UPXIGA

1. Introduction

UPXIGA (manufactured by Lupin) is a branded version of dapagliflozin, a breakthrough SGLT2 inhibitor approved for:

• Type 2 diabetes management

• Heart failure (HFrEF & HFpEF)

• Chronic kidney disease (CKD)

It stands out for its cardio-renal protective benefits beyond glucose control.

2. Description

• Generic Name: Dapagliflozin propanediol monohydrate

• Dosage Forms: 5mg & 10mg tablets

• Manufacturer: Lupin Pharmaceuticals

• Class: Sodium-glucose co-transporter-2 (SGLT2) inhibitor

3. Uses

✅ Type 2 Diabetes:

• Lowers HbA1c by 0.5–1.0%

• Promotes weight loss (2–4 kg avg.)

✅ Heart Failure:

• Reduces hospitalizations by 30%

• Benefits both reduced & preserved ejection fraction

✅ Chronic Kidney Disease:

• Slows eGFR decline by 40%

• Reduces proteinuria

4. Mechanism of Action

• Blocks SGLT2 in renal tubules → prevents glucose reabsorption

• Causes glucosuria (excretion of ~70g glucose/day)

• Promotes natriuresis (mild diuretic effect)

• Shifts metabolism to ketone utilization

Result: Improved glycemic control + reduced cardiac preload.

5. Side Effects

Common (5–15%):

• Genital yeast infections (♀️15%, ♂️8%)

• Urinary tract infections (5–10%)

• Increased urination/thirst

Serious (<1% but critical):

• Euglycemic DKA (glucose may be normal!)

• Necrotizing fasciitis (Fournier’s gangrene)

• Volume depletion (elderly at risk)

6. Storage

• Temperature: Below 30°C

• Packaging: Keep in original blister

• Stability: 24 months unopened

Note: Protect from moisture; no refrigeration needed.

7. Precautions

⚠ Absolute Contraindications:

• Type 1 diabetes (unless insulin-combined)

• ESRD (eGFR <30 for DM, <25 for HF/CKD)

• History of Fournier’s gangrene

⚠ High-Risk Monitoring:

• Ketones during illness/starvation

• Foot exams (infection risk)

• Volume status in elderly

⚠ Drug Interactions:

• Diuretics → Risk of hypotension

• Insulin/SUs → Hypoglycemia

8. Conclusion

UPXIGA redefines diabetes management by offering:

• 3-in-1 benefits (glycemic + cardiac + renal protection)

• Once-daily convenience

• Favorable safety profile (vs. older antidiabetics)

Best for: Patients with T2D + established CVD/HF/CKD.

Key Reminder: Always screen for DKA risk factors before initiation!