Prescribing Information and Adverse Event Reporting can be found at the bottom of this advertisement
FORXIGA ( dapagliflozin ) is indicated in adults for the treatment of : chronic kidney disease ( CKD ); symptomatic chronic heart failure ( HF ); and insufficiently controlled type 2 diabetes ( T2D ). 1
Dapagliflozin Initiation Resources
Based on the Medicine Supply Notification released by the Department of Health and Social Care on the 27 th June regarding GLP-1 receptor agonists supply 2 , you may be reviewing your appropriate T2DM patients and initiating other classes of therapy .
• We have ensured our supply chain for dapagliflozin can accommodate an uplift in demand , as well as providing surety of supply for existing patients .
• We have a range of consultation resources to help make initiation of eligible patients on dapagliflozin as simple as possible .
This is a promotional piece from AstraZeneca for GB healthcare professionals only .
CKD , chronic kidney disease ; GLP-1 , glucagon-like peptide 1 ; HF , heart failure ; T2DM , type 2 diabetes mellitus .
Reference : 1 . FORXIGA ( dapagliflozin ) SmPC . Available at : https :// www . medicines . org . uk / emc / product / 7607 / smpc # gref . 2 . DHSC Medicine Supply Notification MSN / 2023 / 061 . Available at : https :// diabetestimes . co . uk / wp-content / uploads / 2023 / 06 / MSN _ 2023 _ 061 _ GLP1 _ Receptor _ Agonist . pdf . Last Accessed : August 2023 .
PRESCRIBING INFORMATION FORXIGA ® ��������������� ���� �� ����� ����� ���������������� Consult Summary of Product Characteristics ��������������������������
Indications : Adults : ����� �� ��������� ��������� For the treatment of insufficiently controlled type 2 diabetes mellitus as an adjunct to diet and exercise , as monotherapy when metformin is considered inappropriate due to intolerance , or in addition to other medicinal products for the treatment of type 2 diabetes . Heart Failure : For the treatment of symptomatic chronic heart failure . Chronic Kidney Disease : for the treatment of chronic kidney disease . ��������� ����� ��� ������ ���� ������ Type 2 ��������� ��������� For the treatment of insufficiently controlled type 2 diabetes mellitus as an adjunct to diet and exercise , as monotherapy when metformin is considered inappropriate due to intolerance , or in addition to other medicinal products for the treatment of type 2 diabetes Presentation : Film-coated tablets . 5mg or 10mg of dapagliflozin ( as propanediol monohydrate ). Each 5mg tablet contains 25mg of lactose . Each 10mg tablet contains 50mg of lactose . Dosage and Administration : Forxiga can be taken at any time of day with or without food . Tablets should be swallowed whole . Adults : ����� ��� ��������� ��������� The recommended dose is 10mg once daily . Consider a lower dose of insulin or insulin secretagogue such as a sulphonylurea when used in combination with dapagliflozin to reduce the risk of hypoglycaemia . Heart Failure : The recommended dose is 10mg once daily . Chronic kidney disease : The recommended dose is
10mg dapagliflozin once daily . Renal impairment : No dose adjustment is required . Mild or moderate hepatic impairment : No dose adjustment is required . ������� �������� ���������� : Starting dose of 5mg is recommended , if well tolerated , dose may be increased to 10mg . Elderly : ≥65 years : No dose adjustment is required . ������������������������������������������� ��������� ���� ������� No dose adjustment required . The recommended dose is 10mg once daily . Consider a lower dose of insulin or insulin secretagogue such as a sulphonylurea when used in combination with dapagliflozin to reduce the risk of hypoglycaemia . ��������� ���� ������� Safety and efficacy not yet established . Heart Failure / Chronic kidney disease : ��������� ���� ������� Safety and efficacy not yet established . Contraindications : Hypersensitivity to dapagliflozin , or excipients . Warnings and Precautions : Renal impairment : There is limited experience with initiating treatment with dapagliflozin in patients with eGFR < 25 mL / min / 1.73m 2 , and no experience with initiating treatment in patients with eGFR < 15 mL / min / 1.73m 2 . Therefore , it is not recommended to initiate treatment with dapagliflozin in patients with eGFR < 15 mL / min / 1.73m 2 . The glucose lowering efficacy of dapagliflozin is dependent on renal function and is reduced in patients with eGFR < 45 mL / min / 1.73m 2 and is likely absent in patients with severe renal impairment . In patients with moderate renal impairment ( eGFR < 60 mL / min / 1.73m 2 ), a higher proportion of patients treated with dapagliflozin had adverse reactions of increase in parathyroid hormone ( PTH ) and hypotension , compared with placebo . Hepatic impairment : Exposure is increased in patients with severe hepatic impairment . ���� ��� ��������� ��� ����� ��� ������� depletion and / or hypotension : Dapagliflozin increases diuresis which may lead to a modest decrease in blood pressure , it may be more pronounced in patients with very high blood glucose concentrations . Exercise caution in patients for whom a dapagliflozininduced drop in blood pressure could pose a risk , such as patients on anti-hypertensive therapy with a history of hypotension or elderly patients . Careful monitoring of volume status and electrolytes is recommended in conditions leading to volume depletion , such as acute gastrointestinal illness . In volume depleted patients temporary interruption of dapagliflozin is recommended until volume depletion is corrected . ���������������������������� SGLT2 inhibitors should be used with caution in patients with increased risk of DKA . Patients who may be at higher risk of DKA include patients with a low beta-cell function reserve ( e . g . type 2 diabetes patients with low C-peptide or latent autoimmune diabetes in adults ( LADA ) or patients with a history of pancreatitis ), patients with conditions that lead to restricted food intake or severe dehydration , patients for whom insulin doses are reduced and patients with increased insulin requirements due to acute medical illness , surgery or alcohol abuse . The risk of DKA must be considered in the event of non‐specific symptoms such as nausea , vomiting , anorexia , abdominal pain , excessive thirst , difficulty breathing , confusion , unusual fatigue or sleepiness . Patients should be assessed for ketoacidosis immediately if these symptoms occur , regardless of