Dapagliflozin Dosing for Type 2 Diabetes

The recommended dosing for dapagliflozin in adults with type 2 diabetes is 10 mg orally once daily. 1, 2

Standard Dosing Recommendations

The standard recommended dose for dapagliflozin in adults with type 2 diabetes is 10 mg orally once daily 1
For patients new to dapagliflozin, treatment may be initiated at 5 mg orally once daily and increased to 10 mg daily if needed for additional glycemic control 2
Dapagliflozin can be taken without regard to meals 2
No dose adjustment is required based on age, gender, race, or mild to moderate hepatic impairment 2

For patients with eGFR ≥45 mL/min/1.73 m², no dose adjustment is required 1
For patients with eGFR <45 mL/min/1.73 m², dapagliflozin is not recommended for glycemic control as it is likely to be ineffective due to its mechanism of action 1, 3
For patients with eGFR <30 mL/min/1.73 m², dapagliflozin use is contraindicated 1

For patients receiving dapagliflozin for heart failure or chronic kidney disease (non-glycemic indications):
- The recommended dose is 10 mg orally once daily 2
- Dapagliflozin can be initiated in patients with eGFR ≥25 mL/min/1.73 m² 1, 3
- If eGFR falls below 25 mL/min/1.73 m² during treatment, dapagliflozin 10 mg daily may be continued for cardiovascular and renal benefits 1, 2

Withhold dapagliflozin for at least 3 days before major surgery or procedures requiring prolonged fasting 1, 2
Resume dapagliflozin when the patient is clinically stable and has resumed oral intake 2
This precaution helps prevent postoperative ketoacidosis 1

Assess renal function prior to initiation and periodically thereafter 3, 2
Evaluate volume status before starting dapagliflozin and correct volume depletion if present 3, 2
Monitor for signs and symptoms of:
- Genital mycotic infections 1, 3
- Urinary tract infections 1, 3
- Volume depletion 1, 3
- Euglycemic diabetic ketoacidosis 1, 3
If HbA1c is well-controlled at baseline or there is a history of frequent hypoglycemic events, consider reducing doses of sulfonylureas, glinides, or insulin (by approximately 20%) when starting dapagliflozin 1

Glucose-lowering efficacy decreases with declining renal function, but cardiovascular and renal benefits are preserved at lower eGFR levels 1, 3
Dapagliflozin has a low propensity to cause hypoglycemia when used alone or in combination with metformin 4
The 10 mg daily dose has been associated with a 26% reduction in the composite endpoint of worsening heart failure or cardiovascular death in clinical trials 1
Dapagliflozin is typically associated with modest weight loss, which can be beneficial for many patients with type 2 diabetes 4, 5