Dapakem M
Dapakem M - Image 2
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Dapakem M

Composition:

  • Dapagliflozin 10 mg

  • Metformin Hydrochloride IP 500 mg
    Therapeutic Class:

  • SGLT2 Inhibitor + Biguanide
    Schedule: Schedule H (Prescription Only)

Dapakem M is a fixed-dose combination of Dapagliflozin, a selective SGLT2 inhibitor, and Metformin, a first-line oral antidiabetic agent. This powerful dual therapy works synergistically to lower blood glucose in patients with Type 2 Diabetes Mellitus (T2DM)—addressing both insulin resistance and renal glucose reabsorption.

It is ideal for patients requiring early intensification, dual therapy after monotherapy failure, or those with cardio-renal risk factors.

Usage of Dakapem M

Dapakem M is indicated for the management of:

  • Type 2 Diabetes Mellitus (T2DM) not controlled by metformin alone

  • Newly diagnosed diabetics requiring dual therapy

  • Overweight/obese diabetics needing weight and BP control

  • Patients with cardiovascular disease or chronic kidney disease for added protection

  • Metformin-intolerant patients (in extended-release variant, if applicable)

Mechanism of Action

🔹 Dapagliflozin 10 mg

  • Inhibits SGLT2 in renal proximal tubules

  • Promotes urinary glucose excretion, lowering blood glucose

  • Improves insulin sensitivity and provides cardio-renal benefits

  • Causes mild natriuresis and BP reduction

🔹 Metformin 500 mg

  • Decreases hepatic glucose production (gluconeogenesis)

  • Improves peripheral insulin sensitivity

  • Aids in weight neutrality or loss

  • Lowers fasting and postprandial glucose

Together, they provide complementary action with low risk of hypoglycemia and benefits beyond glycemic control.

Key Benefits

✅ HbA1c reduction up to 1.5–2.0%
✅ Weight loss (2–3 kg average)
✅ Blood pressure reduction (up to 5 mmHg systolic)
✅ Low hypoglycemia risk
✅ Cardiovascular and renal protection—independent of glycemic effect

Common Side Effects

  • Genital fungal infections (Dapagliflozin)

  • Increased urination

  • GI disturbances (Metformin): nausea, diarrhea, metallic taste

  • Rare: Lactic acidosis (Metformin), Euglycemic ketoacidosis (Dapagliflozin)

  • Dehydration or hypotension in elderly

Precautions

  • Avoid in Type 1 diabetes, DKA, or severe renal impairment (eGFR < 30 mL/min/1.73 m²)

  • Monitor renal function periodically

  • Discontinue temporarily during surgery, contrast studies, or acute illness

  • Caution in elderly or volume-depleted patients

  • Not advised during pregnancy or breastfeeding

Drug Interactions

  • Dapagliflozin:

    • May enhance diuretic effect

    • Increased risk of hypotension with antihypertensives

  • Metformin:

    • Use cautiously with nephrotoxic drugs

    • Alcohol increases risk of lactic acidosis

    • Avoid cationic drugs that reduce its renal clearance

Dosage and Administration

  • Recommended dose:

    • One tablet once or twice daily, preferably with meals (to reduce GI side effects)

    • Dose may be titrated based on glycemic response and tolerance

  • Extended-release variants (if any): Take once daily with the evening meal

Storage

  • Store at a temperature not exceeding 25°C

  • Protect from light and moisture

  • Keep out of reach of children

Patient Counseling Points

  • Maintain adequate hydration

  • Report symptoms of genital infection or abdominal distress

  • Follow dietary and exercise plan consistently

  • Avoid alcohol and dehydration, especially during illness

  • Inform doctor if undergoing surgery or imaging requiring contrast

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