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Doctors may choose this route when the goal is to bring the therapy closer to the central nervous system , potentially increasing local exposure

Examples Canagliflozin (Invokana) Dosage Initial: 100 mg once daily before the first meal of the day Maximum: 300 mg once daily Dapagliflozin (Farxiga) Dosage Initial: 510 mg once daily Maximum: 10 mg once daily Empagliflozin (Jardiance) Dosage Initial: 10 mg once daily Maximum: 25 mg once daily Possible side effects include: Urinary tract infections Genital fungal (mycotic) infections (ie, Candida infection) Hypovolemia (low extracellular fluid) and hypotension (low blood pressure) Acute kidney injury, possibly as a result of volume depletion (limited and contradictory evidence) Diabetic ketoacidosis (rare) Osteoporosis and bone fractures Dipeptidyl peptidase-IV (DPP-4) inhibitors Primary mechanism(s) of action Enhance incretin signaling via inhibition of the enzyme dipeptidyl peptidase-IV (DPP-4), which breaks down GLP-1 and glucose-dependent insulinotropic polypeptide (GIP)

Sharifi-Rad J, Rayess YE, Rizk AA, Sadaka C, Zgheib R, Zam W, et al

Outpatient treatment offers flexibility to maintain work, school or family obligations