Ertugliflozin

Indications & Dose:

Indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. 

Limitations of Use:

Not for the treatment of type 1 diabetes mellitus or diabetic ketoacidosis. 

DOSAGE

5 mg once daily, taken in themorning, with or without food.

Increase dose to 15 mg once daily in those tolerating ertugliflozin and needing additional glycemic control. 

Assess renal function before initiating ertugliflozin and periodically thereafter

Contraindications:

Severe renal impairment, end-stage renal disease, or dialysis. 

Hypersensitivity reaction to ertugliflozin. 

Side Effects:

Female genital mycotic infections. 

Pregnancy: Advise females of the potential risk to a fetus especially during the second and third trimesters. 

Lactation: Breastfeeding not recommended.

Geriatrics: Higher incidence of adverse reactions related to reduced intravascular volume. 

Cautions:

Precautions:

Hypotension: May occur particularly in patients with renal impairment, the elderly, or patients on diuretics. Before initiating, assess and correct volume status. 

Ketoacidosis: Assess patients who present with signs and symptoms of metabolic acidosis for ketoacidosis, regardless of blood glucose level. If suspected, discontinue, evaluate, and treat

promptly. Before initiating, consider risk factors for ketoacidosis.

Acute Kidney Injury and Impairment in Renal Function: If acute kidney injury occurs, discontinue and promptly treat. Monitor renal function. 

 Urosepsis and Pyelonephritis: Evaluate patients for signs and symptoms of urinary tract infections and treat promptly, if indicated.

Lower Limb Amputation: Monitor patients for infections or ulcers of lower limbs, and discontinue if these occur. 

Hypoglycemia: Consider a lower dose of insulin or insulin secretagogue to reduce risk of hypoglycemia when used in combination. 

Interaction:

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: