Discontinue use if ketoacidosis, necrotizing fasciitis of the perineum (Fournier's gangrene) are suspected. Not to be used in type 1 diabetes or diabetic ketoacidosis. Patients w/ very low carbohydrate diet, acute illness, pancreatic disorders suggesting insulin deficiency, reduced insulin dose, alcohol abuse, severe dehydration & history of ketoacidosis. Vol-depletion risk in patients w/ CV disease, on antihypertensive therapy w/ history of hypotension; conditions leading to fluid loss eg, GI illness; complicated UTI eg, pyelonephritis or urosepsis. Assess renal function prior to & periodically during treatment. Monitor ketones in situations predisposing ketoacidosis eg, prolonged fasting due to acute illness or surgery. Counsel patients on routine prevention foot-care. Positive test for glucose in urine. Not to be taken by patients w/ galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. May affect ability to drive & use machines. Not recommended in severe hepatic impairment. Hepatic injury. Not recommended during 2nd & 3rd trimesters of pregnancy. Not to be used during lactation. Childn & adolescents. Elderly ≥75 yr. Heart failure: Not recommended in patients w/ renal impairment eGFR <20 mL/min/1.73 m
2.