Discontinue use if diabetic ketoacidosis & necrotising perineum fasciitis/Fournier's gangrene is suspected or diagnosed. Vol-depletion risk due to acute disease eg, GI illness, history of hypotension; UTI, urosepsis, pyelonephritis; cardiac failure (NYHA class IV); patients w/ low β-cell function reserve; conditions leading to restricted food intake or severe dehydration; reduced insulin doses; increased insulin requirements due to acute medical illness, surgery or alcohol abuse; +ve glucose urine test. Monitor vol status eg, physical exam, BP, haematocrit & electrolytes. Counsel patients on routine preventative foot care. Galactose intolerance, total lactase deficiency or glucose-galactose malabsorption. Concomitant use w/ antihypertensives. May affect ability to drive & use machines. Not recommended in diabetic patients w/ eGFR persistently <45 mL/min/1.73 m2
. Severe renal impairment (eGFR <30 mL/min/1.73 m2
) or end-stage renal disease. Hepatic impairment. Not recommended during 2nd & 3rd trimesters of pregnancy. Not to be used during lactation. Elderly ≥65 yr. Childn <18 yr.