Overview
Dapagliflozin is a medication of the SGLT2 inhibitor class. Beyond its role in managing type 2 diabetes mellitus, it is extensively used to treat heart failure with reduced ejection fraction and to slow the progression of chronic kidney disease, regardless of diabetes status.

Mechanism of Action
Dapagliflozin selectively and reversibly blocks the sodium-glucose co-transporter 2 (SGLT2) in the kidneys. This inhibition prevents the reabsorption of glucose into the blood, promoting its excretion via urine. The resulting osmotic diuresis also contributes to reductions in blood pressure and body weight.

Dosage and Administration
For type 2 diabetes, the starting dose is usually 5 mg once daily, which can be increased to 10 mg daily. For heart failure and chronic kidney disease, the recommended dose is 10 mg once daily. It can be taken at any time of the day, with or without food.

Side Effects
The most frequent adverse events are female genital mycotic infections, nasopharyngitis, and urinary tract infections. Due to its diuretic effect, it can cause dehydration and hypotension. Patients should be monitored for signs of diabetic ketoacidosis, which can occur even with near-normal blood glucose levels.

Contraindications
It is contraindicated in patients with known hypersensitivity to the active substance. It is not recommended for patients with type 1 diabetes or for the treatment of diabetic ketoacidosis.

Pregnancy and Lactation
Use during the second and third trimesters of pregnancy is not recommended due to risks to the developing fetal kidney. Breastfeeding is not recommended during treatment with dapagliflozin.