One 10 mg once-daily dose covers four separate PBS indications — type 2 diabetes, heart failure (reduced or preserved EF), and chronic kidney disease. CKD eligibility was broadened in February 2026 to cover earlier- and later-stage disease — the exact eGFR/albuminuria bands are detailed and don't reduce to one cut-off; confirm the current wording at pbs.gov.au before applying.
1Eligibility — four pathways
✓Type 2 diabetes — T2DM confirmed (not T1DM, LADA or gestational). Commonly added to metformin unless contraindicated; some patients may qualify without an HbA1c threshold — confirm current wording at pbs.gov.au.
✓Heart failure — PBS-listed as adjunct to standard heart-failure therapy across the ejection-fraction spectrum, irrespective of diabetes status — not as monotherapy.
✓Chronic kidney disease — Eligibility is based on eGFR and albuminuria bands, broadened in Feb 2026 to cover earlier- and later-stage CKD; funded with or without diabetes. The exact bands are detailed — confirm directly at pbs.gov.au rather than relying on a simplified summary.
✓ACEi/ARB stabilisation — Generally expected to be stabilised on an ACE inhibitor or ARB (unless contraindicated) for the CKD and proteinuric pathways.
2By indication
| Indication | Funded irrespective of | Key note |
|---|
| Type 2 diabetes | — | Combine with metformin, SU, DPP-4i or insulin; not with a GLP-1 RA for the diabetes indication |
| Heart failure | Diabetes status | Adjunct to standard HF therapy; covers reduced and preserved EF |
| CKD | Diabetes status | eGFR/albuminuria-based; excludes polycystic kidney disease |
Verify at PBS — 10 mg once daily is the only dose used across all indications (a 5 mg option exists for severe hepatic impairment). Expect a small, reversible eGFR dip in the first few weeks — don't stop for this alone. Exact eGFR/UACR bands, HbA1c thresholds and item codes are not reproduced here — confirm at pbs.gov.au.
Safety
- Sick-day rules: stop temporarily during acute illness with vomiting/diarrhoea/dehydration, major surgery, prolonged fasting, or severe infection — euglycaemic DKA risk; check ketones if unwell despite normal glucose.
- Genital thrush is common — counsel and treat; rare but serious: Fournier's gangrene — urgent review for perineal pain.
- Volume depletion, especially in older patients on diuretics — review BP and hydration.
- Hypoglycaemia risk only if combined with a sulfonylurea or insulin.
Check / exclude
- Confirm current eGFR/UACR bands for the CKD indication at pbs.gov.au — broadened Feb 2026 and multi-tiered, not a single cut-off.
- Exclude: polycystic kidney disease, recent immunosuppression, dialysis/transplant (stop before), pregnancy/breastfeeding.
- Don't combine with another SGLT-2 inhibitor.
- Confirm ACEi/ARB stabilisation where required for the indication.
EN-04 v1.0 · Reviewed Jun 2026 · Review Dec 2026
For health-professional use. Eligibility summarised from public PBS reporting — confirm exact eGFR/UACR bands and item codes at pbs.gov.au. Covers dapagliflozin (Forxiga) across T2DM, HFrEF, HFpEF and CKD — not a complete dose-and-criteria matrix.
