NICE recommendations (TA1075)
- Dapagliflozin can be used for CKD in adults as an add-on to optimised standard care including the highest tolerated ACEi/ARB dose (unless contraindicated).
- Eligibility includes:
- eGFR 20 to <45, or
- eGFR 45 to 90 and either uACR ≥22.6 mg/mmol or type 2 diabetes.
- If suitable options include empagliflozin, NICE advises using the least expensive after discussion.
Primary care monitoring (high-yield)
- Baseline: eGFR/uACR, BP, volume status; review diuretics and sick-day rules.
- Counsel: genital mycotic infections, dehydration, rare ketoacidosis; pause in acute illness/fasting/surgery per local protocol.
- Expect small early eGFR dip; monitor renal function per CKD/SGLT2 pathway.
Frequently asked questions
Is this only for diabetes?
No — TA1075 includes people without diabetes if eGFR criteria are met; in the 45–90 range, eligibility includes uACR ≥22.6 or T2D.
Do patients have to be on ACEi/ARB?
It is recommended as add-on to optimised standard care including the highest tolerated ACEi/ARB dose unless contraindicated.
Transparency
This page is an educational, clinician-written summary of publicly available NICE guidance intended for trained healthcare professionals. It uses original wording (not copied text) and should be used alongside the full NICE source, local pathways, and clinical judgement. Doses provided are for general reference; always check the BNF/SPC.