Not to be used in patients w/ type 1 diabetes. Discontinue use if ketoacidosis; necrotizing fasciitis of the perineum (Fournier's gangrene) are suspected. Patients on a very low carbohydrate diet; w/ acute illness; pancreatic disorders suggesting insulin deficiency (eg, type 1 diabetes, history of pancreatitis or pancreatic surgery); insulin dose reduction; alcohol abuse; severe dehydration; history of ketoacidosis. Consider monitoring of ketones even if treatment has been interrupted in clinical situations known to predispose to ketoacidosis (eg, prolonged fasting due to acute illness or surgery). May lead to modest BP decrease; carefully monitor vol status (eg, physical exam, BP measurements, lab tests including haematocrit) & electrolytes. Consider temporary treatment interruption until fluid loss is corrected; patients w/ complicated UTI including pyelonephritis & urosepsis. May cause +ve result for glucose in urine lab assessment. Contain lactose; not to be taken by patients w/ rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption. Not recommended to initiate treatment in patients w/ eGFR <20 mL/min/1.73 m
2. Assess renal function prior to initiation & periodically during treatment; prior to initiation of any concomitant medicinal product that may have -ve impact on renal function. Not recommended in patients w/ severe hepatic impairment. Possible hepatic injury. Minor influence on the ability to drive & use machines. Avoid use during early pregnancy; not recommended during 2nd & 3rd trimester of pregnancy. Not to be used during breast-feeding. Childn & adolescents. Increased risk of vol depletion in elderly ≥75 yr.
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