Dapagliflozin

Additional information

Pharmacokinetics and dosing

Pooled data from clinical pharmacology studies (349 men, 89 women) showed that women had a greater mean dapagliflozin AUC of 23%, even though Cmax was not increased [1]. In a population pharmacokinetic model (634 men, 619 women), mean dapagliflozin AUC at steady state was 22% higher in women than in men [1]. Despite differences described in AUC between men and women, this does not have any substantially clinically relevant impact and no dose adjustment has been considered necessary according to sex [2].

Effects

According to clinical studies done by the original manufacturer, treatment with dapagliflozin as monotherapy and in combination with metformin, glimepiride, pioglitazone, sitagliptin, or insulin reduced HbA1c at week 24 compared to control in both men and women [2]. Pooled data from several phase III studies show minimal differences in efficacy between men and women (data not shown) [1].

Adverse effects

Data from randomized placebo-controlled clinical trials [3-7] report a higher frequency of genital infections and urinary tract infections in women than men treated with dapagliflozin. Genital infections incidence rates vary from 4.3-4.5% in women and 2.0-2.1% in men. Urinary tract infections incidence rates vary from 2.8-11.9% in women and 2.0-3.5% in men. The incidence of infections was not dose-related [3-7].

Reproductive health issues

Regarding teratogenic aspects, please consult the Drugs and Birth Defects Database (in Swedish, Janusmed fosterpåverkan).

Other information

An international randomized, double-blind, placebo-controlled Phase III study (100 men, 80 women) showed a greater decrease in total body weight in men (-2.8 kg) at 24 weeks with dapagliflozin compared to women (-1.2 kg) [4].