or multiple CV risk factors
The indication for Dapagliflozin (Forxiga) in patients with type 2 diabetes and heart failure is to reduce the risk of hospitalization for heart failure. The recommended dosage is 10 mg orally once daily. Key points to consider:
- Assess renal function prior to initiation of DAPAGLIFLOZIN TABLETS and then as clinically indicated 2
- Assess volume status and correct any volume depletion before initiating DAPAGLIFLOZIN TABLETS 2
- The recommended dosage in patients with an eGFR greater than or equal to 25 mL/min/1.73 m2 is the same as the recommended dosage in patients with normal renal function 2
From the Research
Indication for Dapagliflozin in Patients with Type 2 Diabetes and Heart Failure
- Dapagliflozin (Forxiga) is indicated for the treatment of type 2 diabetes as monotherapy or as add-on combination therapy with other glucose-lowering agents, including insulin, when diet and exercise alone do not provide adequate glycaemic control 3.
- It is also approved to reduce the risk of hospitalization for heart failure (HHF) in adults with type 2 diabetes and established cardiovascular disease or multiple cardiovascular risk factors 4.
- Additionally, dapagliflozin is approved to reduce the risk of cardiovascular death and in adults with heart failure (HF) with reduced ejection fraction (NYHA class II-IV) 4.
Dosage for Dapagliflozin
- The recommended dosage for dapagliflozin is 10mg once daily, taken orally 3.
- No dosage adjustment is needed for patients with mild or moderate renal impairment, but it is not recommended for patients with severe renal impairment or end-stage renal disease 5.
Efficacy and Safety of Dapagliflozin
- Dapagliflozin has been shown to provide effective glycaemic control, reduce body weight and blood pressure, and reduce the rate of cardiovascular death or hospitalization for heart failure in patients with type 2 diabetes 3, 4.
- It has also been shown to be safe and well-tolerated, with a low risk of hypoglycaemia, but with an increased risk of genital infections and urinary tract infections 3, 5.
- The efficacy and safety of dapagliflozin are consistent regardless of background use of cardiovascular medications, including angiotensin-converting enzyme inhibitors, beta-blockers, diuretics, and mineralocorticoid receptor antagonists 6.