Dapawin 10

Indications

• Type 2 diabetes in adults, together with diet and exercise, alone or with other diabetes medicines.
• Heart failure, to lower the risk of hospital stays and death from heart failure.
• Chronic kidney disease, to slow the loss of kidney function.

It is not used for type 1 diabetes.

How It Works

Dapagliflozin is an SGLT2 inhibitor. It stops the kidneys from taking sugar back into the blood, so extra sugar leaves the body in the urine. This lowers blood sugar. It also removes some salt and water, which eases the load on the heart and helps protect the kidneys.

Dosage and Administration

Adults: usually 10 mg once a day, at any time of day, with or without food. Swallow the tablet whole with water. Some people with diabetes are started on 5 mg, as prescribed.

Kidney problems: the doctor decides whether to start or continue it based on kidney tests. Severe liver problems: the doctor may start with 5 mg.

Children: only as prescribed by a specialist.

If a dose is missed, take it when you remember on the same day; do not take two doses in one day.

Interactions

• Insulin and sulfonylureas (such as Gliclazide or Glimepiride): higher risk of low blood sugar; the doctor may lower their dose.
• Water tablets (diuretics such as Furosemide): more risk of dehydration and low blood pressure.
• Lithium: blood levels may fall.

Tell your doctor about all medicines and herbal products you take.

Contraindications

• Allergy to Dapagliflozin or any ingredient of the tablet
• Type 1 diabetes or diabetic ketoacidosis
• People on dialysis (it is usually not started)

Side Effects

Common: fungal infections of the genital area (itching, soreness, discharge), urine infections, passing more urine, thirst, back pain, and dizziness when standing up because of fluid loss.

Rare but serious: diabetic ketoacidosis, which can happen even when blood sugar is not very high, and a severe infection of the skin between the genitals and the back passage (Fournier's gangrene).

Get medical help at once for nausea, vomiting, stomach pain, unusual tiredness, fast breathing or a sweet smell on the breath; pain, tenderness, redness or swelling around the genitals or back passage with fever; burning on passing urine with fever or back pain; or swelling of the face and trouble breathing.

Pregnancy and Lactation

Dapagliflozin is not recommended in pregnancy, especially after the first 3 months. If you become pregnant, tell your doctor; insulin is usually used instead. It is not recommended while breastfeeding.

Precautions and Warnings

• Stop it for a few days before planned surgery (usually at least 3 days), and during serious illness, vomiting, diarrhoea or when you cannot eat or drink. Restart when the doctor says.
• Drink enough fluids, especially in hot weather.
• Very low-carbohydrate diets and heavy alcohol use raise the risk of ketoacidosis.
• Keep the genital area clean and dry to reduce infections.
• Urine tests will show sugar while you take it; this is expected.
• Kidney function is checked from time to time.

Overdose

If too many tablets are taken, contact a doctor or go to hospital. Treatment is supportive, with attention to fluids and blood tests.

Therapeutic Class

Antidiabetic medicine (SGLT2 inhibitor), also used in heart failure and chronic kidney disease.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.