Empagliflozin(자디앙), Dapagliflozin(포시가), eGFR ≥45에서는 용량 조절이 필요하지 않습니다.

Empagliflozin

Dosing: Renal Impairment: Adult

eGFR ≥45 mL/minute/1.73 m2: No dosage adjustment necessary.

eGFR 30 to <45 mL/minute/1.73 m2: The US manufacturer recommends to not initiate therapy, or in patients already taking empagliflozin, discontinue therapy when eGFR is persistently <45 mL/minute/1.73 m2. Recommendations regarding indicated level of eGFR for initiation or continued use may vary in other regions (ADA 2019). Post-hoc analysis of the EMPA-REG OUTCOME trial suggests use of empagliflozin (at doses of 10 mg or 25 mg once daily) in diabetic patients with cardiovascular disease and renal impairment (eGFR 30 to <60 mL/minute/1.73 m2) may be associated with decreases in incident or worsening nephropathy as well as decreased cardiovascular mortality (Wanner 2016; Wanner 2018). However, additional trials may be necessary to define the role of empagliflozin in improving these outcomes in patients with eGFR 30 to <45 mL/minute/1.73 m2.

eGFR <30 mL/minute/1.73 m2: Use is contraindicated.

ESRD, dialysis: Use is contraindicated.

 

Dapagliflozin

Dosing: Renal Impairment: Adult

eGFR ≥45 mL/minute/1.73 m2: No dosage adjustment necessary.

eGFR 30 to <45 mL/minute/1.73 m2: The US manufacturer does not recommend use; however, recommendations regarding indicated level of eGFR for initiation or continued use may vary in other regions (ADA 2019).

eGFR <30 mL/minute/1.73 m2: Use is contraindicated.

ESRD: Use is contraindicated.

Hemodialysis: Use is contraindicated.

 

REF. UpToDate 2019.07.18