Not to be used in type 1 diabetes or diabetic ketoacidosis. Discontinue use if necrotizing infection, Fournier's gangrene, pancreatitis, bullous pemphigoid are suspected. Patients w/ low β-cell function reserve; conditions that lead to restricted food intake or severe dehydration; reduced insulin doses; w/ increased insulin requirements due to acute medical illness, surgery or alcohol abuse. Vol-depletion risk in patients w/ CV disease, on antihypertensive therapy w/ history of hypotension or ≥75 yr; conditions leading to fluid loss eg, GI illness; cardiac failure (NYHA I-IV); complicated UTI; +ve glucose urine test; elevated hematocrit. Assess renal function prior to & periodically during treatment. Monitor ketones in patients hospitalised for major surgery or acute serious medical illnesses. Interference w/ 1,5-anhydroglucitol assay. Counsel patients on routine preventative foot-care. Concomitant use w/ sulphonylureas &/or insulin. May affect ability to drive & use machines. Not to be initiated if eGFR persistently <45 mL/min/1.73 m2
or CrCl persistently <45 mL/min. Not to be used in patients w/ end-stage renal disease or on dialysis. Not recommended in severe hepatic impairment. Hepatic injury. Avoid use during pregnancy. Not to be used during lactation. Paed patients <18 yr. Not recommended in elderly ≥85 yr.