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(trade name)


Therapeutic: antidiabetics
Pharmacologic: sodium glucose co transporter 2 sglt2 inhibitors
Pregnancy Category: C


Adjunct to diet and exercise in the management of type 2 diabetes mellitus.May be used with other antidiabetic agents.


Inhibits proximal renal tubular sodium-glucose co-transporter 2 (SGLT2) which determines reabsorption of glucose from the tubular lumen. Inhibits reabsorption of glucose, lowers renal threshold for glucose and increases excretion of glucose in urine.

Therapeutic effects

Improved glycemic control.


Absorption: 78% absorbed following oral administration.
Distribution: Unknown.
Metabolism and Excretion: Extensively metabolized by UGT1A9 to inactive metabolites which are primarily excreted in urine. 15% excreted in feces as unchanged drug.
Half-life: 12.9 hr

Time/action profile (decrease in HbA1c)

POwithin 4 wk12 wkunknown


Contraindicated in: Hypersensitivity;Severe renal impairment/end-stage renal disease/dialysis GRF <60 mL/min/1.73 m2;Type 1 diabetes;Diabetic ketoacidosis;Active bladder cancer; Lactation: Avoid use, discontinue breastfeeding or discontinue dapagliflozin.
Use Cautiously in: eGFR <60 mL/min/1.73 m2 (monitor frequently), ↑ risk of adverse reactions related to ↓ intravascular volume; Geriatric: ↑ risk of adverse reactions related to ↓ intravascular volume; Hypotension (correct prior to treatment, especially if eGFR 30–60 mL/min, age >65 yr, or concurrent use of loop diuretics, ACE inhibitors, or ARBs; History of bladder cancer; Obstetric: Use during pregnancy only if potential maternal benefit justifies potential fetal risk; Pediatric: Safe and effective use in children <18 yr has not been established.

Adverse Reactions/Side Effects


  • volume depletion


  • genital mycotic infections
  • ↑ urination
  • renal impairment


  • hypoglycemia (with other medications)

Fluid and Electrolyte

  • hyperphosphatemia


  • hyperlipidemia


Drug-Drug interaction

↑ risk of hypotension with antihypertensives or diuretics.↑ risk of hypoglycemia with other antidiabetics (dose adjustments maybe required).renal impairment


Oral (Adults) 5 mg once daily, may be increased to 10 mg once daily.


Tablets: 5 mg, 10 mg

Nursing implications

Nursing assessment

  • Observe for signs and symptoms of hypoglycemic reactions (sweating, hunger, weakness, dizziness, tremor, tachycardia, anxiety), especially in patients taking insulin or other hypoglycemic agents.
  • Monitor BP after initiating and periodically during therapy; may cause hypotension.
  • Lab Test Considerations: Monitor serum glucose and glycosylated hemoglobin periodically during therapy to evaluate effectiveness of treatment.
    • Evaluate renal function prior to starting and periodically during therapy; may cause ↑serum creatinine and ↓ eGFR.
    • May cause ↑ LDL cholesterol.
    • May cause an ↑ hematocrit and serum phosphorous.
    • Will cause urine to test positive for glucose.
  • Overdose is manifested by symptoms of hypoglycemia. Mild hypoglycemia may be treated with administration of oral glucose. Treat severe hypoglycemia with IV D50W followed by continuous IV infusion of more dilute dextrose solution at a rate sufficient to keep serum glucose at approximately 100 mg/dL.

Potential Nursing Diagnoses

Imbalanced nutrition: more than body requirements (Indications)
Noncompliance (Patient/Family Teaching)


  • high alert: Accidental administration of oral hypoglycemic agents to non-diabetic adults and children has resulted in serious harm or death. Before administering, confirm that patient has Type 2 diabetes.
  • Patients stabilized on a diabetic regimen who are exposed to stress, fever, trauma, infection, or surgery may require administration of insulin.
  • Oral: Administer once daily in the morning without regard to food.

Patient/Family Teaching

  • Instruct patient to take medication at same time each day. Take missed doses as soon as remembered unless almost time for next dose; do not double doses. Advise patient to read Medication Guide before starting and with each Rx refill in case of changes.
  • Explain to patient that this medication controls hyperglycemia but does not cure diabetes. Therapy is long term.
  • Inform patient dapagliflozin may cause dehydration and hypotension. Maintain adequate hydration and notify health care professional if dizziness, fainting, weakness or orthostatic hypotension occur.
  • Advise patient to notify health care professional if signs and symptoms of genital mycotic infections; females (vaginal odor, white or yellowish vaginal discharge, vaginal itching), males (rash or redness of glans or foreskin of penis, foul smelling discharge from penis, pain in skin around penis) occur. Instruct patient on treatment options and when to notify health care professional.
  • Review signs of hypoglycemia and hyperglycemia with patient. If hypoglycemia occurs, advise patient to drink a glass of orange juice or ingest 2–3 tsp of sugar, honey, or corn syrup dissolved in water or an appropriate number of glucose tablets and notify health care professional.
  • Encourage patient to follow prescribed diet, medication, and exercise regimen to prevent hypoglycemic or hyperglycemic episodes.
  • Instruct patient in proper testing of serum glucose and ketones. These tests should be closely monitored during periods of stress or illness and health care professional notified if significant changes occur.
  • Advise patient to inform health care professional of medication regimen prior to treatment or surgery.
  • Advise patient to notify health care professional promptly if signs and symptoms of hypersensitivity reactions (rash; raised red patches on skin; swelling of face, lips, tongue, throat; difficulty breathing or swallowing) or bladder cancer (blood or red color in urine, painful urination) occur.
  • Insulin is the recommended method of controlling blood sugar during pregnancy. Counsel female patients to use a form of contraception other than oral contraceptives and to notify health care professional promptly if pregnancy is planned or suspected. May cause fetal harm in 2nd or 3rd trimester.
  • Advise patient to carry a form of sugar (sugar packets, candy) and identification describing disease process and medication regimen at all times.
  • Emphasize the importance of routine follow-up exams.

Evaluation/Desired Outcomes

  • Control of blood glucose levels without the appearance of hypoglycemic or hyperglycemic episodes.
Drug Guide, © 2015 Farlex and Partners
References in periodicals archive ?
AstraZeneca Plc (LON:AZN), a global, science-led biopharmaceutical company, reported on Monday that detailed results from the landmark phase III DAPA-HF trial showed Farxiga (dapagliflozin), on top of standard of care, reduced both the incidence of cardiovascular death and the worsening of heart failure.
Scientists have found dapagliflozin - which helps control blood sugar levels - can reduce the risk of cardiovascular conditions worsening or causing death by more than 25 per cent.
Scientists have found dapagliflozin - a drug that helps control blood sugar levels - can also reduce the risk of cardiovascular conditions worsening or causing death by more than 25 per cent.
AstraZeneca today announced detailed results from the landmark Phase III DAPA-HF trial that showed Farxiga (dapagliflozin) on top of standard of care reduced both the incidence of cardiovascular death and the worsening of heart failure.
Dapagliflozin is known to effectively treat diabetes and also reduce the risk of these patients developing heart failure - a very common complication of type 2 diabetes.
Separately, the company detailed results from the Phase III DAPA-HF trial showed Farxiga, or dapagliflozin, on top of standard of care reduced both the incidence of cardiovascular death and the worsening of heart failure in patients with reduced ejection fraction, with and without Type-2 diabetes.
Release date- 29082019 - AstraZeneca will present results from the Farxiga (dapagliflozin) Phase III DAPA-HF trial at the ESC Congress in Paris, making Farxiga the first medicine in its class to move into a new disease area by demonstrating efficacy and safety data for the treatment of patients with heart failure.
AstraZeneca today announced that the European Commission has approved an update to the marketing authorisation for Forxiga (dapagliflozin) to include positive cardiovascular (CV) outcomes and renal data from the Phase III DECLARE-TIMI 58 trial in adults with type-2 diabetes (T2D).
The anti-cancer drugs included the highly important and expensive Regorafenib and Sorafenib, while Empagliflozin and Dapagliflozin were unveiled for the treatment of diabetic patients.
The latest updates are included as annotations in a document known as "Living Standards of Care" and are based on data from REDUCE-IT (Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial) and the DECLARE-TIMI 58 (Dapagliflozin Effect on Cardiovascular Events-Thrombosis in Myocardial Infarction 58) trial.
NEW ORLEANS -- Dapagliflozin reduces the risks of major adverse cardiovascular events and heart failure hospitalization in the subset of patients with type 2 diabetes (T2D) and prior MI, according to a new subanalysis of the DECLARE-TIMI 58 trial.