Should not be used in patients w/ type 1 DM. Risk of hypotension/vol depletion. Assess & correct vol status before initiating therapy; monitor for signs & symptoms of symptomatic hypotension after initiating therapy. Risk of diabetic ketoacidosis. Reports of increased cases of lower limb amputation (primarily of the toe) in long-term clinical studies w/ another SGLT2 inhibitor. Assess renal function prior to treatment initiation & periodically thereafter. Initiation of treatment is not recommended in patients w/ eGFR <60 mL/min/1.73 m2
or CrCl <60 mL/min. Discontinue if eGFR is persistently <45 mL/min/1.73 m2
or CrCl is persistently <45 mL/min. Increased risk of genital mycotic infections; UTIs. Patients w/ cardiac failure. Rare hereditary problems of galactose intolerance, total lactase deficiency, or glucose-galactose malabsorption. False positive result for glucose in urine laboratory assessments. Monitoring glycaemic control w/ 1,5-AG assay is not recommended. Concomitant use w/ insulin & insulin secretagogues. Should not be used in patients w/ severe renal impairment, w/ end-stage renal disease, or receiving dialysis. Not recommended in patients w/ severe hepatic impairment. Pregnancy & lactation. Childn <18 yr. Elderly.