Ertoxa Tablet
Ertugliflozin
5 mg
Ziska Pharmaceuticals Ltd.
| Pack size | 30’s pack |
|---|---|
| Unite Price | 25.00 BDT |
Indications
Ertoxa Tablet is used for:
Type 2 Diabetes Mellitus
Adult Dose
Type 2 Diabetes Mellitus
Indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus
Recommended starting dose is 5 mg PO qDay in the morning
If starting dose tolerated and additional glycemic control is needed, increase dose to maximum of 15 mg qDay
Hepatic impairment
Mild-to-moderate: No dosage adjustment necessary
Severe: Not recommended
Child Dose
<18 years: Safety and efficacy not established
Renal Dose
Renal impairment
eGFR ?60 mL/min/1.73 m²: No dosage adjustment necessary
eGFR <30 mL/min/1.73 m²: Contraindicated
End-stage renal disease or dialysis: Contraindicated
eGFR 30-60 mL/min/1.73 m²
Initiation of ertugliflozin not recommended
Continued use not recommended with persistent eGFR 30-60 mL/min/1.73 m²
Administration
Take in the morning qDay, with or without food
Contra Indications
Hypersensitivity
Severe renal impairment, end-stage renal disease, or dialysis
Precautions
Causes intravascular volume contraction; symptomatic hypotension may occur after initiating, particularly in patients with renal impairment, with low systolic blood pressure, on diuretics, or who are elderly
Ketoacidosis, a serious life-threatening condition requiring urgent hospitalization, has been reported; before initiating, consider factors that may predispose patient to ketoacidosis, including pancreatic insulin deficiency from any cause, caloric restriction, and alcohol abuse; monitor for ketoacidosis and temporarily discontinue in clinical situations known to predispose to ketoacidosis (eg, prolonged fasting owing to acute illness or surgery)
Renal impairment may occur owing to intravascular volume contraction; before initiating, consider factors that may predispose patients to acute kidney injury, including hypovolemia, chronic renal insufficiency, CHF, and concomitant medications (eg, diuretics, ACE inhibitors, ARBs, NSAIDs); consider temporarily discontinuing ertugliflozin in any setting of reduced oral intake or fluid loss; monitor for signs and symptoms of acute kidney injury, and, if evident, discontinue drug promptly and institute treatment
Genital mycotic infections may occur; patients with history of genital mycotic infections and uncircumcised males are more susceptible
Serious urinary tract infections, including urosepsis and pyelonephritis, requiring hospitalization reported in patients receiving SGLT2 inhibitors
Increases risk of urinary tract infections (UTIs), including life-threatening urospesis and pyelonephritis that started as UTIs
Pregnancy-Lactation
Pregnancy
Based on animal data showing adverse renal effects, not recommended during the second and third trimesters of pregnancy
Data are limited in pregnant women and are not sufficient to determine a drug-associated risk of adverse developmental outcomes; there are risks to the mother and fetus associated with poorly controlled diabetes in pregnancy
Animal data
In animal studies, adverse renal changes were observed in rats when ertugliflozin was administered during a period of renal development corresponding to the late second and third trimesters of human pregnancy; doses ~13 times the maximum clinical dose caused renal pelvic and tubule dilatations and renal mineralization that were not fully reversible
There was no evidence of fetal harm in rats or rabbits at exposures of ertugliflozin ~300 times higher than the maximal clinical dose of 15 mg/day when administered during organogenesis
Lactation
Not recommended while breastfeeding
Unknown if distributed in human breast milk
Since human kidney maturation occurs in utero and during the first 2 years of life when lactational exposure may occur, there may be risk to the developing human kidney
Because of the potential for serious adverse reactions in a breastfed infant, advise women that ertugliflozin is not recommended while breastfeeding
Interactions
Hypoglycemia risk increased with insulin and insulin secretagogues (eg, sulfonylureas); a lower dose of insulin or insulin secretagogue may be required
Monitoring glycemic control with urine glucose tests is not recommended in patients taking SGLT2 inhibitors, as SGLT2 inhibitors, increase urinary glucose excretion and lead to positive urine glucose tests; use alternative methods to monitor glycemic control
Side Effects
Side effects of Ertugliflozin :
>10%
Female genital mycotic infections (9.1-12.2%)
1-10%
Volume depletion adverse effects (1.9-4.4%)
Male genital mycotic infections (3.7-4.2%)
Urinary tract infections (4-4.1%)
Headache (2.9-3.5%)
Vaginal pruritus (2.4-2.8%)
Increased urination (2.4-2.7%)
Nasopharyngitis (2-2.5%)
Back pain (1.7-2.5%)
Renal adverse effects (1.3-2.5%)
Weight decreased (1.2-2.4%)
Thirst (1.4-2.7%)
Mode of Action
Selective sodium-glucose transporter-2 (SGLT2) inhibitor
SGLT-2 inhibition lowers the renal glucose threshold (ie, the plasma glucose concentration, which exceeds the maximum glucose reabsorption capacity of the kidney); lowering the renal glucose threshold results in increased urinary glucose excretion
Note
Ertoxa 5 mg Tablet generic name is Ertugliflozin. Ertoxa 5 mg Tablet is manufactured by Ziska Pharmaceuticals Ltd.Ertoxa is availble in all over Bangladesh.
Mes BD drug index information on Ertoxa Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.