Antidiabetic Agent, Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitor

Question 1

what are the brand names for dapagliflozin and canagliflozin?

Answer 1

Dapagliflozin: Farxiga
Canagliflozin: Invokana

Question 2

dosage form for dapagliflozin

Answer 2

oral tablet 5mg, 10mg

Question 3

dosage form of canagliflozin

Answer 3

oral tablet 100mg, 300mg

Question 4

Farxiga Indication

Answer 4

DM T2, adults

Heart failure with reduced ejection fraction

Question 5

What is the MOA for Canagliflozin and dapagliflozin?

Answer 5

inhibits SGLT2 in the proximal renal tubules, which reduces reabsorption of filtered glucose from the tubular lumen

Question 6

Contraindication for dapagliflozin?

Answer 6

Severe renal impairment

Question 7

Contraindication of canagliflozin?

Answer 7

Severe renal impairment
Serious hypersensitivity (eg, anaphylaxis, angioedema) to canagliflozin

Question 8

Dapagliflozin ADR?

Answer 8

Common: None

Less Common: Hypoglycemia, hypovolemia, electrolyte abnormalities, nasopharyngitis, urinary tract infections

Serious: Acute renal failure, bone fracture, hypersensitivity, pancreatitis, perineal necrotizing fasciitis

Question 9

CANAGLIFLOZIN ADR?

Answer 9

Common: Hyperkalemia, GU fungal infection, renal insufficiency

Less common: Hypoglycemia, hypersensitivity, hypovolemia, electrolyte abnormalities

Serious: Acute renal failure, pancreatitis, photosensitivity, metabolic acidosis, risk of foot amputations

Question 10

Canagliflozin Monitoring?

Answer 10

Efficacy: HbA1c <7%, monitored every 3-6 mo.

Toxicity: Renal function, BP, Hgb electrolytes to assess volume status

Question 11

Dapagliflozin Key patient counseling points?

Answer 11

Take before the first meal of the day to help reduce post meal hyperglycemia. Be aware of symptoms of dehydration (dizziness, low BP, decreased urination), and urinary tract infections and report to HCP.

initial therapy for DM T2 is lifestyle modifications and metformin; can be added to metformin for those with CV disease and not reaching glycemic control goals; dapagliflozin has less drug interaction than canagliflozin, but requires renal fxn*

Question 12

Dapagliflozin monitoring?

Answer 12

Efficacy Monitoring Parameters. HbA1c <7%, monitored every 3-6 mo.
Toxicity Monitoring Parameters. Renal function, BP, Hgb electrolytes to assess volume status

Question 13

Canagliflozin Key counseling points?

Answer 13

Take before the first meal of the day to help reduce post meal hyperglycemia. Be aware of symptoms of foot ulcers, pain or tenderness or dehydration (dizzy, low BP, decreased urination), and vaginal infections and report to HCP.

Initial therapy for type 2 diabetes is lifestyle modifications and metformin. An SGLT2 can be added to metformin for those with cardiovascular disease and not reaching glycemic control goals. Available SGLT2 inhibitors are canagliflozin, dapagliflozin, empagliflozin, and ertugliflozin. Both dapagliflozin and canagliflozin have cardiovascular benefits; however, increased risk of lower limb amputation is reported with canagliflozin, but not other SGLT2 inhibitors**