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Type 2 diabetes mellitus: to improve glycaemic control in adults as an adjunct to diet and exercise, when dual therapy with metformin and an SGLT2 inhibitor is appropriate

Dapagliflozin is an SGLT2 inhibitor that reduces glucose reabsorption in the kidneys, increasing urinary glucose excretion. Metformin decreases hepatic glucose production and improves insulin sensitivity; the SR form releases drug slowly to improve GI tolerability and provide prolonged effect.

Oral tablet (SR). Take exactly as prescribed, usually once daily with a meal (preferably with/after the main meal) to reduce stomach upset. Swallow whole; do not crush, chew or break. Maintain adequate hydration.

Nausea, diarrhoea, abdominal discomfort, decreased appetite, headache, increased urination, genital fungal infection, urinary tract infection, dizziness

Not for type 1 diabetes. Risk of lactic acidosis with metformin (higher risk in severe kidney impairment, dehydration, sepsis, hypoxia, alcohol abuse); stop and seek care for rapid breathing, severe weakness, abdominal pain. Dapagliflozin may cause genital mycotic infections, UTIs, volume depletion/low BP, and rarely ketoacidosis (can occur with normal sugars); stop and seek care for nausea, vomiting, abdominal pain, rapid breathing. Assess kidney function before and periodically; dose/use may be restricted in reduced eGFR. Withhold before major surgery and during acute illness or prolonged fasting; restart when stable and eating. Use caution in elderly, on diuretics, or with low BP. Consider vitamin B12 monitoring with long-term metformin. Inform doctor before iodinated contrast procedures; may need temporary discontinuation.

Insulin and sulfonylureas (increased hypoglycaemia risk), diuretics (increased dehydration/low BP risk), ACE inhibitors/ARBs (may enhance BP lowering), NSAIDs and nephrotoxic drugs (worsen renal function affecting metformin safety), alcohol (increases lactic acidosis risk), iodinated contrast media (risk of lactic acidosis—temporary stop), cationic drugs affecting renal tubular secretion e.g. cimetidine (may increase metformin levels)

Store below 25°C in a dry place, protected from moisture and light. Keep in original blister pack and out of reach of children.

Xigduo XR 10/1000 Tablet, Dapamet XR 10/1000 Tablet, Dapamate XR 10/1000 Tablet, Dapaglyn-M XR 10/1000 Tablet, Dapavel-M XR 10/1000 Tablet