ERLI PLUS
DAPAGLIFLOZIN AND METFORMIN · by PHARMEVO
Composition
Tab 5/8500 mg: Dapagliflozin 5mg and Metformin 850 mg, Tab 5/1000 mg: Dapagliflozin 5mg and Metformin 1000 mg
Indications & Dosage
Type 2 diabetes mellitus not controlled by metformin alone or by metformin in combination with insulin or other antidiabetic drugs: Adult 18-74 years: 1 tablet twice daily, based on patients current metformin dose Adult 75 yrs and over: Initiation not recommended
Contraindications
Diabetic ketoacidosis, elderly over 80 yrs age, moderate to severe renal failure, severe hepatic failure, volume depletion, Acute metabolic acidosis or pre-coma, Acute conditions predisposing to renal impairment, cardiac or respiratory failure, recent MI, alcoholism and elderly (above 75yrs).
Precautions
Cardiovascular disease, heart failure, elderly; risk of hypotension, electrolyte disturbances, hypotension, raised haematocrit, pyelonephritis, urosepsis,glycosuria. Correct hypovolaemia before starting treatment to avoid risk of volume depletion. Consider interrupting treatment if volume depletion occurs. In renal impairment avoid if eGFR less than 60 ml/minute/1.73m2 (ineffective). Iodinated contrast materials, discontinue for 48 hrs before and after elective surgery, assess risk factors and discontinue immediately if metabolic acidosis suspected. Monitor renal function at least annually.
Interactions
Diuretics, antihypertensive, ACE inhibitors, angiotensin II antagonist, DPP4 inhibitors, incretin mimetics, alcohol, iodinated contrast agents, corticosteroids, NSAIDs, inhibitors of OCT1 & OCT2
Pregnancy
Contraindicated
Lactation
Contraindicated
Side Effects
Genital infection, hypoglycaemia (in combination with insulin or sulfonylurea), polyuria, pruritus, urinary tract infection, dysuria, haematocrit, volume depletion (rare). Reports of altered LFTs, hepatitis, GI upset, taste disturbance, skin reactions, reduced B12 absorptions, abnormal liver function tests, rarely lactic acidosis