Dapagliflozin
A once-daily SGLT2 inhibitor (gliflozin) for type 2 diabetes, chronic kidney disease and heart failure.
Drug card
- Class
- SGLT2 inhibitor
- How it works
- Blocking glucose reabsorption in the kidney, so glucose leaves in the urine
- Used for
- Type 2 diabetes (adults and children aged 10 and over)
- Heart failure
- Chronic kidney disease
- Known for
- Genital yeast infections (thrush)
- Ketoacidosis, even with near-normal glucose
- Its name
- -gliflozin means an SGLT2 inhibitor (gliflozin)
Study it as a flashcard, and it comes back before you forget it.
Mechanism of action
How does dapagliflozin work?
Dapagliflozin selectively inhibits SGLT2 over SGLT1, the glucose transporter of the gut, so filtered glucose is lost in the urine. Less sodium is reabsorbed too, which lowers preload and afterload and, through tubuloglomerular feedback, pressure inside the glomerulus, an effect thought to protect the kidney.
Like other SGLT2 inhibitors: SGLT2 inhibitors block sodium-glucose cotransporter 2 in the proximal tubule, which normally reabsorbs about 90% of filtered glucose. Glucose and sodium pass into the urine, lowering blood glucose without relying on insulin and causing a mild osmotic diuresis. More sodium reaching the distal tubule lowers preload, afterload and glomerular pressure, which may explain their heart and kidney benefits.
Uses
What is dapagliflozin used for?
- Type 2 diabetes (adults and children aged 10 and over)
- Heart failure
- Chronic kidney disease
Side effects
Side effects of dapagliflozin
- Genital yeast infections (thrush)Known for
- Ketoacidosis, even with near-normal glucoseKnown forSerious
- Urinary tract infections, including urosepsisSerious
- Fournier's gangrene (perineal necrotizing fasciitis)Serious
- Dehydration and low blood pressure
- Passing more urine
- Back pain
- Colds and sore throat (nasopharyngitis)
- Acute kidney injurySerious
- Hypoglycemia with insulin or a sulfonylurea
- Severe allergic reaction and angioedemaSerious
- Rash
Known for marks what an exam expects you to know it for.
Watch for
Cautions and what sets it apart
- Not for glucose control in type 1 diabetes, where it markedly raises the risk of ketoacidosis.
- Check fluid status and kidney function first in older people, those with low blood pressure and those on diuretics.
- Not advised for glucose control when eGFR is below 45, where it is unlikely to work.
Good to know: Its benefit in heart failure and chronic kidney disease does not depend on lowering glucose.
Remember it
A way to remember it
Gliflozins make you pee sugar.
Blocking SGLT2 sends glucose into the urine. Follow the sugar: genital yeast infections and UTIs; follow the water it pulls out: dehydration; and watch for ketoacidosis while glucose still looks near normal.
Written for biofideX
Its name
-gliflozin means SGLT2 inhibitor (gliflozin)
WHO defines it as sodium-glucose cotransporter inhibitors related to phlorizin. Empagliflozin and dapagliflozin block SGLT2 in the kidney, so more glucose leaves in the urine.
- Every drug name stem
Its class
SGLT2 inhibitors
Other SGLT2 inhibitors with a card:
Easily mixed up with DPP-4 inhibitors and sulfonylureas.
Sources
Checked against
Written for biofideX in plain words, after checking these references:
For learning pharmacology, not for treatment decisions: no doses are given, and a prescriber, pharmacist or the product's own label is the word on any one patient. Spotted a mistake? Tell us and we'll correct it.
Diabetes
Dapagliflozin is one of 14 drugs practiced together here: their classes, how they work, what they treat and what they're known for.
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