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[4] [5] It is a combination of dapagliflozin and metformin [4] and is taken by mouth. [4] Dapagliflozin/metformin was approved for use in the European Union in January 2014, [ 3 ] in the United States in February 2014, [ 5 ] [ 6 ] and in Australia in July 2014.
Metformin has an oral bioavailability of 50–60% under fasting conditions, and is absorbed slowly. [9] [131] Peak plasma concentrations (C max) are reached within 1–3 hours of taking immediate-release metformin and 4–8 hours with extended-release formulations.
In the European Union it is indicated in adults aged 18 years and older with type 2 diabetes: to improve glycemic control when metformin with or without sulphonylurea (SU) and either saxagliptin or dapagliflozin does not provide adequate glycemic control. [2] when already being treated with metformin and saxagliptin and dapagliflozin. [2]
Further, metformin comes in the form of immediate-release tablets, extended-release tablets, and as a liquid. Each type of metformin has different requirements in terms of when and how to take it:
The 2022 American Diabetes Association (ADA) standards of medical care in diabetes include SGLT2 inhibitors as a first line pharmacological therapy for type 2 diabetes (usually together with metformin), specifically in patients with chronic kidney disease, cardiovascular disease or heart failure.
Typical reduction in glycated hemoglobin (A1C) values for Metformin is 1.5–2.0% Metformin (Glucophage) may be the best choice for patients who also have heart failure, [10] but it should be temporarily discontinued before any radiographic procedure involving intravenous iodinated contrast, as patients are at an increased risk of lactic acidosis.
2. Alleviates Hunger. Metformin improves how well your cells respond to insulin. This helps regulate your blood sugar levels and manage spikes in insulin that can trigger hunger and food cravings.
To reduce the risk of developing ketoacidosis (a serious condition where the body produces high levels of blood acids called ketones) after surgery, the FDA has approved changes to the prescribing information for SGLT2 inhibitor diabetes medications, recommending they be temporarily stopped before scheduled surgery.
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