Not to be used in type 1 diabetes or diabetic ketoacidosis. Discontinue use if ketoacidosis, necrotizing infection, Fournier's gangrene are suspected. Patients w/ very low carbohydrate diet, acute illness, pancreatic disorders suggesting insulin deficiency, reduced insulin dose, alcohol abuse, severe dehydration & history of ketoacidosis. 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; complicated UTI eg, pyelonephritis or urosepsis; cardiac failure (NYHA class I-IV); +ve glucose urine test. Assess renal function prior to & periodically during treatment. Monitor ketones in situations known to predispose ketoacidosis eg, prolonged fasting due to acute illness or surgery. Interference w/ 1,5-anhydroglucitol assay. Counsel patients on routine prevention foot-care. Galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. 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. Not recommended during 2nd & 3rd trimester of pregnancy. Not to be used during lactation. Childn & adolescents. Not recommended in elderly ≥85 yr.