Dapagliflozin (Forxiga®): medicine to treat CKD and type 2 diabetes
- Type of drug: Dapagliflozin (Forxiga®) is a sodium-glucose cotransporter 2 (SGLT-2) inhibitor
- Use: type 2 diabetes; CKD with protein in urine; chronic heart failure (CHF)
- Dose: 10 mg once a day (including CKD patients)
- Side-effects:
- Initial decrease (<10%) in GFR (increases later); low blood glucose (sugar)
- UTIs; vulvovaginal disorders; DKA.
- Monitor: creatinine/GFR; glucose.
Notes
- Its anti-proteinuric effect is augmented if the patient is also on an ACE or ARB.
- Do not use in DM1.
- Indicated in proteinuric CKD (uACR >25 mg/mmol) with GFR <60 and >25 ml/min (with or without DM). But do not initiate in Stage 5 CKD (GFR < 15 ml/min).
- Do not measure U+E within 4 weeks – as there may be a small (reversible) increase in creatinine/fall in GFR.
How does dapagliflozin work in chronic kidney disease (CKD)?
Reducing protein loss reduces kidney damage by reducing pressure and inflammation in the kidneys. It also reduces blood pressure and body weight, which helps the kidneys.
Other resources
CKD drug side-effects
CKD referral advice (GP Gateway)
Dapagliflozin (BNF)
This is a review article: Young, 2023
