BNF:

6.1.2.3

Status:

Do Not Prescribe (DNP), Green

Decision Date:

October 2024

Comments

Type 2 Diabetes without CKD: GREEN second line if dapagliflozin is not tolerated or otherwise unsuitable. Also indicated for use as per NICE TA336 and NICE TA390 for type 2 diabetes : in combination with other glucose-lowering agents and for use as monotherapy. See local type 2 diabetes guidance. (Decision date - December 2022, updated January 2026)

Type 2 Diabetes with CKD: GREEN second line if dapagliflozin is not tolerated or otherwise unsuitable. As per NICE NG28 and NG203, for adults with CKD and type 2 diabetes, in additions to an ACEI or ARB at an optimised dose.  (Decision date - Sep 2021, updated Dec 2021, updated Dec 2022, updated January 2026)

Heart Failure: GREEN second line if dapagliflozin is not tolerated or otherwise unsuitable (decision date April 2026) 

Chronic Kidney Disease (CKD): GREEN: NICE TA942. 

Empagliflozin is recommended as an option only if:

• it is an add-on to optimised standard care including the highest tolerated licensed dose of ACEi or ARBs, unless contraindicated,
• and people have an eGFR of - 
• 20 to less than 45 ml/min/1.73 m2 or
• 45 to 90 ml/min/1.73 m2 and either: a urine albumin-to-creatinine ratio of 22.6 mg/mmol or more, or type 2 diabetes. (Decision date - January 2024)

DNP: NICE TA1006 (terminated appraisal) - for treating type 2 diabetes in people 10 to 17 years (Decision date - October 2024) 

Do Not Prescribe (DNP) Drug Classifications

• 6: Have NICE guidance that recommends they should not be used

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