Indications: diabetes mellitus

Cautions: discontinue if symptoms of acute pancreatitis (persistent, severe abdominal pain).

Contra-indications: ketoacidosis

Renal impairment: reduce dose to 50 mg once daily if eGFR 3050 ml/minute/1.73 m2; reduce dose to 25 mg once daily if eGFR less than 30 ml/minute/1.73 m2.

Pregnancy: avoid—toxicity in animal studies.

Breast-feeding: avoid—present in milk in animal studies.

Side Effects: gastro-intestinal disturbances; peripheral oedema; upper respiratory tract infection, nasopharyngitis; pain; less commonly dry mouth, anorexia, headache, drowsiness, dizziness, hypoglycaemia, osteoarthritis; pancreatitis, rash, cutaneous vasculitis, and Stevens-Johnson syndrome.

Dose: ADULT over 18 years, 100 mg once daily.

Note: Dose of concomitant sulfonylurea or insulin may need to be reduced.