Hypersensitivity. Not to be used in patients w/ type 1 diabetes or diabetic ketoacidosis. Discontinue use if pancreatitis, ketoacidosis, recurrent UTI, Fournier's gangrene, bullous pemphigoid are suspected. Risk of vol depletion, hypotension &/or electrolyte imbalance; GI illness, heat stress, severe infections; known CV disease; on antihypertensive therapy w/ history of hypotension; dehydration; increased/decreased insulin requirements, reduced caloric intake, low carbohydrate diet, acute illness, surgery, alcohol abuse; ulcerative & necrotic skin lesions; cardiac failure; arthralgia. Immunocompromised patients. Monitor renal function prior to & at least yrly thereafter. Monitor vol status eg, physical exam, BP, hematocrit & electrolytes. Not recommended in concomitant use w/ diuretics. Combination w/ glucagon-like peptide 1, insulin & insulin secretagogues eg, sulfonylureas. Counsel patients on routine preventive foot care. May affect ability to drive & use machines. Not recommended in moderate or severe renal impairment, ESRD or patient on dialysis. Not to be used in severe hepatic impairment. Not to be used during pregnancy & lactation. Paed & adolescents <18 yr. Not recommended in elderly ≥75 yr.
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