FDA Approves Dapagliflozin Tablets (dapagliflozin) to Reduce Heart Failure Hospitalization Risk and Improve Glycemic Control in Adults with Type 2 Diabetes
The FDA has approved dapagliflozin tablets for two indications in adults with type 2 diabetes mellitus: to reduce the risk of hospitalization for heart failure in those with established cardiovascular disease or multiple cardiovascular risk factors, and as an adjunct to diet and exercise to improve glycemic control. This approval provides clinicians with an SGLT2 inhibitor option for managing both glycemic control and cardiovascular risk in this patient population. The label includes specific dosing guidance and limitations of use, particularly regarding renal function. For glycemic control, the recommended starting dose is 5 mg once daily, which can be increased to 10 mg. For the heart failure hospitalization risk reduction indication, the recommended dose is 10 mg once daily. The label advises assessing renal function and volume status prior to initiation and recommends withholding the drug before major surgery.
+ Clinical Details (Mechanism · Dosing · Trial Data · Warnings)
Dapagliflozin is a sodium-glucose cotransporter 2 (SGLT2) inhibitor.
Dapagliflozin tablets are indicated: 1) To reduce the risk of hospitalization for heart failure in adults with type 2 diabetes mellitus and either established cardiovascular disease or multiple cardiovascular risk factors. 2) As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. Limitations of Use: Dapagliflozin tablets are not recommended for use to improve glycemic control in patients with type 1 diabetes mellitus. Dapagliflozin tablet is not recommended for use to improve glycemic control in patients with type 2 diabetes mellitus with an eGFR less than 45 mL/min/1.73 m2, as it is likely to be ineffective in this setting based upon its mechanism of action.
Assess renal function prior to initiation and then as clinically indicated. Assess volume status and correct volume depletion before initiating. For glycemic control: The recommended starting dosage is 5 mg orally once daily. Dosage can be increased to 10 mg orally once daily for additional glycemic control. For patients with an eGFR greater than or equal to 45 mL/min/1.73 m2, the dosage is the same as for normal renal function. Not recommended for glycemic control if eGFR is less than 45 mL/min/1.73 m2. For reducing the risk of hospitalization for heart failure: The recommended dosage is 10 mg orally once daily. For patients with an eGFR greater than or equal to 25 mL/min/1.73 m2, the dosage is the same as for normal renal function. Initiation is not recommended in patients with an eGFR less than 25 mL/min/1.73 m2. Withhold dapagliflozin tablets for at least 3 days, if possible, prior to major surgery or procedures associated with prolonged fasting.
Trial data not available in label.
Not reported in label.
Not reported in label.