If you have type 2 diabetes, it’s important to keep your blood sugar levels under control. Along with changes to your diet and exercise, your health care provider may recommend medication to help lower your blood glucose levels. One of those medications is dapagliflozin, commonly known by its brand name Farxiga.
Dapagliflozin belongs to a class of drugs called sodium-glucose co-transporter 2 (SGLT2) inhibitors. The SGLT2 protein absorbs glucose (sugar) from the urine and puts it back into the bloodstream through the kidneys. Blocking this protein helps keep the kidneys from reabsorbing glucose. Instead, the glucose passes out of the body in the urine.
Dapagliflozin may be a good choice for people with type 2 diabetes who don’t get enough blood sugar control with lifestyle changes or other medications. “It can also be used to reduce the risk of hospitalization for heart failure in people with type 2 diabetes and cardiovascular disease,” said Paul Thompson, a pharmacist with Banner Pharmacy Services.
It is generally safe and effective for most people with type 2 diabetes. However, it may not be suitable for people with certain medical conditions or allergies. “Farxiga is not recommended for patients with severe kidney disease, those on dialysis, or individuals with a history of serious hypersensitivity reactions to the drug,” Dr. Thompson said. Farxiga is also not recommended during the second and third trimesters of pregnancy or while breastfeeding due to potential risks to the baby.
Benefits of dapagliflozin
While some other diabetes medications can cause low blood sugar (hypoglycemia) if they aren’t carefully managed, dapagliflozin works differently, so it is less likely to increase the risk of low blood sugar. It can provide more stable blood sugar control throughout the day. However, if you take dapagliflozin along with other medications like insulin or sulfonylureas, your risk of low blood sugar may increase.
Dapagliflozin also offers cardiovascular benefits. Research has found that it lowers the risk of heart attacks, strokes and cardiovascular-related deaths in people with type 2 diabetes who are at high risk for cardiovascular disease. “It is also sometimes used to treat heart failure even in patients without diabetes,” Dr. Thompson said.
Dapagliflozin may promote weight loss in people with type 2 diabetes. That’s because passing excess glucose out of the body in urine means passing excess calories out as well.
“Farxiga can also help lower blood pressure, adding another layer of benefit for people with hypertension (high blood pressure),” Dr. Thompson said. Monitoring is needed for people who already take medication for high blood pressure.
How to take dapagliflozin
You should take dapagliflozin exactly as prescribed so it’s effective and less likely to cause side effects. Do not take more or less than prescribed, and do not stop taking it without talking to your health care provider.
“Consistency in taking Farxiga as prescribed is crucial for its effectiveness. Missing doses can lead to uncontrolled blood sugar levels and reduce the medication's benefits,” Dr. Thompson said.
If you miss a dose, take it as soon as you remember. If it's almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose to make up for one you missed.
Most people start with five milligrams once daily, taken by mouth, with or without food. Your provider may adjust the dosage based on how you respond to the medication and other factors like your kidney function. In some cases, the dose is increased to 10 milligrams daily.
Tell your provider about all medications, vitamins and supplements you take, since they may cause interactions. Medications that may interact with Dapagliflozin include:
- Other diabetes medications, such as insulin or sulfonylureas
- Diuretics (water pills)
- Medications that affect kidney function
- Medications that lower blood pressure
- Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen (Advil) or naproxen sodium (Aleve)
- Certain supplements or herbal products
“Regularly monitor your blood glucose levels as directed by your health care provider to ensure the medication is effectively managing your diabetes,” Dr. Thompson said.
Possible side effects of dapagliflozin
If you take dapagliflozin, your health care provider will recommend regular check-ups and blood tests to see how you are responding to the medication and watch for any side effects. Your health care provider may check your blood sugar levels, kidney function and overall health and adjust your treatment plan if necessary.
Most people tolerate dapagliflozin well, but it may cause side effects such as:
- Urinary tract infections, since having more glucose in your urine can make UTIs more likely. “Be vigilant for symptoms like pain or burning during urination, frequent urination or cloudy urine,” Dr. Thompson said.
- Genital yeast infections.
- Dehydration, because urinating more can lead to fluid loss. It’s important to drink plenty of water if you take dapagliflozin and to watch for signs of dehydration such as increased thirst, dry mouth, dark urine, dizziness, fainting or lightheadedness.
Some side effects may be mild and resolve on their own, but for others, you may need medical care. You should contact your health care provider right away if you have:
- Severe symptoms of UTIs or dehydration.
- Symptoms of diabetic ketoacidosis (DKA), such as nausea, vomiting, abdominal pain, confusion or difficulty breathing. DKA is a serious complication of diabetes where the body produces high levels of blood acids called ketones.
- Signs of kidney problems, include changes in how much or how often you urinate, swelling in the feet or ankles or unexplained weight gain.
Precautions to take before surgery or medical procedures
Your health care provider may recommend temporarily stopping dapagliflozin before a procedure to reduce the risk of complications like ketoacidosis or dehydration. Your provider can let you know when to stop and resume dapagliflozin based on the type of procedure and your health status.
Lifestyle considerations
“Farxiga works best when combined with a balanced diet and regular physical activity,” Dr. Thompson said. Aim to eat a balanced diet that includes a variety of fruits, vegetables, lean proteins and whole grains. Focus on controlling your portion sizes and monitoring the amount of carbohydrates you eat.
You may want to work with a registered dietitian or diabetes educator to create a meal plan that meets your nutritional needs and helps you manage your blood sugar levels. They can teach you how to measure your carbohydrates, time your meals and make healthier food choices.
Regular physical activity is also an important part of managing diabetes. Exercise helps improve your insulin sensitivity, lower your blood sugar levels and promote your overall health and well-being. Aim for at least 150 minutes of moderate-intensity exercise, such as brisk walking, cycling or swimming each week, along with muscle-strengthening activities on two or more days per week.
Before starting an exercise program, talk to your provider to make sure it is safe. They can make recommendations based on your health status and fitness level.
Managing diabetes while traveling
When you’re traveling, you’ll want to:
- Pack enough dapagliflozin and other diabetes medications, plus testing supplies and snacks to manage blood sugar levels.
- If you’re flying, keep your medication and supplies in your carry-on luggage.
- Know where to find medical facilities and pharmacies at your destination in case you need care.
- Stick to your meal and medication schedule as much as possible, even with changes in time zones.
- Stay hydrated and check your blood sugar levels regularly, especially during long flights or when you’re more active than usual.
The bottom line
If you have type 2 diabetes, dapagliflozin (Farxiga) may help control your blood sugar, lower your risk of cardiovascular problems, manage your weight and lower your blood pressure. But isn’t right for everyone, and it comes with certain side effects and risks.
Your health care provider or a Banner Health specialist can help you find the best treatment plan for managing diabetes.
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The content in this article is for informational use only. Always discuss any medication with your health care provider or pharmacist before taking it. Also, refer to the medication package insert supplied by the pharmaceutical manufacturer with your prescription.
