Important Warnings
Not for type 1 diabetes. Risk of lactic acidosis with metformin (higher risk in kidney impairment, dehydration, severe infection, heavy alcohol use, liver disease, heart failure, hypoxia); seek urgent care for fast breathing, severe weakness, abdominal pain, drowsiness. Dapagliflozin may cause genital mycotic infections, UTIs, volume depletion/low BP, and rare ketoacidosis (can occur with near-normal sugars); stop and seek care if nausea/vomiting, abdominal pain, rapid breathing. Assess renal function before and during therapy; dose/continuation depends on eGFR and product label. Temporarily withhold during acute illness, prolonged fasting, major surgery, or dehydration. Hold metformin around iodinated contrast procedures as per clinician advice. Monitor for hypoglycaemia if used with insulin/sulfonylureas.
Pregnancy Safety
Not recommended; consult doctor (insufficient safety data and potential fetal risk especially in 2nd/3rd trimester)
Alcohol Interaction
Avoid or use with caution; alcohol increases risk of lactic acidosis and hypoglycaemia
Storage
Store below 25°C in a cool, dry place. Protect from moisture and direct light. Keep in original blister pack and out of reach of children.
