Home Drug Guide Dapagliflozin

Drug Guide

Generic Name

Dapagliflozin

Brand Names Farxiga

Classification

Therapeutic: Antidiabetic agent

Pharmacological: SGLT2 inhibitor

FDA Approved Indications

  • Type 2 diabetes mellitus

Mechanism of Action

Dapagliflozin inhibits the sodium-glucose co-transporter 2 (SGLT2) in the proximal renal tubules, reducing glucose reabsorption and increasing urinary glucose excretion, thereby lowering blood glucose levels.

Dosage and Administration

Adult: Start with 5 mg once daily, with or without food. Can be increased to 10 mg based on effectiveness and tolerability.

Pediatric: Not approved for pediatric use.

Geriatric: Use with caution in elderly; consider renal function.

Renal Impairment: Use is contraindicated if eGFR is below 45 mL/min/1.73 m²; dose adjustment recommended.

Hepatic Impairment: No specific adjustment, but use cautiously.

Pharmacokinetics

Absorption: Rapidly absorbed, peak plasma levels in 2 hours.

Distribution: Widely distributed; protein binding approximately 91%.

Metabolism: Minimal metabolism; primarily excreted unchanged.

Excretion: Excreted mainly via urine and feces.

Half Life: Approximately 13 hours.

Contraindications

  • Severe renal impairment (eGFR below 30 mL/min/1.73 m²)
  • End-stage renal disease
  • Ketoacidosis

Precautions

  • Risk of urinary tract infections, genital mycotic infections, dehydration, hypotension, hyperkalemia, and acute kidney injury.

Adverse Reactions - Common

  • Genital fungal infections (Frequent)
  • Urinary tract infections (Frequent)
  • Hypotension (Infrequent)

Adverse Reactions - Serious

  • Ketoacidosis (including euglycemic ketoacidosis) (Rare)
  • Acute kidney injury (Infrequent)
  • Serious urinary tract infections leading to sepsis (Rare)

Drug-Drug Interactions

  • Diuretics, insulin, and insulin secretagogues (may increase risk of hypoglycemia)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood glucose, renal function, blood pressure, and signs of dehydration.

Diagnoses:

  • Risk for hypoglycemia
  • Risk for dehydration or electrolyte imbalance

Implementation: Administer as prescribed; ensure patient remains hydrated; monitor renal function.

Evaluation: Assess glycemic control and renal function periodically.

Patient/Family Teaching

  • Take medication as directed, even if feeling well.
  • Report signs of urinary tract infections or genital infections.
  • Maintain adequate hydration.
  • Understand the importance of regular blood glucose monitoring.

Special Considerations

Black Box Warnings:

  • There is a risk of diabetic ketoacidosis, which can be life-threatening.
  • Risk of acute kidney injury.

Genetic Factors: None specified.

Lab Test Interference: None known.

Overdose Management

Signs/Symptoms: Severe dehydration, hypotension, electrolyte abnormalities, ketoacidosis.

Treatment: Discontinue medication; provide supportive care including rehydration, electrolytes correction, and monitoring.

Storage and Handling

Storage: Store at room temperature (20°C to 25°C).

Stability: Stable for 24 months when stored properly.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.