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Title: Caution advised with dapagliflozin in the setting of male urinary tract outlet obstruction.
Austin Authors: Hall, Victoria;Kwong, Jason;Johnson, Douglas F;Ekinci, Elif I 
Affiliation: General Medicine, Austin Health, Heidelberg, Victoria, Australia
Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Issue Date: 22-May-2017 2017
Publication information: BMJ Case Reports 2017; 2017: bcr-2017-219335
Abstract: We describe an adverse outcome in a 70-year-old man with type 2 diabetes mellitus treated with sodium-glucose cotransporter type 2 (SGLT2) inhibitor dapagliflozin. SGLT2 inhibitors act in the proximal tubules to prevent glucose reabsorption and induce urinary glucose excretion, they have been associated with increased risk of urinary tract infection (UTI). Our patient presented to hospital withEscherichia colisepticaemia with positive urine and blood cultures on the background of two previous UTIs occurring post commencement of dapagliflozin in the community. Renal tract ultrasound in hospital revealed incomplete bladder emptying with evidence of urinary stasis, and a postvoid residual volume of 180 mL. His dapagliflozin was ceased, and he has had no further episodes of UTI. This case suggests there may be an increased risk of UTI in patients prescribed SGLT2 inhibitors who also have evidence of bladder outlet obstruction-caution is advised in the prescribing of SGLT2 inhibitors in this setting.
DOI: 10.1136/bcr-2017-219335
ORCID: 0000-0003-2372-395X
PubMed URL: 28536217
Type: Journal Article
Subjects: Contraindications and precautions
Endocrine system
Urinary and genital tract disorders
Urinary tract infections
Appears in Collections:Journal articles

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