Adults

The recommended starting dose is 10 mg once daily, taken in the morning, with or without food. For type 2 diabetes, if eGFR is < 45 mL/min/1.73 m², it is not recommended for glycemic control. For heart failure or chronic kidney disease, it can be initiated if eGFR ≥ 25 mL/min/1.73 m² and continued.

Elderly

No dose adjustment is required based on age alone. However, renal function should be assessed before initiation and periodically thereafter.

Renal_impairment

For type 2 diabetes glycemic control: Not recommended to initiate if eGFR < 45 mL/min/1.73 m². For heart failure or chronic kidney disease: Initiate and continue if eGFR ≥ 25 mL/min/1.73 m². Discontinue if eGFR consistently falls below 25 mL/min/1.73 m².

Onset

Glucose-lowering effects within hours of the first dose. Cardiovascular and renal benefits are observed with long-term use.

Excretion

Approximately 75% of the administered dose is excreted in the urine (primarily as metabolites) and 21% in the feces.

Half life

The mean terminal half-life (t½) of dapagliflozin is approximately 12.9 hours.

Absorption

Rapid and well-absorbed after oral administration, with peak plasma concentrations (Cmax) typically achieved within 1-2 hours. Absolute oral bioavailability is approximately 78%.

Metabolism

Primarily metabolized in the liver and kidneys by UGT1A9 to dapagliflozin 3-O-glucuronide, which is an inactive metabolite.

Lithium

Dapagliflozin may decrease serum lithium concentrations. Monitor lithium levels if co-administered.

Diuretics

Co-administration with diuretics may increase the risk of volume depletion and hypotension.

Insulin and Insulin Secretagogues (e.g., Sulfonylureas)

Increased risk of hypoglycemia; a lower dose of insulin or the insulin secretagogue may be required.