Dapagliflozin for Type 2 Diabetes and Cardiovascular Risk Reduction
Indications and Benefits
- The American College of Cardiology recommends dapagliflozin to reduce the risk of hospitalization for heart failure in adults with type 2 diabetes mellitus who have established cardiovascular disease or multiple cardiovascular risk factors 1
- Dapagliflozin can reduce the risk of cardiovascular death, hospitalization for heart failure, and urgent heart failure visits in adults with heart failure, regardless of diabetes status 1
Dosing and Administration
- For cardiovascular and renal indications, a fixed dose of 10 mg orally once daily is recommended 1
Safety and Monitoring
- Temporary interruption of dapagliflozin is recommended for at least 3 days before major surgery or procedures with prolonged fasting, and it can be resumed when the patient is clinically stable and has resumed oral intake 1
- The American College of Cardiology notes that dapagliflozin is associated with a low risk of hypoglycemia when used as monotherapy, but patients should be monitored for diabetic ketoacidosis, a rare but serious adverse effect 1
Special Populations
- Patients with cardiovascular disease may particularly benefit from dapagliflozin due to its cardiovascular risk reduction properties 1
- For patients on insulin, the Journal of the American College of Cardiology recommends considering a reduction in insulin dose by approximately 20% when starting dapagliflozin to prevent hypoglycemia 3
- The Journal of the American College of Cardiology also notes that dapagliflozin reduces hospitalization for heart failure and cardiovascular death 2