A once-daily tablet that flushes sugar out in the urine. It reduces heart-failure hospitalizations and slows loss of kidney filtering, with or without diabetes. Smaller gains: fat loss, lower blood pressure, less uric acid. Genital yeast infections are common; dangerous blood acid clusters around fasting and very low-carbohydrate eating. The ageing claim rests on mice. (Full Review)
| Marker | Target | Why |
|---|---|---|
| eGFR | ≥ 90 mL/min/1.73 m²; trend over absolute | Detects the initial dip; tracks the slope |
| UACR | < 10 mg/g | Earliest signal of filter damage |
| Serum potassium | 4.0–4.5 mmol/L | Raised by the drug and by co-therapies |
| Serum sodium | 137–142 mmol/L | Flags over-diuresis before symptoms appear |
| Serum magnesium | 2.0–2.4 mg/dL | Low levels worsen cramps and arrhythmia |
| HbA1c | 4.8–5.4% in a non-diabetic adult | Confirms glucose-lowering |
| Serum uric acid | 3.5–5.5 mg/dL | Tracks the urate benefit; predicts gout |
| Haematocrit | 40–48% in men, 36–44% in women | Rises predictably; excess thickens blood |
| Blood ketones (beta-hydroxybutyrate) | < 0.6 mmol/L when eating normally | Detects ketoacidosis at normal blood sugar |
| Blood pressure, seated and standing | < 120/80 seated; < 20 mmHg drop standing | Detects the postural drop causing falls |
Cadence: Baseline; kidney function and electrolytes at 4 weeks; blood pressure seated and standing at 2 and 4 weeks; then all three every 6 months, with HbA1c and uric acid annually.