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Available in 20 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-20" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">20 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%AF%D8%A7%D8%A8%D8%A7%D8%BA%D9%84%D9%8A%D9%81%D9%84%D9%88%D8%B2%D9%8A%D9%86" title="داباغليفلوزين – Arabic" lang="ar" hreflang="ar" data-title="داباغليفلوزين" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Dapagliflozin" title="Dapagliflozin – German" lang="de" hreflang="de" data-title="Dapagliflozin" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/%CE%94%CE%B1%CF%80%CE%B1%CE%B3%CE%BB%CE%B9%CF%86%CE%BB%CE%BF%CE%B6%CE%AF%CE%BD%CE%B7" title="Δαπαγλιφλοζίνη – Greek" lang="el" hreflang="el" data-title="Δαπαγλιφλοζίνη" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target"><span>Ελληνικά</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Dapagliflozina" title="Dapagliflozina – Spanish" lang="es" hreflang="es" data-title="Dapagliflozina" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%AF%D8%A7%D9%BE%D8%A7%DA%AF%D9%84%DB%8C%D9%81%D9%84%D9%88%D8%B2%DB%8C%D9%86" title="داپاگلیفلوزین – Persian" lang="fa" hreflang="fa" data-title="داپاگلیفلوزین" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Dapagliflozine" title="Dapagliflozine – French" lang="fr" hreflang="fr" data-title="Dapagliflozine" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Dapagliflozin" title="Dapagliflozin – Italian" lang="it" hreflang="it" data-title="Dapagliflozin" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%93%D7%90%D7%A4%D7%90%D7%92%D7%9C%D7%99%D7%A4%D7%9C%D7%95%D7%96%D7%99%D7%9F" title="דאפאגליפלוזין – Hebrew" lang="he" hreflang="he" data-title="דאפאגליפלוזין" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Dapagliflozine" title="Dapagliflozine – Dutch" lang="nl" hreflang="nl" data-title="Dapagliflozine" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E3%83%80%E3%83%91%E3%82%B0%E3%83%AA%E3%83%95%E3%83%AD%E3%82%B8%E3%83%B3" title="ダパグリフロジン – Japanese" lang="ja" hreflang="ja" data-title="ダパグリフロジン" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%A1%E0%AC%BE%E0%AC%AA%E0%AC%BE%E0%AC%97%E0%AD%8D%E0%AC%B2%E0%AC%BF%E0%AC%AB%E0%AD%8D%E0%AC%B2%E0%AD%8B%E0%AC%9C%E0%AC%BF%E0%AC%A8" title="ଡାପାଗ୍ଲିଫ୍ଲୋଜିନ – Odia" lang="or" hreflang="or" data-title="ଡାପାଗ୍ଲିଫ୍ଲୋଜିନ" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target"><span>ଓଡ଼ିଆ</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Dapagliflozyna" title="Dapagliflozyna – Polish" lang="pl" hreflang="pl" data-title="Dapagliflozyna" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Dapagliflozina" title="Dapagliflozina – Portuguese" lang="pt" hreflang="pt" data-title="Dapagliflozina" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Dapagliflozin%C4%83" title="Dapagliflozină – Romanian" lang="ro" hreflang="ro" data-title="Dapagliflozină" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/Dapagliflozin" title="Dapagliflozin – Serbian" lang="sr" hreflang="sr" data-title="Dapagliflozin" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Dapagliflozin" title="Dapagliflozin – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Dapagliflozin" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target"><span>Srpskohrvatski / српскохрватски</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Dapagliflotsiini" title="Dapagliflotsiini – Finnish" lang="fi" hreflang="fi" data-title="Dapagliflotsiini" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Dapagliflozin" title="Dapagliflozin – Turkish" lang="tr" hreflang="tr" data-title="Dapagliflozin" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%94%D0%B0%D0%BF%D0%B0%D0%B3%D0%BB%D1%96%D1%84%D0%BB%D0%BE%D0%B7%D0%B8%D0%BD" title="Дапагліфлозин – Ukrainian" lang="uk" hreflang="uk" data-title="Дапагліфлозин" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a href="https://zh.wikipedia.org/wiki/%E8%BE%BE%E6%A0%BC%E5%88%97%E5%87%80" title="达格列净 – Chinese" lang="zh" hreflang="zh" data-title="达格列净" data-language-autonym="中文" data-language-local-name="Chinese" class="interlanguage-link-target"><span>中文</span></a></li> </ul> <div class="after-portlet after-portlet-lang"><span class="wb-langlinks-edit wb-langlinks-link"><a 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dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Diabetes medication</div> <p class="mw-empty-elt"> </p> <style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox" style="border-spacing:2px;"><caption class="infobox-title"><span title="International nonproprietary name (INN): Dapagliflozin">Dapagliflozin</span></caption><tbody><tr><td colspan="2" class="infobox-image notheme" style="background-color: #f8f9fa;"><span typeof="mw:File"><a href="/wiki/File:Dapagliflozin_skeletal.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/9/9e/Dapagliflozin_skeletal.svg/275px-Dapagliflozin_skeletal.svg.png" decoding="async" width="275" height="76" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/9e/Dapagliflozin_skeletal.svg/413px-Dapagliflozin_skeletal.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/9e/Dapagliflozin_skeletal.svg/550px-Dapagliflozin_skeletal.svg.png 2x" data-file-width="512" data-file-height="142" /></a></span></td></tr><tr><td colspan="2" class="infobox-image notheme" style="background-color: #f8f9fa;"><span typeof="mw:File"><a href="/wiki/File:Haworth_projection_of_dapagliflozin.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/e/e6/Haworth_projection_of_dapagliflozin.svg/225px-Haworth_projection_of_dapagliflozin.svg.png" decoding="async" width="225" height="142" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/e6/Haworth_projection_of_dapagliflozin.svg/338px-Haworth_projection_of_dapagliflozin.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/e6/Haworth_projection_of_dapagliflozin.svg/450px-Haworth_projection_of_dapagliflozin.svg.png 2x" data-file-width="512" data-file-height="324" /></a></span><div class="infobox-caption"><a href="/wiki/Haworth_projection" title="Haworth projection">Haworth projection</a> (bottom)</div></td></tr><tr><td colspan="2" class="infobox-image notheme" style="background-color: #f8f9fa;"><table style="width:100%; margin:0;"><tbody><tr> <td style="vertical-align:top; text-align:center; width:50%;"></td> <td style="vertical-align:top; text-align:center; width:50%;"><span typeof="mw:File"><a href="/wiki/File:Dapagliflozin-from-xtal-Mercury-3D-bs.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/c/c1/Dapagliflozin-from-xtal-Mercury-3D-bs.png/250px-Dapagliflozin-from-xtal-Mercury-3D-bs.png" decoding="async" width="250" height="137" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/c/c1/Dapagliflozin-from-xtal-Mercury-3D-bs.png/375px-Dapagliflozin-from-xtal-Mercury-3D-bs.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/c/c1/Dapagliflozin-from-xtal-Mercury-3D-bs.png/500px-Dapagliflozin-from-xtal-Mercury-3D-bs.png 2x" data-file-width="3000" data-file-height="1639" /></a></span></td> </tr></tbody></table></td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd">Clinical data</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;">Pronunciation</th><td class="infobox-data"><span class="rt-commentedText nowrap"><span class="IPA nopopups noexcerpt" lang="en-fonipa"><a href="/wiki/Help:IPA/English" title="Help:IPA/English">/<span style="border-bottom:1px dotted"><span title="/ˌ/: secondary stress follows">ˌ</span><span title="'d' in 'dye'">d</span><span title="/æ/: 'a' in 'bad'">æ</span><span title="'p' in 'pie'">p</span><span title="/ə/: 'a' in 'about'">ə</span><span title="/ɡ/: 'g' in 'guy'">ɡ</span><span title="'l' in 'lie'">l</span><span title="/ɪ/: 'i' in 'kit'">ɪ</span><span title="/ˈ/: primary stress follows">ˈ</span><span title="'f' in 'find'">f</span><span title="'l' in 'lie'">l</span><span title="/oʊ/: 'o' in 'code'">oʊ</span><span title="'z' in 'zoom'">z</span><span title="/ɪ/: 'i' in 'kit'">ɪ</span><span title="'n' in 'nigh'">n</span></span>/</a></span></span> <a href="/wiki/Help:Pronunciation_respelling_key" title="Help:Pronunciation respelling key"><i title="English pronunciation respelling"><span style="font-size:90%">DAP</span>-ə-glif-<span style="font-size:90%">LOH</span>-zin</i></a> </td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Drug_nomenclature#Trade_names" title="Drug nomenclature">Trade names</a></th><td class="infobox-data">Forxiga, Farxiga, others</td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;">Other names</th><td class="infobox-data">BMS-512148; (1<i>S</i>)-1,5-anhydro-1-<i>C</i>-{4-chloro-3-[(4-ethoxyphenyl)methyl]phenyl}-<small>D</small>-glucitol</td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/American_Society_of_Health-System_Pharmacists" title="American Society of Health-System Pharmacists">AHFS</a>/<a href="/wiki/Drugs.com" title="Drugs.com">Drugs.com</a></th><td class="infobox-data"><span title="www.drugs.com"><a rel="nofollow" class="external text" href="https://www.drugs.com/monograph/dapagliflozin-propanediol.html">Monograph</a></span></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a></th><td class="infobox-data"><span title="medlineplus.gov"><a rel="nofollow" class="external text" href="https://medlineplus.gov/druginfo/meds/a614015.html">a614015</a></span></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Regulation_of_therapeutic_goods" title="Regulation of therapeutic goods">License data</a></th><td class="infobox-data"><style data-mw-deduplicate="TemplateStyles:r1126788409">.mw-parser-output .plainlist ol,.mw-parser-output .plainlist ul{line-height:inherit;list-style:none;margin:0;padding:0}.mw-parser-output .plainlist ol li,.mw-parser-output .plainlist ul li{margin-bottom:0}</style><div class="plainlist"> <ul><li><small><abbr class="country-name" title="United States">US</abbr></small> <a href="/wiki/DailyMed" title="DailyMed">DailyMed</a>: <span title="dailymed.nlm.nih.gov"><a rel="nofollow" class="external text" href="https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=Dapagliflozin">Dapagliflozin</a></span></li></ul></div> </td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Pregnancy_category" title="Pregnancy category">Pregnancy<br />category</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"> <ul><li><small><abbr class="country-name" title="Australia">AU</abbr>:</small> D<sup id="cite_ref-pregnancy_1-0" class="reference"><a href="#cite_note-pregnancy-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></li> <li class="mw-empty-elt"></li></ul> </div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Route_of_administration" title="Route of administration">Routes of<br />administration</a></th><td class="infobox-data"><a href="/wiki/Oral_administration" title="Oral administration">By mouth</a></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Drug_class" title="Drug class">Drug class</a></th><td class="infobox-data"><a href="/wiki/SGLT2_inhibitor" title="SGLT2 inhibitor">Sodium-glucose co-transporter 2 (SGLT2) inhibitor</a></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Anatomical_Therapeutic_Chemical_Classification_System" title="Anatomical Therapeutic Chemical Classification System">ATC code</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><a href="/wiki/ATC_code_A10" title="ATC code A10">A10BK01</a> (<span title="www.whocc.no"><a rel="nofollow" class="external text" href="https://www.whocc.no/atc_ddd_index/?code=A10BK01">WHO</a></span>) </li></ul></div></td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd">Legal status</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Regulation_of_therapeutic_goods" title="Regulation of therapeutic goods">Legal status</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"> <ul><li><small><abbr class="country-name" title="Australia">AU</abbr>:</small> <a href="/wiki/Standard_for_the_Uniform_Scheduling_of_Medicines_and_Poisons#Schedule_4" title="Standard for the Uniform Scheduling of Medicines and Poisons">S4</a> (Prescription only)<sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup></li> <li><small><abbr class="country-name" title="Canada">CA</abbr></small>: <a href="/wiki/Prescription_drug" title="Prescription drug"> ℞-only</a><sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup></li> <li><small><abbr class="country-name" title="United Kingdom">UK</abbr>:</small> <a href="/wiki/Prescription_drug" title="Prescription drug">POM</a> (Prescription only)</li> <li><small><abbr class="country-name" title="United States">US</abbr>:</small> <a href="/wiki/Prescription_drug" title="Prescription drug">℞-only</a><sup id="cite_ref-Farxiga_FDA_label_6-0" class="reference"><a href="#cite_note-Farxiga_FDA_label-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup></li> <li><small><abbr class="country-name" title="European Union">EU</abbr>:</small> Rx-only<sup id="cite_ref-Forxiga_EPAR_7-0" class="reference"><a href="#cite_note-Forxiga_EPAR-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Dapagliflozin_Viatris_EPAR_8-0" class="reference"><a href="#cite_note-Dapagliflozin_Viatris_EPAR-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup></li> <li>In general: ℞ (Prescription only)</li></ul></div> </td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd"><a href="/wiki/Pharmacokinetics" title="Pharmacokinetics">Pharmacokinetic</a> data</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Bioavailability" title="Bioavailability">Bioavailability</a></th><td class="infobox-data">78% (after 10 mg dose)</td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Plasma_protein_binding" title="Plasma protein binding">Protein binding</a></th><td class="infobox-data">~91%</td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Drug_metabolism" title="Drug metabolism">Metabolism</a></th><td class="infobox-data"><a href="/wiki/UGT1A9" title="UGT1A9">UGT1A9</a> (major), <a href="/wiki/Cytochrome_P450" title="Cytochrome P450">CYP</a> (minor)</td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Metabolite" title="Metabolite">Metabolites</a></th><td class="infobox-data">Dapagliflozin 3-<i>O</i>-glucuronide (inactive)</td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Biological_half-life" title="Biological half-life">Elimination <span class="nowrap">half-life</span></a></th><td class="infobox-data">~12.9 hours</td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Excretion" title="Excretion">Excretion</a></th><td class="infobox-data"><a href="/wiki/Urine" title="Urine">Urine</a> (75%), <a href="/wiki/Feces" title="Feces">feces</a> (21%)<sup id="cite_ref-Farxiga_FDA_label_6-1" class="reference"><a href="#cite_note-Farxiga_FDA_label-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup></td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd">Identifiers</th></tr><tr><td colspan="2" class="infobox-full-data"><div class="collapsible-list mw-collapsible mw-collapsed" style="text-align: left;"> <div style="line-height: 1.6em; font-weight: bold;"><div><a href="/wiki/IUPAC_nomenclature_of_chemistry" title="IUPAC nomenclature of chemistry">IUPAC name</a></div></div> <ul class="mw-collapsible-content" style="margin-top: 0; margin-bottom: 0; line-height: inherit; list-style: none; margin-left: 0; word-break:break-all; text-align:left; padding-left:1.5em; text-indent:-1.5em;"><li style="line-height: inherit; margin: 0"><div style="font-size: 97%;">(2<i>S</i>,3<i>R</i>,4<i>R</i>,5<i>S</i>,6<i>R</i>)-2-[4-Chloro-3-(4-ethoxybenzyl)phenyl]-6-(hydroxymethyl)tetrahydro-2<i>H</i>-pyran-3,4,5-triol</div></li></ul> </div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/CAS_Registry_Number" title="CAS Registry Number">CAS Number</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="commonchemistry.cas.org"><a rel="nofollow" class="external text" href="https://commonchemistry.cas.org/detail?cas_rn=461432-26-8">461432-26-8</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/PubChem#CID" title="PubChem">PubChem</a> <span style="font-weight:normal"><abbr title="Compound ID">CID</abbr></span></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="pubchem.ncbi.nlm.nih.gov"><a rel="nofollow" class="external text" href="https://pubchem.ncbi.nlm.nih.gov/compound/9887712">9887712</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Guide_to_Pharmacology" title="Guide to Pharmacology">IUPHAR/BPS</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="www.guidetopharmacology.org"><a rel="nofollow" class="external text" href="https://www.guidetopharmacology.org/GRAC/LigandDisplayForward?ligandId=4594">4594</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/DrugBank" title="DrugBank">DrugBank</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="www.drugbank.ca"><a rel="nofollow" class="external text" href="https://www.drugbank.ca/drugs/DB06292">DB06292</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/ChemSpider" title="ChemSpider">ChemSpider</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="www.chemspider.com"><a rel="nofollow" class="external text" href="https://www.chemspider.com/Chemical-Structure.8063384.html">8063384</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Unique_Ingredient_Identifier" title="Unique Ingredient Identifier">UNII</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="precision.fda.gov"><a rel="nofollow" class="external text" href="https://precision.fda.gov/uniisearch/srs/unii/1ULL0QJ8UC">1ULL0QJ8UC</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/KEGG" title="KEGG">KEGG</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="www.kegg.jp"><a rel="nofollow" class="external text" href="https://www.kegg.jp/entry/D08897">D08897</a></span></li><li>as salt: <span title="www.kegg.jp"><a rel="nofollow" class="external text" href="https://www.kegg.jp/entry/D09763">D09763</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/ChEBI" title="ChEBI">ChEBI</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="www.ebi.ac.uk"><a rel="nofollow" class="external text" href="https://www.ebi.ac.uk/chebi/searchId.do?chebiId=CHEBI:85078">CHEBI:85078</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/ChEMBL" title="ChEMBL">ChEMBL</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div 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typeof="mw:File/Frameless"><a href="https://www.wikidata.org/wiki/Q409898#P2566" title="Edit this at Wikidata"><img alt="Edit this at Wikidata" src="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/10px-OOjs_UI_icon_edit-ltr-progressive.svg.png" decoding="async" width="10" height="10" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/15px-OOjs_UI_icon_edit-ltr-progressive.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png 2x" data-file-width="20" data-file-height="20" /></a></span></td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd">Chemical and physical data</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Chemical_formula" title="Chemical formula">Formula</a></th><td class="infobox-data"><span title="Carbon">C</span><sub>21</sub><span title="Hydrogen">H</span><sub>25</sub><span title="Chlorine">Cl</span><span title="Oxygen">O</span><sub>6</sub></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Molar_mass" title="Molar mass">Molar mass</a></th><td class="infobox-data"><span class="nowrap"><span data-sort-value="7002408880000000000♠"></span>408.88</span> g·mol<sup>−1</sup></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;">3D model (<a href="/wiki/JSmol" class="mw-redirect" title="JSmol">JSmol</a>)</th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="chemapps.stolaf.edu (3D interactive model)"><a rel="nofollow" class="external text" href="https://chemapps.stolaf.edu/jmol/jmol.php?model=Clc1ccc%28cc1Cc2ccc%28OCC%29cc2%29%5BC%40%40H%5D3O%5BC%40H%5D%28CO%29%5BC%40%40H%5D%28O%29%5BC%40H%5D%28O%29%5BC%40H%5D3O">Interactive image</a></span></li></ul></div></td></tr><tr><td colspan="2" class="infobox-full-data"><div class="collapsible-list mw-collapsible mw-collapsed" style="text-align: left;"> <div style="line-height: 1.6em; font-weight: bold;"><div><a href="/wiki/Simplified_molecular-input_line-entry_system" class="mw-redirect" title="Simplified molecular-input line-entry system">SMILES</a></div></div> <ul class="mw-collapsible-content" style="margin-top: 0; margin-bottom: 0; line-height: inherit; list-style: none; margin-left: 0; word-break:break-all;"><li style="line-height: inherit; margin: 0"><div style="word-wrap:break-word; text-indent:-1.5em; text-align:left; padding-left:1.5em; font-size:97%; line-height:120%;">Clc1ccc(cc1Cc2ccc(OCC)cc2)[C@@H]3O[C@H](CO)[C@@H](O)[C@H](O)[C@H]3O</div></li></ul> </div></td></tr><tr><td colspan="2" class="infobox-full-data"><div class="collapsible-list mw-collapsible mw-collapsed" style="text-align: left;"> <div style="line-height: 1.6em; font-weight: bold;"><div><a href="/wiki/International_Chemical_Identifier" title="International Chemical Identifier">InChI</a></div></div> <ul class="mw-collapsible-content" style="margin-top: 0; margin-bottom: 0; line-height: inherit; list-style: none; margin-left: 0; word-break:break-all;"><li style="line-height: inherit; margin: 0"><div style="word-wrap:break-word; text-indent:-1.5em; text-align:left; padding-left:1.5em; font-size:97%; line-height:120%;">InChI=1S/C21H25ClO6/c1-2-27-15-6-3-12(4-7-15)9-14-10-13(5-8-16(14)22)21-20(26)19(25)18(24)17(11-23)28-21/h3-8,10,17-21,23-26H,2,9,11H2,1H3/t17-,18-,19+,20-,21+/m1/s1</div></li><li style="line-height: inherit; margin: 0"><div style="word-wrap:break-word; text-indent:-1.5em; text-align:left; padding-left:1.5em; font-size:97%; line-height:120%;">Key:JVHXJTBJCFBINQ-ADAARDCZSA-N</div></li></ul> </div></td></tr></tbody></table> <p><b>Dapagliflozin</b>, sold under the brand names <b>Farxiga</b> (US) and <b>Forxiga</b> (EU) among others, is a medication used to treat <a href="/wiki/Type_2_diabetes" title="Type 2 diabetes">type 2 diabetes</a>.<sup id="cite_ref-Farxiga_FDA_label_6-2" class="reference"><a href="#cite_note-Farxiga_FDA_label-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Forxiga_EPAR_7-1" class="reference"><a href="#cite_note-Forxiga_EPAR-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-EMA_DHPC_notice_10-0" class="reference"><a href="#cite_note-EMA_DHPC_notice-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> It is also used to treat adults with <a href="/wiki/Heart_failure" title="Heart failure">heart failure</a> and <a href="/wiki/Chronic_kidney_disease" title="Chronic kidney disease">chronic kidney disease</a>.<sup id="cite_ref-FDA_PR_20200505_11-0" class="reference"><a href="#cite_note-FDA_PR_20200505-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-NICE_TA697_12-0" class="reference"><a href="#cite_note-NICE_TA697-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Forxiga_EPAR_7-2" class="reference"><a href="#cite_note-Forxiga_EPAR-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> It reversibly inhibits sodium-glucose co-transporter 2 (SGLT-2) in the renal proximal convoluted tubule to reduce glucose reabsorption and increase urinary glucose excretion.<sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </p><p>Common side effects include <a href="/wiki/Hypoglycaemia" class="mw-redirect" title="Hypoglycaemia">hypoglycaemia</a> (low blood sugar), urinary tract infections, genital infections, and <a href="/wiki/Volume_depletion" class="mw-redirect" title="Volume depletion">volume depletion</a> (reduced amount of water in the body).<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Diabetic_ketoacidosis" title="Diabetic ketoacidosis">Diabetic ketoacidosis</a> is a common side effect in people with type 1 diabetes.<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> Serious but rare side effects include <a href="/wiki/Fournier_gangrene" title="Fournier gangrene">Fournier gangrene</a>.<sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> </p><p>It was developed by <a href="/wiki/Bristol-Myers_Squibb" class="mw-redirect" title="Bristol-Myers Squibb">Bristol-Myers Squibb</a> in partnership with <a href="/wiki/AstraZeneca" title="AstraZeneca">AstraZeneca</a>. It is on the <a href="/wiki/WHO_Model_List_of_Essential_Medicines" title="WHO Model List of Essential Medicines">World Health Organization's List of Essential Medicines</a>.<sup id="cite_ref-WHO23rd_17-0" class="reference"><a href="#cite_note-WHO23rd-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> In 2022, it was the 115th most commonly prescribed medication in the United States, with more than 5<span class="nowrap"> </span>million prescriptions.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> Dapagliflozin is available as a <a href="/wiki/Generic_medication" class="mw-redirect" title="Generic medication">generic medication</a>. </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Medical_uses">Medical uses</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Dapagliflozin&action=edit&section=1" title="Edit section: Medical uses"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Dapagliflozin is used along with diet, exercise, and usually with other glucose-lowering medications, to improve glycaemic control in adults with type 2 diabetes. Dapagliflozin, in addition to other SGLT2-inhibitors, was shown to reduce the rate of decline in kidney function and kidney failure in non-diabetic and type 2 diabetic adults when added to the existing treatment regimen.<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Heerspink_2020_21-0" class="reference"><a href="#cite_note-Heerspink_2020-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-23" class="reference"><a href="#cite_note-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> </p><p>Dapagliflozin is also considered as an option for people with heart failure with reduced ejection fraction with a <a href="/wiki/Ejection_fraction" title="Ejection fraction">LVEF</a> <40%.<sup id="cite_ref-McMurray_2019_24-0" class="reference"><a href="#cite_note-McMurray_2019-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> It can be given regardless of current diabetes status, in addition to standard medical therapy. Recent studies have indicated that the use of dapagliflozin and other medications from the SGLT-2 inhibitor class can reduce the risk of worsening heart failure, death, and hospitalization from cardiovascular disease.<sup id="cite_ref-McMurray_2019_24-1" class="reference"><a href="#cite_note-McMurray_2019-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> SGLT-2 inhibitors reduce the risk of hospitalisation due to heart failure in people with or without atherosclerotic cardiovascular disease <sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> A small number of meta-analyses and cohort studies have shown that dapagliflozin is superior to others such as empagliflozin.<sup id="cite_ref-28" class="reference"><a href="#cite_note-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Association_of_SGLT2_Inhibitors_Wit_29-0" class="reference"><a href="#cite_note-Association_of_SGLT2_Inhibitors_Wit-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-30" class="reference"><a href="#cite_note-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> </p><p>In the European Union, dapagliflozin is indicated in adults: </p> <ul><li>For the treatment of insufficiently controlled type 2 diabetes as an adjunct to diet and exercise:<sup id="cite_ref-Forxiga_EPAR_7-3" class="reference"><a href="#cite_note-Forxiga_EPAR-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Cefalu_2015_31-0" class="reference"><a href="#cite_note-Cefalu_2015-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Dapagliflozin_monotherapy_in_type_2_32-0" class="reference"><a href="#cite_note-Dapagliflozin_monotherapy_in_type_2-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Rossing_2022_33-0" class="reference"><a href="#cite_note-Rossing_2022-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> <ul><li>as monotherapy when <a href="/wiki/Metformin" title="Metformin">metformin</a> is considered inappropriate due to intolerance;<sup id="cite_ref-Forxiga_EPAR_7-4" class="reference"><a href="#cite_note-Forxiga_EPAR-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Cefalu_2015_31-1" class="reference"><a href="#cite_note-Cefalu_2015-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Dapagliflozin_monotherapy_in_type_2_32-1" class="reference"><a href="#cite_note-Dapagliflozin_monotherapy_in_type_2-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Rossing_2022_33-1" class="reference"><a href="#cite_note-Rossing_2022-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup></li> <li>in addition to other medicinal products for the treatment of type 2 diabetes;<sup id="cite_ref-Forxiga_EPAR_7-5" class="reference"><a href="#cite_note-Forxiga_EPAR-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup></li></ul></li> <li>For the treatment of heart failure with reduced ejection fraction<sup id="cite_ref-Forxiga_EPAR_7-6" class="reference"><a href="#cite_note-Forxiga_EPAR-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup></li></ul> <p>In November 2021, the <a href="/wiki/European_Medicines_Agency" title="European Medicines Agency">European Medicines Agency</a> (EMA) stated that dapagliflozin should no longer be used to treat type 1 diabetes.<sup id="cite_ref-EMA_DHPC_notice_10-1" class="reference"><a href="#cite_note-EMA_DHPC_notice-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Effects_in_nondiabetic_chronic_kidney_disease">Effects in nondiabetic chronic kidney disease</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Dapagliflozin&action=edit&section=2" title="Edit section: Effects in nondiabetic chronic kidney disease"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In 2021, the US <a href="/wiki/Food_and_Drug_Administration" title="Food and Drug Administration">Food and Drug Administration</a> (FDA) and the EMA expanded the indications for dapagliflozin to include the treatment of people who have chronic kidney disease but don't have diabetes.<sup id="cite_ref-FDA_PR_20210430_34-0" class="reference"><a href="#cite_note-FDA_PR_20210430-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Forxiga_EPAR_35-0" class="reference"><a href="#cite_note-Forxiga_EPAR-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> Clinical trials have shown the following effects of such a treatment. </p><p>The DIAMOND trial (2017-2019) showed in treatment periods of 6 weeks no improvement of excess proteins in the urine (<a href="/wiki/Proteinuria" title="Proteinuria">proteinuria</a>), a significant deterioration of the kidney's <a href="/wiki/Glomerular_filtration_rate" title="Glomerular filtration rate">filtration rate</a> (reversible within 6 weeks after dapagliflozin discontinuation), and a significant mean loss of body weight of 1.5 kg.<sup id="cite_ref-DIAMOND_trial_36-0" class="reference"><a href="#cite_note-DIAMOND_trial-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Yau_2022_37-0" class="reference"><a href="#cite_note-Yau_2022-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup> </p><p>The DAPA-CKD trial (2017-2020) showed in a median treatment period of 2.4 years of participants who had already been under <a href="/wiki/ACE_inhibitor" title="ACE inhibitor">ACE</a> or <a href="/wiki/Angiotensin_II_receptor_blocker" title="Angiotensin II receptor blocker">ARB</a> therapy that the events of a sustained decline of 50% in the kidney's filtration rate, kidney failure, or death occurred statistically around eight months later in the treatment group than in the placebo group. In the first 12-16 months of treatment, however, the kidney filtration rate was worse in the treatment group than in the placebo group, being slightly less negative in the treatment group than in the placebo group only thereafter.<sup id="cite_ref-Heerspink_2020_21-1" class="reference"><a href="#cite_note-Heerspink_2020-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Yau_2022_37-1" class="reference"><a href="#cite_note-Yau_2022-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Adverse_effects">Adverse effects</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Dapagliflozin&action=edit&section=3" title="Edit section: Adverse effects"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Since dapagliflozin leads to heavy <a href="/wiki/Glycosuria" title="Glycosuria">glycosuria</a> (sometimes up to about 70 grams per day), it can lead to rapid weight loss and tiredness. The glucose acts as an osmotic diuretic (this effect is the cause of <a href="/wiki/Polyuria" title="Polyuria">polyuria</a> in diabetes), which can lead to <a href="/wiki/Dehydration" title="Dehydration">dehydration</a>. The increased amount of glucose in the urine can also worsen the infections already associated with diabetes, particularly <a href="/wiki/Urinary_tract_infection" title="Urinary tract infection">urinary tract infections</a> and <a href="/wiki/Candidiasis" title="Candidiasis">thrush</a> (candidiasis). Rarely, the use of an SGLT-2 inhibitor medication, including dapagliflozin, is associated with <a href="/wiki/Necrotizing_fasciitis" title="Necrotizing fasciitis">necrotizing fasciitis</a> of the perineum, also called <a href="/wiki/Fournier_gangrene" title="Fournier gangrene">Fournier gangrene</a>.<sup id="cite_ref-38" class="reference"><a href="#cite_note-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup> </p><p>Dapagliflozin is also associated with <a href="/wiki/Hypotension" title="Hypotension">hypotensive</a> reactions. Concerns exist that it may increase the risk of <a href="/wiki/Diabetic_ketoacidosis" title="Diabetic ketoacidosis">diabetic ketoacidosis</a>.<sup id="cite_ref-39" class="reference"><a href="#cite_note-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup> Dapagliflozin and other SGLT2 inhibitors increase the risk of diabetic ketoacidosis in type 2 diabetic patients.<sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-41" class="reference"><a href="#cite_note-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup> However, the DEPICT-1 and DEPICT-2 trials showed that dapagliflozin caused additional diabetic ketoacidosis events in the Type I diabetic patients who received dapagliflozin.<sup id="cite_ref-42" class="reference"><a href="#cite_note-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> Symptoms of ketoacidosis include nausea, vomiting, abdominal pain, fatigue, and trouble breathing.<sup id="cite_ref-FDA_drug_safety_20200319_43-0" class="reference"><a href="#cite_note-FDA_drug_safety_20200319-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup> </p><p>Dapagliflozin can cause dehydration, serious urinary tract infections, and genital yeast infections.<sup id="cite_ref-FDA_PR_20200505_11-1" class="reference"><a href="#cite_note-FDA_PR_20200505-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Elderly people and people with kidney dysfunction, low blood pressure, or who are on diuretic medications should have their volume status and kidney function assessed.<sup id="cite_ref-FDA_PR_20200505_11-2" class="reference"><a href="#cite_note-FDA_PR_20200505-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Individuals with signs and symptoms of metabolic acidosis or ketoacidosis should also be assessed.<sup id="cite_ref-FDA_PR_20200505_11-3" class="reference"><a href="#cite_note-FDA_PR_20200505-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Dapagliflozin can cause low blood sugar when combined with insulin.<sup id="cite_ref-FDA_PR_20200505_11-4" class="reference"><a href="#cite_note-FDA_PR_20200505-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p><p>To lessen the risk of developing ketoacidosis after surgery, the FDA has approved changes to the prescribing information for SGLT-2 inhibitors to recommend they be stopped temporarily before scheduled surgery. Canagliflozin, dapagliflozin, and empagliflozin should each be stopped at least three days before, and ertugliflozin should be stopped at least four days before scheduled surgery.<sup id="cite_ref-FDA_drug_safety_20200319_43-1" class="reference"><a href="#cite_note-FDA_drug_safety_20200319-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup> </p><p>The glucose-lowering effect of dapagliflozin starts to diminish in people with chronic kidney disease with reduced kidney function (eGFR <45mL/min), and may not be as effective for glycemic control. However, studies have demonstrated a renoprotective effect in reducing kidney function decline, dapagliflozin can still be used to reduce kidney function decline regardless of diabetes status. Therefore, while dapagliflozin can be used in people with diabetes and chronic kidney disease to prevent kidney function decline, further interventions may be needed for glycemic control.<sup id="cite_ref-Heerspink_2020_21-2" class="reference"><a href="#cite_note-Heerspink_2020-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-44" class="reference"><a href="#cite_note-44"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Chemistry">Chemistry</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Dapagliflozin&action=edit&section=4" title="Edit section: Chemistry"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The first synthesis of dapagliflozin was disclosed in a patent filed by <a href="/wiki/Bristol_Myers_Squibb" title="Bristol Myers Squibb">Bristol Myers Squibb</a> in 2002.<sup id="cite_ref-US6515117B2_45-0" class="reference"><a href="#cite_note-US6515117B2-45"><span class="cite-bracket">[</span>45<span class="cite-bracket">]</span></a></sup> </p> <dl><dd><span typeof="mw:File"><a href="/wiki/File:Dapaglifloxin_synthesis.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/2/21/Dapaglifloxin_synthesis.svg/650px-Dapaglifloxin_synthesis.svg.png" decoding="async" width="650" height="202" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/21/Dapaglifloxin_synthesis.svg/975px-Dapaglifloxin_synthesis.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/21/Dapaglifloxin_synthesis.svg/1300px-Dapaglifloxin_synthesis.svg.png 2x" data-file-width="512" data-file-height="159" /></a></span></dd></dl> <p>The two main carbon-containing fragments are combined by the reaction of an <a href="/wiki/Organolithium_reagent" title="Organolithium reagent">aryl lithium</a> with a <a href="/wiki/Trimethylsilyl" class="mw-redirect" title="Trimethylsilyl">trimethylsilyl</a>-<a href="/wiki/Protecting_group" title="Protecting group">protected</a> <a href="/wiki/Gluconolactone" class="mw-redirect" title="Gluconolactone">gluconolactone</a>. The trimethylsilyl groups are then removed by treatment with <a href="/wiki/Methanesulfonic_acid" title="Methanesulfonic acid">methanesulfonic acid</a> in methanol. This gives an intermediate with an unwanted <a href="/wiki/Methoxy_group" title="Methoxy group">methoxy group</a> at the <a href="/wiki/Anomeric_centre" class="mw-redirect" title="Anomeric centre">anomeric centre</a>, which is removed by reaction with <a href="/wiki/Triethylsilane" title="Triethylsilane">triethylsilane</a> in the presence of <a href="/wiki/Boron_trifluoride_etherate" title="Boron trifluoride etherate">boron trifluoride etherate</a>. This route, as well as others developed for the manufacture of the drug, have been reviewed.<sup id="cite_ref-46" class="reference"><a href="#cite_note-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Mechanism_of_action">Mechanism of action</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Dapagliflozin&action=edit&section=5" title="Edit section: Mechanism of action"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Dapagliflozin inhibits subtype 2 of the <a href="/wiki/Sodium-glucose_transport_proteins" title="Sodium-glucose transport proteins">sodium-glucose transport proteins</a> (<a href="/wiki/SGLT2" class="mw-redirect" title="SGLT2">SGLT2</a>), which are responsible for at least 90% of the glucose <a href="/wiki/Reabsorption" title="Reabsorption">reabsorption</a> in the kidney. Blocking this transporter mechanism causes blood glucose to be eliminated through the urine.<sup id="cite_ref-47" class="reference"><a href="#cite_note-47"><span class="cite-bracket">[</span>47<span class="cite-bracket">]</span></a></sup> In combination with metformin, dapagliflozin at standard treatment dose of 10 mg daily lowered HbA1c by 0.54-0.84% (5.9-9.3 mmol/mol) when compared to metformin monotherapy in patients with inadequately controlled type 2 diabetes and normal renal function.<sup id="cite_ref-48" class="reference"><a href="#cite_note-48"><span class="cite-bracket">[</span>48<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-49" class="reference"><a href="#cite_note-49"><span class="cite-bracket">[</span>49<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-50" class="reference"><a href="#cite_note-50"><span class="cite-bracket">[</span>50<span class="cite-bracket">]</span></a></sup> </p><p>Its protective effects in heart failure are attributed primarily to haemodynamic effects, where SGLT2 inhibitors potently reduce intravascular volume through osmotic diuresis and natriuresis. This consequently may lead to a reduction in preload and afterload, thereby alleviating cardiac workload and improving left ventricular function.<sup id="cite_ref-51" class="reference"><a href="#cite_note-51"><span class="cite-bracket">[</span>51<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Selectivity">Selectivity</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Dapagliflozin&action=edit&section=6" title="Edit section: Selectivity"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The <a href="/wiki/IC50" title="IC50">IC<sub>50</sub></a> for SGLT2 is less than one-thousandth of the IC<sub>50</sub> for <a href="/wiki/SLC5A1" class="mw-redirect" title="SLC5A1">SGLT1</a> (1.1 versus 1390 nmol/L), so that the drug does not interfere with intestinal glucose absorption.<sup id="cite_ref-52" class="reference"><a href="#cite_note-52"><span class="cite-bracket">[</span>52<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Names">Names</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Dapagliflozin&action=edit&section=7" title="Edit section: Names"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Dapagliflozin is the <a href="/wiki/International_nonproprietary_name" title="International nonproprietary name">International nonproprietary name</a> (INN),<sup id="cite_ref-INN_53-0" class="reference"><a href="#cite_note-INN-53"><span class="cite-bracket">[</span>53<span class="cite-bracket">]</span></a></sup> and the <a href="/wiki/United_States_Adopted_Name" title="United States Adopted Name">United States Adopted Name</a> (USAN).<sup id="cite_ref-USAN_54-0" class="reference"><a href="#cite_note-USAN-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup> </p><p>The fixed-dose combination product, <a href="/wiki/Dapagliflozin/metformin" title="Dapagliflozin/metformin">dapagliflozin/metformin</a> extended-release, is called Xigduo XR.<sup id="cite_ref-55" class="reference"><a href="#cite_note-55"><span class="cite-bracket">[</span>55<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-56" class="reference"><a href="#cite_note-56"><span class="cite-bracket">[</span>56<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-57" class="reference"><a href="#cite_note-57"><span class="cite-bracket">[</span>57<span class="cite-bracket">]</span></a></sup> </p><p>In July 2016, the fixed-dose combination of <a href="/wiki/Dapagliflozin/saxagliptin" title="Dapagliflozin/saxagliptin">saxagliptin and dapagliflozin</a> was approved for medical use in the European Union and is sold under the brand name Qtern.<sup id="cite_ref-58" class="reference"><a href="#cite_note-58"><span class="cite-bracket">[</span>58<span class="cite-bracket">]</span></a></sup> The combination drug was approved for medical use in the United States in February 2017, where it also is sold under the brand name Qtern.<sup id="cite_ref-59" class="reference"><a href="#cite_note-59"><span class="cite-bracket">[</span>59<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-60" class="reference"><a href="#cite_note-60"><span class="cite-bracket">[</span>60<span class="cite-bracket">]</span></a></sup> </p><p>In May 2019, the fixed-dose combination of <a href="/wiki/Dapagliflozin/saxagliptin/metformin" title="Dapagliflozin/saxagliptin/metformin">dapagliflozin, saxagliptin, and metformin hydrochloride</a> as extended-release tablets was approved in the United States to improve glycemic control in adults with type 2 diabetes when used in combination with diet and exercise. The FDA granted the approval of Qternmet XR to AstraZeneca.<sup id="cite_ref-61" class="reference"><a href="#cite_note-61"><span class="cite-bracket">[</span>61<span class="cite-bracket">]</span></a></sup> The combination drug was approved for use in the European Union in November 2019, and is sold under the brand name Qtrilmet.<sup id="cite_ref-62" class="reference"><a href="#cite_note-62"><span class="cite-bracket">[</span>62<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Dapagliflozin&action=edit&section=8" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In 2012, the <a href="/wiki/Committee_for_Medicinal_Products_for_Human_Use" title="Committee for Medicinal Products for Human Use">Committee for Medicinal Products for Human Use</a> (CHMP) of the EMA issued a positive opinion on the drug.<sup id="cite_ref-Forxiga_EPAR_7-7" class="reference"><a href="#cite_note-Forxiga_EPAR-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p><p>Dapagliflozin was found effective in several studies in participants with type 2.<sup id="cite_ref-Forxiga_EPAR_7-8" class="reference"><a href="#cite_note-Forxiga_EPAR-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> The main measure of effectiveness was the level of <a href="/wiki/Glycated_haemoglobin" class="mw-redirect" title="Glycated haemoglobin">glycated haemoglobin</a> (HbA<sub>1c</sub>), which indicates how well blood glucose is controlled.<sup id="cite_ref-Forxiga_EPAR_7-9" class="reference"><a href="#cite_note-Forxiga_EPAR-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p><p>In two studies involving 840 participants with type 2 diabetes, dapagliflozin when used alone decreased HbA<sub>1c</sub> levels by 0.66% more than placebo (a dummy treatment) after 24 weeks.<sup id="cite_ref-Forxiga_EPAR_7-10" class="reference"><a href="#cite_note-Forxiga_EPAR-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> In four other studies involving 2,370 participants, adding dapagliflozin to other diabetes medicines decreased HbA<sub>1c</sub> levels by 0.54–0.68% more than adding placebo after 24 weeks.<sup id="cite_ref-Forxiga_EPAR_7-11" class="reference"><a href="#cite_note-Forxiga_EPAR-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p><p>In a study involving 814 participants with type 2 diabetes, dapagliflozin used in combination with metformin was at least as effective as a sulphonylurea (another type of diabetes medicine) used with metformin.<sup id="cite_ref-Forxiga_EPAR_7-12" class="reference"><a href="#cite_note-Forxiga_EPAR-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> Both combinations reduced HbA<sub>1c</sub> levels by 0.52% after 52 weeks.<sup id="cite_ref-Forxiga_EPAR_7-13" class="reference"><a href="#cite_note-Forxiga_EPAR-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p><p>A long-term study, involving over 17,000 participants with type 2 diabetes, looked at the effects of dapagliflozin on cardiovascular (heart and circulation) disease.<sup id="cite_ref-Forxiga_EPAR_7-14" class="reference"><a href="#cite_note-Forxiga_EPAR-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> The study indicated that dapagliflozin's effects were in line with those of other diabetes medicines that also work by blocking SGLT2.<sup id="cite_ref-Forxiga_EPAR_7-15" class="reference"><a href="#cite_note-Forxiga_EPAR-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p><p>In two studies involving 1,648 participants with type 1 diabetes whose blood sugar was not controlled well enough on insulin alone, adding dapagliflozin 5 mg decreased HbA<sub>1c</sub> levels after 24 hours by 0.37% and by 0.42% more than adding placebo.<sup id="cite_ref-Forxiga_EPAR_7-16" class="reference"><a href="#cite_note-Forxiga_EPAR-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p><p>Dapagliflozin was approved for medical use in the European Union in November 2012.<sup id="cite_ref-Forxiga_EPAR_7-17" class="reference"><a href="#cite_note-Forxiga_EPAR-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> It is marketed in a number of European countries.<sup id="cite_ref-63" class="reference"><a href="#cite_note-63"><span class="cite-bracket">[</span>63<span class="cite-bracket">]</span></a></sup> </p><p>Dapagliflozin was approved for medical use in the United States in January 2014.<sup id="cite_ref-64" class="reference"><a href="#cite_note-64"><span class="cite-bracket">[</span>64<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-FDA_PR_20210430_34-1" class="reference"><a href="#cite_note-FDA_PR_20210430-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> </p><p>In 2020, the US FDA expanded the indications for dapagliflozin to include treatment for adults with heart failure with reduced ejection fraction to reduce the risk of cardiovascular death and hospitalization for heart failure.<sup id="cite_ref-FDA_PR_20200505_11-5" class="reference"><a href="#cite_note-FDA_PR_20200505-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> It is the first in this particular drug class, sodium-glucose co-transporter 2 inhibitors, to be approved to treat adults with New York Heart Association's functional class II-IV heart failure with reduced ejection fraction.<sup id="cite_ref-FDA_PR_20200505_11-6" class="reference"><a href="#cite_note-FDA_PR_20200505-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p><p>The results of the DAPA-HF and DECLARE-TIMI 58 clinical trials demonstrated the efficacy of dapagliflozin compared to placebo in improving survival in adults with heart failure with reduced ejection fraction by 17%. They both showed a reduction in the number of hospitalizations from worsening heart failure, cardiovascular death and all-cause mortality.<sup id="cite_ref-McMurray_2019_24-2" class="reference"><a href="#cite_note-McMurray_2019-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-65" class="reference"><a href="#cite_note-65"><span class="cite-bracket">[</span>65<span class="cite-bracket">]</span></a></sup> </p><p>The safety and effectiveness of dapagliflozin were evaluated in a randomized, double-blind, placebo-controlled study of 4,744 participants.<sup id="cite_ref-FDA_PR_20200505_11-7" class="reference"><a href="#cite_note-FDA_PR_20200505-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> The average age of participants was 66 years and more participants were male (77%) than female.<sup id="cite_ref-FDA_PR_20200505_11-8" class="reference"><a href="#cite_note-FDA_PR_20200505-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> To determine the drug's effectiveness, investigators examined the occurrence of cardiovascular death, hospitalization for heart failure, and urgent heart failure visits.<sup id="cite_ref-FDA_PR_20200505_11-9" class="reference"><a href="#cite_note-FDA_PR_20200505-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Participants were randomly assigned to receive a once-daily dose of either 10 mg of dapagliflozin or a placebo (inactive treatment).<sup id="cite_ref-FDA_PR_20200505_11-10" class="reference"><a href="#cite_note-FDA_PR_20200505-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> After about 18 months, people who received dapagliflozin had fewer cardiovascular deaths, hospitalizations for heart failure, and urgent heart-failure visits than those receiving the placebo.<sup id="cite_ref-FDA_PR_20200505_11-11" class="reference"><a href="#cite_note-FDA_PR_20200505-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p><p>In July 2020, the FDA granted AstraZeneca a Fast Track Designation in the US for the development of dapagliflozin to reduce the risk of hospitalization for <a href="/wiki/Heart_failure" title="Heart failure">heart failure</a> or cardiovascular death in adults following a <a href="/wiki/Heart_attack" class="mw-redirect" title="Heart attack">heart attack</a>.<sup id="cite_ref-66" class="reference"><a href="#cite_note-66"><span class="cite-bracket">[</span>66<span class="cite-bracket">]</span></a></sup> </p><p>In August 2020, detailed results from the Phase III DAPA-CKD trial reportedly showed that dapagliflozin on top of standard of care reduced the composite measure of worsening of renal function or risk of cardiovascular or renal death by 39% compared to placebo (p<0.0001) in patients with <a href="/wiki/Chronic_kidney_disease" title="Chronic kidney disease">chronic kidney disease</a> stages 2–4 and elevated urinary albumin excretion. The results were consistent in patients both with and without type 2 diabetes.<sup id="cite_ref-67" class="reference"><a href="#cite_note-67"><span class="cite-bracket">[</span>67<span class="cite-bracket">]</span></a></sup> </p><p>In April 2021, the FDA expanded the indications for dapagliflozin to include reducing the risk of kidney function decline, kidney failure, cardiovascular death, and hospitalization for heart failure in adults with chronic kidney disease who are at risk of disease progression.<sup id="cite_ref-FDA_PR_20210430_34-2" class="reference"><a href="#cite_note-FDA_PR_20210430-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> The efficacy of dapagliflozin to improve kidney outcomes and reduce cardiovascular death in people with chronic kidney disease was evaluated in a multicenter, double-blind study of 4,304 participants.<sup id="cite_ref-FDA_PR_20210430_34-3" class="reference"><a href="#cite_note-FDA_PR_20210430-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> </p><p>In February 2023, the EU approved dapagliflozin for extended use to cover heart failure patients across the full spectrum of <a href="/wiki/Ejection_fraction" title="Ejection fraction">left ventricular ejection fraction (LVEF)</a>, including those with mildly reduced and preserved ejection fraction.<sup id="cite_ref-68" class="reference"><a href="#cite_note-68"><span class="cite-bracket">[</span>68<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-69" class="reference"><a href="#cite_note-69"><span class="cite-bracket">[</span>69<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Society_and_culture">Society and culture</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Dapagliflozin&action=edit&section=9" title="Edit section: Society and culture"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Legal_status">Legal status</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Dapagliflozin&action=edit&section=10" title="Edit section: Legal status"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>A <a href="/wiki/Generic_medication" class="mw-redirect" title="Generic medication">generic</a> version of dapagliflozin was approved by the US FDA in February 2022,<sup id="cite_ref-70" class="reference"><a href="#cite_note-70"><span class="cite-bracket">[</span>70<span class="cite-bracket">]</span></a></sup> but cannot be sold until October 2025.<sup id="cite_ref-71" class="reference"><a href="#cite_note-71"><span class="cite-bracket">[</span>71<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-72" class="reference"><a href="#cite_note-72"><span class="cite-bracket">[</span>72<span class="cite-bracket">]</span></a></sup> A generic version was approved in Canada in May 2023.<sup id="cite_ref-73" class="reference"><a href="#cite_note-73"><span class="cite-bracket">[</span>73<span class="cite-bracket">]</span></a></sup> </p><p>In January 2023, the <a href="/wiki/Committee_for_Medicinal_Products_for_Human_Use" title="Committee for Medicinal Products for Human Use">Committee for Medicinal Products for Human Use</a> (CHMP) of the <a href="/wiki/European_Medicines_Agency" title="European Medicines Agency">European Medicines Agency</a> (EMA) adopted a positive opinion, recommending the granting of a marketing authorization for a generic version of Forxiga, which has been authorized in the EU since November 2012.<sup id="cite_ref-74" class="reference"><a href="#cite_note-74"><span class="cite-bracket">[</span>74<span class="cite-bracket">]</span></a></sup> Dapagliflozin Viatris was approved for medical use in the European Union in March 2023.<sup id="cite_ref-Dapagliflozin_Viatris_EPAR_8-1" class="reference"><a href="#cite_note-Dapagliflozin_Viatris_EPAR-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Research">Research</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Dapagliflozin&action=edit&section=11" title="Edit section: Research"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>A systematic review concluded that dapagliflozin reduced heart failure hospitalization, cardiovascular death, and all-cause mortality in people with HFrEF (i.e., congestive heart failure) and diabetes.<sup id="cite_ref-75" class="reference"><a href="#cite_note-75"><span class="cite-bracket">[</span>75<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Dapagliflozin&action=edit&section=12" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-pregnancy-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-pregnancy_1-0">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.drugs.com/pregnancy/dapagliflozin.html">"Dapagliflozin (Farxiga) Use During Pregnancy"</a>. <i>Drugs.com</i>. 30 August 2018. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20210417093531/https://www.drugs.com/pregnancy/dapagliflozin.html">Archived</a> from the original on 17 April 2021<span class="reference-accessdate">. Retrieved <span class="nowrap">5 May</span> 2020</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Drugs.com&rft.atitle=Dapagliflozin+%28Farxiga%29+Use+During+Pregnancy&rft.date=2018-08-30&rft_id=https%3A%2F%2Fwww.drugs.com%2Fpregnancy%2Fdapagliflozin.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADapagliflozin" class="Z3988"></span></span> </li> <li id="cite_note-2"><span class="mw-cite-backlink"><b><a href="#cite_ref-2">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.tga.gov.au/resources/artg/180147">"Forxiga dapagliflozin (as propanediol monohydrate) 10 mg film-coated tablet blister pack (180147)"</a>. <i>Therapeutic Goods Administration (TGA)</i>. 27 May 2022<span class="reference-accessdate">. Retrieved <span class="nowrap">20 April</span> 2024</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Therapeutic+Goods+Administration+%28TGA%29&rft.atitle=Forxiga+dapagliflozin+%28as+propanediol+monohydrate%29+10+mg+film-coated+tablet+blister+pack+%28180147%29&rft.date=2022-05-27&rft_id=https%3A%2F%2Fwww.tga.gov.au%2Fresources%2Fartg%2F180147&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADapagliflozin" class="Z3988"></span></span> </li> <li id="cite_note-3"><span class="mw-cite-backlink"><b><a href="#cite_ref-3">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.tga.gov.au/resources/auspar/auspar-dapagliflozin">"AusPAR: Dapagliflozin"</a>. <i>Therapeutic Goods Administration (TGA)</i>. 21 June 2022<span class="reference-accessdate">. Retrieved <span class="nowrap">20 April</span> 2024</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Therapeutic+Goods+Administration+%28TGA%29&rft.atitle=AusPAR%3A+Dapagliflozin&rft.date=2022-06-21&rft_id=https%3A%2F%2Fwww.tga.gov.au%2Fresources%2Fauspar%2Fauspar-dapagliflozin&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADapagliflozin" class="Z3988"></span></span> </li> <li id="cite_note-4"><span class="mw-cite-backlink"><b><a href="#cite_ref-4">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.tga.gov.au/resources/auspar/auspar-dapagliflozin-propanediol-monohydrate-0">"AusPAR: Dapagliflozin (as propanediol monohydrate)"</a>. <i>Therapeutic Goods Administration (TGA)</i>. 21 June 2022<span class="reference-accessdate">. Retrieved <span class="nowrap">20 April</span> 2024</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Therapeutic+Goods+Administration+%28TGA%29&rft.atitle=AusPAR%3A+Dapagliflozin+%28as+propanediol+monohydrate%29&rft.date=2022-06-21&rft_id=https%3A%2F%2Fwww.tga.gov.au%2Fresources%2Fauspar%2Fauspar-dapagliflozin-propanediol-monohydrate-0&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADapagliflozin" class="Z3988"></span></span> </li> <li id="cite_note-5"><span class="mw-cite-backlink"><b><a href="#cite_ref-5">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/drug-product-database/label-safety-assessment-update/product-monograph-brand-safety-updates.html">"Product monograph brand safety updates"</a>. <i><a href="/wiki/Health_Canada" title="Health Canada">Health Canada</a></i>. 7 July 2016<span class="reference-accessdate">. Retrieved <span class="nowrap">1 April</span> 2024</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Health+Canada&rft.atitle=Product+monograph+brand+safety+updates&rft.date=2016-07-07&rft_id=https%3A%2F%2Fwww.canada.ca%2Fen%2Fhealth-canada%2Fservices%2Fdrugs-health-products%2Fdrug-products%2Fdrug-product-database%2Flabel-safety-assessment-update%2Fproduct-monograph-brand-safety-updates.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADapagliflozin" class="Z3988"></span></span> </li> <li id="cite_note-Farxiga_FDA_label-6"><span class="mw-cite-backlink">^ <a href="#cite_ref-Farxiga_FDA_label_6-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Farxiga_FDA_label_6-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Farxiga_FDA_label_6-2"><sup><i><b>c</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=72ad22ae-efe6-4cd6-a302-98aaee423d69">"Farxiga- dapagliflozin tablet, film coated"</a>. <i>DailyMed</i>. National Institutes of Health, National Library of Medicine, U.S. Department of Health & Human Services. 3 February 2020. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20201030234119/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=72ad22ae-efe6-4cd6-a302-98aaee423d69">Archived</a> from the original on 30 October 2020<span class="reference-accessdate">. Retrieved <span class="nowrap">5 May</span> 2020</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=DailyMed&rft.atitle=Farxiga-+dapagliflozin+tablet%2C+film+coated&rft.date=2020-02-03&rft_id=https%3A%2F%2Fdailymed.nlm.nih.gov%2Fdailymed%2FdrugInfo.cfm%3Fsetid%3D72ad22ae-efe6-4cd6-a302-98aaee423d69&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADapagliflozin" class="Z3988"></span></span> </li> <li id="cite_note-Forxiga_EPAR-7"><span class="mw-cite-backlink">^ <a href="#cite_ref-Forxiga_EPAR_7-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Forxiga_EPAR_7-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Forxiga_EPAR_7-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-Forxiga_EPAR_7-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-Forxiga_EPAR_7-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-Forxiga_EPAR_7-5"><sup><i><b>f</b></i></sup></a> <a href="#cite_ref-Forxiga_EPAR_7-6"><sup><i><b>g</b></i></sup></a> <a href="#cite_ref-Forxiga_EPAR_7-7"><sup><i><b>h</b></i></sup></a> <a href="#cite_ref-Forxiga_EPAR_7-8"><sup><i><b>i</b></i></sup></a> <a href="#cite_ref-Forxiga_EPAR_7-9"><sup><i><b>j</b></i></sup></a> <a href="#cite_ref-Forxiga_EPAR_7-10"><sup><i><b>k</b></i></sup></a> <a href="#cite_ref-Forxiga_EPAR_7-11"><sup><i><b>l</b></i></sup></a> <a href="#cite_ref-Forxiga_EPAR_7-12"><sup><i><b>m</b></i></sup></a> <a href="#cite_ref-Forxiga_EPAR_7-13"><sup><i><b>n</b></i></sup></a> <a href="#cite_ref-Forxiga_EPAR_7-14"><sup><i><b>o</b></i></sup></a> <a href="#cite_ref-Forxiga_EPAR_7-15"><sup><i><b>p</b></i></sup></a> <a href="#cite_ref-Forxiga_EPAR_7-16"><sup><i><b>q</b></i></sup></a> <a href="#cite_ref-Forxiga_EPAR_7-17"><sup><i><b>r</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.ema.europa.eu/en/medicines/human/EPAR/forxiga">"Forxiga EPAR"</a>. <i><a href="/wiki/European_Medicines_Agency" title="European Medicines Agency">European Medicines Agency</a> (EMA)</i>. 17 September 2018. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20200217204844/https://www.ema.europa.eu/en/medicines/human/EPAR/forxiga">Archived</a> from the original on 17 February 2020<span class="reference-accessdate">. Retrieved <span class="nowrap">17 February</span> 2020</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=European+Medicines+Agency+%28EMA%29&rft.atitle=Forxiga+EPAR&rft.date=2018-09-17&rft_id=https%3A%2F%2Fwww.ema.europa.eu%2Fen%2Fmedicines%2Fhuman%2FEPAR%2Fforxiga&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADapagliflozin" class="Z3988"></span> Text was copied from this source which is copyright European Medicines Agency. Reproduction is authorized provided the source is acknowledged.</span> </li> <li id="cite_note-Dapagliflozin_Viatris_EPAR-8"><span class="mw-cite-backlink">^ <a href="#cite_ref-Dapagliflozin_Viatris_EPAR_8-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Dapagliflozin_Viatris_EPAR_8-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.ema.europa.eu/en/medicines/human/EPAR/dapagliflozin-viatris">"Dapagliflozin Viatris EPAR"</a>. <i>European Medicines Agency</i>. 4 April 2023<span class="reference-accessdate">. Retrieved <span class="nowrap">17 June</span> 2023</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=European+Medicines+Agency&rft.atitle=Dapagliflozin+Viatris+EPAR&rft.date=2023-04-04&rft_id=https%3A%2F%2Fwww.ema.europa.eu%2Fen%2Fmedicines%2Fhuman%2FEPAR%2Fdapagliflozin-viatris&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADapagliflozin" class="Z3988"></span> Text was copied from this source which is copyright European Medicines Agency. Reproduction is authorized provided the source is acknowledged.</span> </li> <li id="cite_note-9"><span class="mw-cite-backlink"><b><a href="#cite_ref-9">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.ema.europa.eu/en/medicines/human/EPAR/edistride">"Edistride EPAR"</a>. <i>European Medicines Agency (EMA)</i>. 9 November 2015<span class="reference-accessdate">. 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Archived from <a rel="nofollow" class="external text" href="https://www.ema.europa.eu/en/medicines/human/summaries-opinion/dapagliflozin-viatris">the original</a> on 27 January 2023<span class="reference-accessdate">. Retrieved <span class="nowrap">29 January</span> 2023</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=European+Medicines+Agency&rft.atitle=Dapagliflozin+Viatris%3A+Pending+EC+decision&rft.date=2023-01-26&rft_id=https%3A%2F%2Fwww.ema.europa.eu%2Fen%2Fmedicines%2Fhuman%2Fsummaries-opinion%2Fdapagliflozin-viatris&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADapagliflozin" class="Z3988"></span> Text was copied from this source which is copyright European Medicines Agency. Reproduction is authorized provided the source is acknowledged.</span> </li> <li id="cite_note-75"><span class="mw-cite-backlink"><b><a href="#cite_ref-75">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFZhaiDuLiuXu2021" class="citation journal cs1">Zhai M, Du X, Liu C, Xu H (30 June 2021). <a rel="nofollow" class="external text" href="https://doi.org/10.3389%2Ffcdhc.2021.703937">"The Effects of Dapagliflozin in Patients With Heart Failure Complicated With Type 2 Diabetes: A Meta-Analysis of Placebo-Controlled Randomized Trials"</a>. <i>Frontiers in Clinical Diabetes and Healthcare</i>. <b>2</b>: 703937. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.3389%2Ffcdhc.2021.703937">10.3389/fcdhc.2021.703937</a></span>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10012068">10012068</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/36994345">36994345</a>.</cite><span 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navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Oral_hypoglycemics_and_insulin_analogs" title="Template:Oral hypoglycemics and insulin analogs"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Oral_hypoglycemics_and_insulin_analogs" title="Template talk:Oral hypoglycemics and insulin analogs"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Oral_hypoglycemics_and_insulin_analogs" title="Special:EditPage/Template:Oral hypoglycemics and insulin analogs"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Oral_diabetes_medication,_insulins_and_insulin_analogs,_and_other_drugs_used_in_diabetes_(A10)" style="font-size:114%;margin:0 4em">Oral <a href="/wiki/Diabetes_medication" title="Diabetes medication">diabetes medication</a>, <a href="/wiki/Insulin" title="Insulin">insulins</a> and <a href="/wiki/Insulin_analog" title="Insulin analog">insulin analogs</a>, and other drugs used in diabetes (<a href="/wiki/ATC_code_A10" title="ATC code A10">A10</a>)</div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible mw-collapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Insulins_/_insulin_analogs" style="font-size:114%;margin:0 4em"><a href="/wiki/Insulin" title="Insulin">Insulins</a> / <a href="/wiki/Insulin_analog" title="Insulin analog">insulin analogs</a></div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><i>fast-acting</i></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Insulin_aspart" title="Insulin aspart">Insulin aspart</a></li> <li><a href="/wiki/Insulin_glulisine" title="Insulin glulisine">Insulin glulisine</a></li> <li><a href="/wiki/Insulin_lispro" title="Insulin lispro">Insulin lispro</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><i>short-acting</i></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Regular_insulin" title="Regular insulin">Regular insulin</a><sup>#</sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><i>long-acting</i></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Insulin_detemir" title="Insulin detemir">Insulin detemir</a><sup>#</sup></li> <li><a href="/wiki/Insulin_glargine" title="Insulin glargine">Insulin glargine</a><sup>#</sup> (<a href="/wiki/Insulin_glargine/lixisenatide" title="Insulin glargine/lixisenatide">+lixisenatide</a>)</li> <li><a href="/wiki/NPH_insulin" title="NPH insulin">NPH insulin</a></li> <li><a href="/wiki/Lente_insulin" title="Lente insulin">Lente insulin</a><sup>‡</sup></li> <li><a href="/wiki/Ultralente_insulin" title="Ultralente insulin">Ultralente insulin</a><sup>‡</sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><i>ultra-long-acting</i></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Insulin_degludec" title="Insulin degludec">Insulin degludec</a><sup>#</sup> (<a href="/wiki/Insulin_degludec/insulin_aspart" title="Insulin degludec/insulin aspart">+insulin aspart</a>, <a href="/wiki/Insulin_degludec/liraglutide" title="Insulin degludec/liraglutide">+liraglutide</a>)</li> <li><a href="/wiki/Insulin_icodec" title="Insulin icodec">Insulin icodec</a><sup>†</sup> (<a href="/wiki/Insulin_icodec/semaglutide" title="Insulin icodec/semaglutide">+semaglutide</a>)</li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><i><a href="/wiki/Inhalable_insulin" title="Inhalable insulin">inhalable</a></i></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>Exubera<sup>‡</sup></li> <li>Afrezza</li></ul> </div></td></tr></tbody></table><div> <div class="hlist"> <ul><li><sup>#</sup><a href="/wiki/WHO_Model_List_of_Essential_Medicines" title="WHO Model List of Essential Medicines">WHO-EM</a></li> <li><sup>‡</sup><a href="/wiki/List_of_withdrawn_drugs" title="List of withdrawn drugs">Withdrawn</a> from market</li> <li><a href="/wiki/Clinical_trial" title="Clinical trial">Clinical trials</a>: <ul><li><sup>†</sup><a href="/wiki/Phases_of_clinical_research#Phase_III" title="Phases of clinical research">Phase III</a></li> <li><sup>§</sup>Never to phase III</li></ul></li></ul> </div></div></td></tr></tbody></table><div></div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible mw-collapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Non-insulins" style="font-size:114%;margin:0 4em">Non-insulins</div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Anti-diabetic_medication#Sensitizers" class="mw-redirect" title="Anti-diabetic medication">Insulin sensitizers</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Biguanide" title="Biguanide">Biguanides</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Buformin" title="Buformin">Buformin</a><sup>‡</sup></li> <li><a href="/wiki/Metformin" title="Metformin">Metformin</a><sup>#</sup></li> <li><a href="/wiki/Phenformin" title="Phenformin">Phenformin</a><sup>‡</sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Thiazolidinedione" title="Thiazolidinedione">TZDs</a>/"glitazones" (<a href="/wiki/PPAR_agonist" title="PPAR agonist">PPAR</a>)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Ciglitazone" title="Ciglitazone">Ciglitazone</a><sup>§</sup></li> <li><a href="/wiki/Darglitazone" title="Darglitazone">Darglitazone</a><sup>§</sup></li> <li><a href="/wiki/Englitazone" title="Englitazone">Englitazone</a><sup>§</sup></li> <li><a href="/wiki/Lobeglitazone" title="Lobeglitazone">Lobeglitazone</a></li> <li><a href="/wiki/Netoglitazone" title="Netoglitazone">Netoglitazone</a><sup>§</sup></li> <li><a href="/wiki/Pioglitazone" title="Pioglitazone">Pioglitazone</a></li> <li><a href="/wiki/Rivoglitazone" title="Rivoglitazone">Rivoglitazone</a><sup>†</sup></li> <li><a href="/wiki/Rosiglitazone" title="Rosiglitazone">Rosiglitazone</a></li> <li><a href="/wiki/Troglitazone" title="Troglitazone">Troglitazone</a><sup>‡</sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/PPAR_agonist#Dual_PPAR_agonists" title="PPAR agonist">Dual PPAR agonists</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Aleglitazar" title="Aleglitazar">Aleglitazar</a><sup>†</sup></li> <li><a href="/wiki/Muraglitazar" title="Muraglitazar">Muraglitazar</a><sup>§</sup></li> <li><a href="/wiki/Saroglitazar" title="Saroglitazar">Saroglitazar</a></li> <li><a href="/wiki/Tesaglitazar" title="Tesaglitazar">Tesaglitazar</a><sup>§</sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Amylin" title="Amylin">Amylin</a> analogs and <a href="/wiki/DACRA" class="mw-redirect" title="DACRA">DACRAs</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cagrilintide" title="Cagrilintide">Cagrilintide</a><sup>§</sup></li> <li><a href="/wiki/Pramlintide" title="Pramlintide">Pramlintide</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Anti-diabetic_medication#Secretagogues" class="mw-redirect" title="Anti-diabetic medication">Secretagogues</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/ATP-sensitive_potassium_channel" title="ATP-sensitive potassium channel">K<sup>+</sup><sub>ATP</sub></a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Sulfonylurea" title="Sulfonylurea">Sulfonylureas</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i>1st generation</i>: <a href="/wiki/Acetohexamide" title="Acetohexamide">Acetohexamide</a></li> <li><a href="/wiki/Carbutamide" title="Carbutamide">Carbutamide</a></li> <li><a href="/wiki/Chlorpropamide" title="Chlorpropamide">Chlorpropamide</a></li> <li><a href="/w/index.php?title=Glycyclamide&action=edit&redlink=1" class="new" title="Glycyclamide (page does not exist)">Glycyclamide</a></li> <li><a href="/wiki/Metahexamide" title="Metahexamide">Metahexamide</a></li> <li><a href="/wiki/Tolazamide" title="Tolazamide">Tolazamide</a></li> <li><a href="/wiki/Tolbutamide" title="Tolbutamide">Tolbutamide</a></li></ul> <ul><li><i>2nd generation</i>: <a href="/wiki/Glibenclamide" title="Glibenclamide">Glibenclamide (glyburide)</a></li> <li><a href="/wiki/Glibornuride" title="Glibornuride">Glibornuride</a></li> <li><a href="/wiki/Glicaramide" title="Glicaramide">Glicaramide</a></li> <li><a href="/wiki/Gliclazide" title="Gliclazide">Gliclazide</a><sup>#</sup></li> <li><a href="/wiki/Glimepiride" title="Glimepiride">Glimepiride</a></li> <li><a href="/wiki/Glipizide" title="Glipizide">Glipizide</a></li> <li><a href="/wiki/Gliquidone" title="Gliquidone">Gliquidone</a></li> <li><a href="/wiki/Glisoxepide" title="Glisoxepide">Glisoxepide</a></li> <li><a href="/wiki/Glyclopyramide" title="Glyclopyramide">Glyclopyramide</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Meglitinide" title="Meglitinide">Meglitinides</a>/"glinides"</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Mitiglinide" title="Mitiglinide">Mitiglinide</a></li> <li><a href="/wiki/Nateglinide" title="Nateglinide">Nateglinide</a></li> <li><a href="/wiki/Repaglinide" title="Repaglinide">Repaglinide</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Glucagon-like_peptide-1_receptor_agonist" class="mw-redirect" title="Glucagon-like peptide-1 receptor agonist">GLP-1 receptor agonists</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Albiglutide" title="Albiglutide">Albiglutide</a><sup>‡</sup></li> <li><a href="/wiki/Danuglipron" title="Danuglipron">Danuglipron</a><sup>†</sup></li> <li><a href="/wiki/Dulaglutide" title="Dulaglutide">Dulaglutide</a></li> <li><a href="/wiki/Exenatide" title="Exenatide">Exenatide</a></li> <li><a href="/wiki/Liraglutide" title="Liraglutide">Liraglutide</a></li> <li><a href="/wiki/Lixisenatide" title="Lixisenatide">Lixisenatide</a></li> <li><a href="/wiki/Orforglipron" title="Orforglipron">Orforglipron</a><sup>§</sup></li> <li><a href="/wiki/Semaglutide" title="Semaglutide">Semaglutide</a></li> <li><a href="/wiki/Taspoglutide" title="Taspoglutide">Taspoglutide</a><sup>†</sup></li></ul> </div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="GLP1_poly-agonist_peptides" scope="row" class="navbox-group" style="width:1%"><a href="/wiki/GLP1_poly-agonist_peptides" title="GLP1 poly-agonist peptides">GLP1 poly-agonist peptides</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Mazdutide" title="Mazdutide">Mazdutide</a> (GLP-1/<a href="/wiki/Glucagon_receptor" title="Glucagon receptor">GCGR</a>)</li> <li><a href="/wiki/Retatrutide" title="Retatrutide">Retatrutide</a><sup>§</sup> (GLP-1/GIP/GCGR)</li> <li><a href="/wiki/Tirzepatide" title="Tirzepatide">Tirzepatide</a> (GLP-1/GIP)</li></ul> </div></td></tr></tbody></table><div> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Dipeptidyl_peptidase-4_inhibitor" title="Dipeptidyl peptidase-4 inhibitor">DPP-4 inhibitors</a>/"gliptins"</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Alogliptin" title="Alogliptin">Alogliptin</a></li> <li><a href="/wiki/Anagliptin" title="Anagliptin">Anagliptin</a></li> <li><a href="/wiki/Evogliptin" title="Evogliptin">Evogliptin</a></li> <li><a href="/w/index.php?title=Garvagliptin&action=edit&redlink=1" class="new" title="Garvagliptin (page does not exist)">Garvagliptin</a></li> <li><a href="/wiki/Gemigliptin" title="Gemigliptin">Gemigliptin</a></li> <li><a href="/wiki/Gosogliptin" title="Gosogliptin">Gosogliptin</a></li> <li><a href="/wiki/Linagliptin" title="Linagliptin">Linagliptin</a></li> <li><a href="/w/index.php?title=Melogliptin&action=edit&redlink=1" class="new" title="Melogliptin (page does not exist)">Melogliptin</a></li> <li><a href="/wiki/Omarigliptin" title="Omarigliptin">Omarigliptin</a></li> <li><a href="/wiki/Saxagliptin" title="Saxagliptin">Saxagliptin</a></li> <li><a href="/wiki/Sitagliptin" title="Sitagliptin">Sitagliptin</a></li> <li><a href="/wiki/Teneligliptin" title="Teneligliptin">Teneligliptin</a></li> <li><a href="/wiki/Trelagliptin" title="Trelagliptin">Trelagliptin</a></li> <li><a href="/wiki/Vildagliptin" title="Vildagliptin">Vildagliptin</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Aldose_reductase_inhibitor" title="Aldose reductase inhibitor">Aldose reductase inhibitors</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Epalrestat" title="Epalrestat">Epalrestat</a></li> <li><a href="/wiki/Fidarestat" title="Fidarestat">Fidarestat</a><sup>§</sup></li> <li><a href="/wiki/Ranirestat" title="Ranirestat">Ranirestat</a><sup>†</sup></li> <li><a href="/wiki/Tolrestat" title="Tolrestat">Tolrestat</a><sup>‡</sup></li> <li><a href="/wiki/Zenarestat" title="Zenarestat">Zenarestat</a><sup>§</sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Alpha-glucosidase_inhibitor" title="Alpha-glucosidase inhibitor">Alpha-glucosidase inhibitors</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Acarbose" title="Acarbose">Acarbose</a></li> <li><a href="/wiki/Miglitol" title="Miglitol">Miglitol</a></li> <li><a href="/wiki/Voglibose" title="Voglibose">Voglibose</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gliflozin" class="mw-redirect" title="Gliflozin">SGLT2 inhibitors</a>/"gliflozins"</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Canagliflozin" title="Canagliflozin">Canagliflozin</a></li> <li><a class="mw-selflink selflink">Dapagliflozin</a></li> <li><a href="/wiki/Empagliflozin" title="Empagliflozin">Empagliflozin</a><sup>#</sup></li> <li><a href="/wiki/Ertugliflozin" title="Ertugliflozin">Ertugliflozin</a></li> <li><a href="/wiki/Ipragliflozin" title="Ipragliflozin">Ipragliflozin</a></li> <li><a href="/wiki/Luseogliflozin" title="Luseogliflozin">Luseogliflozin</a></li> <li><a href="/wiki/Remogliflozin_etabonate" title="Remogliflozin etabonate">Remogliflozin</a><sup>§</sup></li> <li><a href="/wiki/Sergliflozin_etabonate" title="Sergliflozin etabonate">Sergliflozin</a><sup>§</sup></li> <li><a href="/wiki/Sotagliflozin" title="Sotagliflozin">Sotagliflozin</a></li> <li><a href="/wiki/Tofogliflozin" title="Tofogliflozin">Tofogliflozin</a><sup>†</sup></li> <li><a href="/wiki/Velagliflozin" title="Velagliflozin">Velagliflozin</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Benfluorex" title="Benfluorex">Benfluorex</a><sup>‡</sup></li> <li><a href="/wiki/Bromocriptine" title="Bromocriptine">Bromocriptine</a></li> <li><a href="/wiki/Imeglimin" title="Imeglimin">Imeglimin</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Combination_drug" title="Combination drug">Combinations</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><td colspan="2" class="navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Alogliptin/metformin" class="mw-redirect" title="Alogliptin/metformin">Alogliptin/metformin</a></li> <li><a href="/wiki/Canagliflozin/metformin" title="Canagliflozin/metformin">Canagliflozin/metformin</a></li> <li><a href="/wiki/Cagrilintide/semaglutide" title="Cagrilintide/semaglutide">Cagrilintide/semaglutide</a><sup>§</sup></li> <li><a href="/wiki/Dapagliflozin/metformin" title="Dapagliflozin/metformin">Dapagliflozin/metformin</a></li> <li><a href="/wiki/Dapagliflozin/saxagliptin" title="Dapagliflozin/saxagliptin">Dapagliflozin/saxagliptin</a></li> <li><a href="/wiki/Dapagliflozin/saxagliptin/metformin" title="Dapagliflozin/saxagliptin/metformin">Dapagliflozin/saxagliptin/metformin</a></li> <li><a href="/wiki/Empagliflozin/linagliptin" title="Empagliflozin/linagliptin">Empagliflozin/linagliptin</a></li> <li><a href="/wiki/Empagliflozin/metformin" title="Empagliflozin/metformin">Empagliflozin/metformin</a></li> <li><a href="/w/index.php?title=Gemigliptin/rosuvastatin&action=edit&redlink=1" class="new" title="Gemigliptin/rosuvastatin (page does not exist)">Gemigliptin/rosuvastatin</a></li> <li><a href="/wiki/Glibenclamide/metformin" title="Glibenclamide/metformin">Glibenclamide (glyburide)/metformin</a></li> <li><a href="/w/index.php?title=Glimepiride/rosiglitazone&action=edit&redlink=1" class="new" title="Glimepiride/rosiglitazone (page does not exist)">Glimepiride/rosiglitazone</a></li> <li><a href="/wiki/Linagliptin/metformin" class="mw-redirect" title="Linagliptin/metformin">Linagliptin/metformin</a></li> <li><a href="/w/index.php?title=Metformin/acarbose&action=edit&redlink=1" class="new" title="Metformin/acarbose (page does not exist)">Metformin/acarbose</a></li> <li><a href="/wiki/Metformin/ertugliflozin" class="mw-redirect" title="Metformin/ertugliflozin">Metformin/ertugliflozin</a></li> <li><a href="/w/index.php?title=Metformin/evogliptin&action=edit&redlink=1" class="new" title="Metformin/evogliptin (page does not exist)">Metformin/evogliptin</a></li> <li><a href="/w/index.php?title=Metformin/gemigliptin&action=edit&redlink=1" class="new" title="Metformin/gemigliptin (page does not exist)">Metformin/gemigliptin</a></li> <li><a href="/w/index.php?title=Metformin/repaglinide&action=edit&redlink=1" class="new" title="Metformin/repaglinide (page does not exist)">Metformin/repaglinide</a></li> <li><a href="/w/index.php?title=Metformin/sulfonylureas&action=edit&redlink=1" class="new" title="Metformin/sulfonylureas (page does not exist)">Metformin/sulfonylureas</a></li> <li><a href="/w/index.php?title=Metformin/teneligliptin&action=edit&redlink=1" class="new" title="Metformin/teneligliptin (page does not exist)">Metformin/teneligliptin</a></li> <li><a href="/w/index.php?title=Phenformin/sulfonylureas&action=edit&redlink=1" class="new" title="Phenformin/sulfonylureas (page does not exist)">Phenformin/sulfonylureas</a></li> <li><a href="/wiki/Pioglitazone/alogliptin" class="mw-redirect" title="Pioglitazone/alogliptin">Pioglitazone/alogliptin</a></li> <li><a href="/wiki/Pioglitazone/glimepiride" title="Pioglitazone/glimepiride">Pioglitazone/glimepiride</a></li> <li><a href="/wiki/Pioglitazone/metformin" title="Pioglitazone/metformin">Pioglitazone/metformin</a></li> <li><a href="/w/index.php?title=Pioglitazone/sitagliptin&action=edit&redlink=1" class="new" title="Pioglitazone/sitagliptin (page does not exist)">Pioglitazone/sitagliptin</a></li> <li><a href="/wiki/Rosiglitazone/metformin" class="mw-redirect" title="Rosiglitazone/metformin">Rosiglitazone/metformin</a></li> <li><a href="/wiki/Saxagliptin/metformin" class="mw-redirect" title="Saxagliptin/metformin">Saxagliptin/metformin</a></li> <li><a href="/wiki/Dapagliflozin/sitagliptin" title="Dapagliflozin/sitagliptin">Sitagliptin/dapagliflozin</a></li> <li><a href="/w/index.php?title=Sitagliptin/ertugliflozin&action=edit&redlink=1" class="new" title="Sitagliptin/ertugliflozin (page does not exist)">Sitagliptin/ertugliflozin</a></li> <li><a href="/wiki/Sitagliptin/metformin" title="Sitagliptin/metformin">Sitagliptin/metformin</a></li> <li><a href="/wiki/Simvastatin/sitagliptin" class="mw-redirect" title="Simvastatin/sitagliptin">Sitagliptin/simvastatin</a></li> <li><a href="/wiki/Vildagliptin/metformin" title="Vildagliptin/metformin">Vildagliptin/metformin</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div> <div class="hlist"> <ul><li><sup>#</sup><a href="/wiki/WHO_Model_List_of_Essential_Medicines" title="WHO Model List of Essential Medicines">WHO-EM</a></li> <li><sup>‡</sup><a href="/wiki/List_of_withdrawn_drugs" title="List of withdrawn drugs">Withdrawn</a> from market</li> <li><a href="/wiki/Clinical_trial" title="Clinical trial">Clinical trials</a>: <ul><li><sup>†</sup><a href="/wiki/Phases_of_clinical_research#Phase_III" title="Phases of clinical research">Phase III</a></li> <li><sup>§</sup>Never to phase III</li></ul></li></ul> </div></div></td></tr></tbody></table><div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Sodium-glucose_transporter_modulators" style="padding:3px"><table class="nowraplinks mw-collapsible mw-collapsed navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Sodium-glucose_transporter_modulators" title="Template:Sodium-glucose transporter modulators"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Sodium-glucose_transporter_modulators" title="Template talk:Sodium-glucose transporter modulators"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Sodium-glucose_transporter_modulators" title="Special:EditPage/Template:Sodium-glucose transporter modulators"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Sodium-glucose_transporter_modulators" style="font-size:114%;margin:0 4em"><a href="/wiki/Sodium-glucose_transporter" class="mw-redirect" title="Sodium-glucose transporter">Sodium-glucose transporter</a> <a href="/wiki/Transporter_modulator" class="mw-redirect" title="Transporter modulator">modulators</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/Sodium-glucose_transporter_1" class="mw-redirect" title="Sodium-glucose transporter 1"><abbr title="Sodium-glucose transporter 1">SGLT1</abbr></a><span class="sr-only" style="border: 0; clip: rect(0, 0, 0, 0); clip-path: polygon(0px 0px, 0px 0px, 0px 0px); height: 1px; margin: -1px; overflow: hidden; padding: 0; position: absolute; width: 1px; white-space: nowrap;">Tooltip Sodium-glucose transporter 1</span></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><b>Inhibitors:</b> <a href="/wiki/Phloretin" title="Phloretin">Phloretin</a></li> <li><a href="/wiki/Phlorizin" title="Phlorizin">Phlorizin</a></li> <li><a href="/w/index.php?title=T-1095&action=edit&redlink=1" class="new" title="T-1095 (page does not exist)">T-1095</a></li> <li><a href="/w/index.php?title=T-1095A&action=edit&redlink=1" class="new" title="T-1095A (page does not exist)">T-1095A</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/Sodium-glucose_transporter_2" class="mw-redirect" title="Sodium-glucose transporter 2"><abbr title="Sodium-glucose transporter 2">SGLT2</abbr></a><span class="sr-only" style="border: 0; clip: rect(0, 0, 0, 0); clip-path: polygon(0px 0px, 0px 0px, 0px 0px); height: 1px; margin: -1px; overflow: hidden; padding: 0; position: absolute; width: 1px; white-space: nowrap;">Tooltip Sodium-glucose transporter 2</span></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><b>Inhibitors:</b> <a href="/w/index.php?title=Atigliflozin&action=edit&redlink=1" class="new" title="Atigliflozin (page does not exist)">Atigliflozin</a></li> <li><a href="/wiki/Bexagliflozin" title="Bexagliflozin">Bexagliflozin</a></li> <li><a href="/wiki/Canagliflozin" title="Canagliflozin">Canagliflozin</a></li> <li><a class="mw-selflink selflink">Dapagliflozin</a></li> <li><a href="/wiki/Empagliflozin" title="Empagliflozin">Empagliflozin</a></li> <li><a href="/wiki/Enavogliflozin" title="Enavogliflozin">Enavogliflozin</a></li> <li><a href="/wiki/Ertugliflozin" title="Ertugliflozin">Ertugliflozin</a></li> <li><a href="/wiki/Henagliflozin" title="Henagliflozin">Henagliflozin</a></li> <li><a href="/wiki/Ipragliflozin" title="Ipragliflozin">Ipragliflozin</a></li> <li><a href="/wiki/Janagliflozin" title="Janagliflozin">Janagliflozin</a></li> <li><a href="/wiki/Licogliflozin" title="Licogliflozin">Licogliflozin</a></li> <li><a href="/wiki/Luseogliflozin" title="Luseogliflozin">Luseogliflozin</a></li> <li><a href="/wiki/Mizagliflozin" title="Mizagliflozin">Mizagliflozin</a></li> <li><a href="/wiki/Phloretin" title="Phloretin">Phloretin</a></li> <li><a href="/wiki/Phlorizin" title="Phlorizin">Phlorizin</a></li> <li><a href="/wiki/Remogliflozin" class="mw-redirect" title="Remogliflozin">Remogliflozin</a></li> <li><a href="/wiki/Sergliflozin" class="mw-redirect" title="Sergliflozin">Sergliflozin</a></li> <li><a href="/w/index.php?title=T-1095&action=edit&redlink=1" class="new" title="T-1095 (page does not exist)">T-1095</a></li> <li><a href="/w/index.php?title=T-1095A&action=edit&redlink=1" class="new" title="T-1095A (page does not exist)">T-1095A</a></li> <li><a href="/wiki/Tofogliflozin" title="Tofogliflozin">Tofogliflozin</a></li> <li><a href="/wiki/Velagliflozin" title="Velagliflozin">Velagliflozin</a></li></ul> <ul><li><b>Antisense oligonucleotides:</b> <a href="/w/index.php?title=ISIS-388626&action=edit&redlink=1" class="new" title="ISIS-388626 (page does not exist)">ISIS-388626</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/Sodium-glucose_transporter_1" class="mw-redirect" title="Sodium-glucose transporter 1"><abbr title="Sodium-glucose transporter 1">SGLT1</abbr></a><span class="sr-only" style="border: 0; clip: rect(0, 0, 0, 0); clip-path: polygon(0px 0px, 0px 0px, 0px 0px); height: 1px; margin: -1px; overflow: hidden; padding: 0; position: absolute; width: 1px; white-space: nowrap;">Tooltip Sodium-glucose transporter 1</span> & <a href="/wiki/Sodium-glucose_transporter_2" class="mw-redirect" title="Sodium-glucose transporter 2"><abbr title="Sodium-glucose transporter 2">SGLT2</abbr></a><span class="sr-only" style="border: 0; clip: rect(0, 0, 0, 0); clip-path: polygon(0px 0px, 0px 0px, 0px 0px); height: 1px; margin: -1px; overflow: hidden; padding: 0; position: absolute; width: 1px; white-space: nowrap;">Tooltip Sodium-glucose transporter 2</span></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><b>Inhibitors:</b> <a href="/wiki/Sotagliflozin" title="Sotagliflozin">Sotagliflozin</a></li></ul> </div></td></tr><tr><td class="navbox-abovebelow" colspan="2"><div><i><b>See also:</b> <a href="/wiki/Template:Receptor_modulators" title="Template:Receptor modulators">Receptor/signaling modulators</a></i></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="AstraZeneca" style="padding:3px"><table class="nowraplinks hlist mw-collapsible mw-collapsed navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:AstraZeneca" title="Template:AstraZeneca"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:AstraZeneca" title="Template talk:AstraZeneca"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:AstraZeneca" title="Special:EditPage/Template:AstraZeneca"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="AstraZeneca" style="font-size:114%;margin:0 4em"><a href="/wiki/AstraZeneca" title="AstraZeneca">AstraZeneca</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Products</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Acalabrutinib" title="Acalabrutinib">Acalabrutinib</a></li> <li><a href="/wiki/Anastrozole" title="Anastrozole">Anastrozole</a></li> <li><a href="/wiki/Andexanet_alfa" title="Andexanet alfa">Andexanet alfa</a></li> <li><a href="/wiki/Anifrolumab" title="Anifrolumab">Anifrolumab</a></li> <li><a href="/wiki/Asfotase_alfa" title="Asfotase alfa">Asfotase alfa</a></li> <li><a href="/wiki/Atenolol" title="Atenolol">Atenolol</a></li> <li><a href="/wiki/Benralizumab" title="Benralizumab">Benralizumab</a></li> <li><a href="/wiki/Bicalutamide" title="Bicalutamide">Bicalutamide</a></li> <li><a href="/wiki/Brompheniramine" title="Brompheniramine">Brompheniramine</a></li> <li><a href="/wiki/Budesonide" title="Budesonide">Budesonide</a></li> <li><a href="/wiki/Budesonide/formoterol" title="Budesonide/formoterol">Budesonide/formoterol</a></li> <li><a href="/wiki/Budesonide/glycopyrronium_bromide/formoterol" title="Budesonide/glycopyrronium bromide/formoterol">Budesonide/glycopyrronium bromide/formoterol</a></li> <li><a href="/wiki/Candesartan" title="Candesartan">Candesartan</a></li> <li><a class="mw-selflink selflink">Dapagliflozin</a></li> <li><a href="/wiki/Disufenton_sodium" title="Disufenton sodium">Disufenton sodium</a></li> <li><a href="/wiki/Durvalumab" title="Durvalumab">Durvalumab</a></li> <li><a href="/wiki/Eculizumab" title="Eculizumab">Eculizumab</a></li> <li><a href="/wiki/Esomeprazole" title="Esomeprazole">Esomeprazole</a></li> <li><a href="/wiki/Exenatide" title="Exenatide">Exenatide</a></li> <li><a href="/wiki/Live_attenuated_influenza_vaccine" title="Live attenuated influenza vaccine">FluMist</a></li> <li><a href="/wiki/Fulvestrant" title="Fulvestrant">Fulvestrant</a></li> <li><a href="/wiki/Gefitinib" title="Gefitinib">Gefitinib</a></li> <li><a href="/wiki/Glycopyrronium_bromide/formoterol" title="Glycopyrronium bromide/formoterol">Glycopyrronium bromide/formoterol</a></li> <li><a href="/wiki/Goserelin" title="Goserelin">Goserelin</a></li> <li><a href="/wiki/Isosorbide_mononitrate" title="Isosorbide mononitrate">Isosorbide mononitrate</a></li> <li><a href="/wiki/Metoprolol" title="Metoprolol">Metoprolol</a></li> <li><a href="/wiki/Motavizumab" title="Motavizumab">Motavizumab</a></li> <li><a href="/wiki/Olaparib" title="Olaparib">Olaparib</a></li> <li><a href="/wiki/Omeprazole" title="Omeprazole">Omeprazole</a></li> <li><a href="/wiki/Osimertinib" title="Osimertinib">Osimertinib</a></li> <li><a href="/wiki/Palivizumab" title="Palivizumab">Palivizumab</a></li> <li><a href="/wiki/Propofol" title="Propofol">Propofol</a></li> <li><a href="/wiki/Quetiapine" title="Quetiapine">Quetiapine</a></li> <li><a href="/wiki/Ravulizumab" title="Ravulizumab">Ravulizumab</a></li> <li><a href="/wiki/Roflumilast" title="Roflumilast">Roflumilast</a></li> <li><a href="/wiki/Rosuvastatin" title="Rosuvastatin">Rosuvastatin</a></li> <li><a href="/wiki/Roxadustat" title="Roxadustat">Roxadustat</a></li> <li><a href="/wiki/Salbutamol/budesonide" title="Salbutamol/budesonide">Salbutamol/budesonide</a></li> <li><a href="/wiki/Savolitinib" title="Savolitinib">Savolitinib</a></li> <li><a href="/wiki/Saxagliptin" title="Saxagliptin">Saxagliptin</a></li> <li><a href="/wiki/Sebelipase_alfa" title="Sebelipase alfa">Sebelipase alfa</a></li> <li><a href="/wiki/Selumetinib" title="Selumetinib">Selumetinib</a></li> <li><a href="/wiki/Sodium_zirconium_cyclosilicate" title="Sodium zirconium cyclosilicate">Sodium zirconium cyclosilicate</a></li> <li><a href="/wiki/Tamoxifen" title="Tamoxifen">Tamoxifen</a></li> <li><a href="/wiki/Ticagrelor" title="Ticagrelor">Ticagrelor</a></li> <li><a href="/wiki/Tixagevimab/cilgavimab" title="Tixagevimab/cilgavimab">Tixagevimab/cilgavimab</a></li> <li><a href="/wiki/Trastuzumab_deruxtecan" title="Trastuzumab deruxtecan">Trastuzumab deruxtecan</a></li> <li><a href="/wiki/Vandetanib" title="Vandetanib">Vandetanib</a></li> <li><a href="/wiki/Oxford%E2%80%93AstraZeneca_COVID-19_vaccine" title="Oxford–AstraZeneca COVID-19 vaccine">Vaxzevria</a></li> <li><a href="/wiki/Ximelagatran" title="Ximelagatran">Ximelagatran</a></li> <li><a href="/wiki/Zafirlukast" title="Zafirlukast">Zafirlukast</a></li> <li><a href="/wiki/Zolmitriptan" title="Zolmitriptan">Zolmitriptan</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Predecessors and<br />acquired companies</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Astra_AB" title="Astra AB">Astra AB</a></li> <li><a href="/wiki/Alexion_Pharmaceuticals" title="Alexion Pharmaceuticals">Alexion Pharmaceuticals</a></li> <li><a href="/wiki/Cambridge_Antibody_Technology" title="Cambridge Antibody Technology">Cambridge Antibody Technology</a></li> <li><a href="/wiki/MedImmune" title="MedImmune">MedImmune</a></li> <li><a href="/wiki/Zeneca" title="Zeneca">Zeneca</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">People</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Tom_McKillop" title="Tom McKillop">Tom McKillop</a></li> <li><a href="/wiki/Louis_Schweitzer_(CEO)" class="mw-redirect" title="Louis Schweitzer (CEO)">Louis Schweitzer</a></li></ul> </div></td></tr><tr><td class="navbox-abovebelow" colspan="2" style="font-weight: bold;"><div> 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