Forxiga (Dapagliflozin): What is it used for, How does it work, What are the side effects?
What is Forxiga used for?
- FORXIGA (Dapagliflozin) is used along with diet and exercise to:
- improve blood sugar levels in adults with type 2 diabetes. FORXIGA can be used:
- alone, if you cannot take metformin,
- with metformin,
- with a sulfonylurea,
- with metformin and a sulfonylurea,
- with sitagliptin (with or without metformin),
- with insulin (with or without metformin).
- reduce the risk of hospitalization due to heart failure in adults:
- with type 2 diabetes; and
- that have or are at risk of developing cardiovascular disease (heart and blood vessel problems)
- improve blood sugar levels in adults with type 2 diabetes. FORXIGA can be used:
- FORXIGA is used in adults along with other medicines to treat heart failure. In these patients, FORXIGA reduces the risk of:
- death due to cardiovascular problems
- hospitalization or urgent visits due to heart failure
- FORXIGA is used in adults with chronic kidney disease to reduce their risk of:
- further decline in kidney function
- progression to end-stage kidney disease
- death due to cardiovascular problems or kidney failure
How does FORXIGA work?
FORXIGA belongs to a class of medicines called Sodium-glucose co-transporter 2 (SGLT2) inhibitors. It removes excess sugar from the body through the urine. This reduces the amount of sugar in the blood. FORXIGA also provides benefits to the heart and kidneys.
What are the ingredients in Forxiga?
Medicinal ingredients: Dapagliflozin (as dapagliflozin propanediol monohydrate).
Non-medicinal ingredients: Anhydrous lactose, crospovidone, magnesium stearate, microcrystalline cellulose, polyethylene glycol, polyvinyl alcohol, silicon dioxide, talc, titanium dioxide and yellow iron oxide.
What strengths is Forxiga available in?
Tablets: 5 mg and 10 mg.
Who should not use Forxiga?
- you are allergic to dapagliflozin or to any of the other ingredients in FORXIGA.
- you are on dialysis
To help avoid side effects and ensure proper use, talk to your healthcare professional before you take Forxiga. Talk about any health conditions or problems you may have, including if you:
- have type 1 diabetes (your body does not produce any insulin). FORXIGA should not be used in patients with type 1 diabetes.
- have an increased chance of developing diabetic ketoacidosis (DKA), including if you:
- are dehydrated or suffer from excessive vomiting, diarrhea, or sweating
- are on a very low carbohydrate diet
- have been fasting for a while
- are eating less, or there is a change in your diet
- drink a lot of alcohol
- have/have had problems with your pancreas, including pancreatitis or surgery on your pancreas
- are hospitalized for major surgery, serious infection or serious medical illness. If you are going to have a surgery and after your surgery, or if you are hospitalized for a major surgery, a serious infection, or a serious medical illness, your healthcare professional may stop your treatment with FORXIGA. Talk to your healthcare professional about when to stop taking FORXIGA and when to start taking it again.
- have a sudden reduction in your insulin dose
- have a history of DKA.
- are older than 65 years of age
- have or have had any kidney problems
- have received immunosuppressive therapy (treatment that lowers the activity of your immune system) to treat your kidney problems.
- are on dialysis
- have or have had any cases of liver disease
- have low blood pressure
- have or have had heart disease or heart failure
- are taking a medicine to lower your blood pressure, including diuretics, known as water pills. If you take FORXIGA with these medicines, it can increase the risk of dehydration.
- are taking medicines to lower your blood sugar. Tell your healthcare professional about all of the medicines you are taking to control your diabetes.
- have a history of yeast infection of the vagina or penis
- have a history of urinary tract infections
- have Anti-Neutrophil Cytoplasmic Antibody (ANCA)-associated vasculitis, which is an autoimmune disease affecting small blood vessels in the body
- have intolerance to some milk sugars. FORXIGA tablets contain lactose.
Other warnings you should know about Forxiga?
FORXIGA can cause serious side effects, including:
- Hypotension (low blood pressure): This is common in patients with high blood sugar (glucose).
- Hypoglycemia (low blood sugar) in patients with type 2 diabetes: FORXIGA can cause low blood sugar when used with other antidiabetic medications, including insulin. Your healthcare professional may adjust your dose of insulin or other antidiabetic medicines when taking FORXIGA. This is to help you keep your blood sugar levels within the normal range during your treatment.
- Yeast infection: FORXIGA increases your chance of getting a yeast infection of the vagina or penis, especially if you have had them in the past.
- Urinary tract infection
- Urosepsis: This is a severe infection that spreads from the urinary tract throughout the body. This condition is serious and may be life-threatening if left untreated. If you experience signs of this condition, stop taking FORXIGA right away and seek immediate medical help.
- Fournier’s gangrene: This is a serious infection affecting the soft tissue around the groin. Rare cases of Fournier’s gangrene have been reported in patients with type 2 diabetes while taking SGLT2 inhibitors like FORXIGA. This condition is serious and may be life threatening. If you experience signs of this condition, stop taking FORXIGA right away and seek immediate medical help.
- Kidney problems in patients with type 2 diabetes: This may happen shortly after you start taking FORXIGA.
See the Serious side effects and what to do about them table, below, for more information on these and other serious side effects.
Driving and using machines: Before doing tasks that require special attention, wait until you know how you respond to FORXIGA. Dizziness, light-headedness, or fainting can occur, particularly when FORXIGA is taken with insulin or other antidiabetic medicines.
Can you use Forxiga while pregnant or breastfeeding?
Pregnancy: FORXIGA should not be taken during pregnancy. It is not known if FORXIGA will harm your unborn baby. If you discover that you are pregnant while taking FORXIGA, stop the medication and contact your healthcare professional as soon as possible.
Breastfeeding: FORXIGA should not be taken if you are breastfeeding. It is not known if FORXIGA will pass into your breastmilk and harm your baby. Talk to your healthcare professional about ways to feed your baby if you are planning to breastfeed while taking FORXIGA.
Can children and adolescents use Forxiga?
FORXIGA is not to be used in children and adolescents under 18 years of age.
What testing and followup is recommended for Forxiga?
- Your healthcare professional may decide to perform tests before taking FORXIGA and/or during treatment. These tests will check:
- The amount of cholesterol (a type of fat) in your blood
- The amount of red blood cells in your body
- The amount of sugar (glucose) in your blood
- That your kidneys are working properly
- The volume of blood in your body
- The level of electrolytes in your blood
- FORXIGA will cause your urine to test positive for sugar (glucose).
Tell your healthcare professional about all the medicines you take, including any drugs, vitamins, minerals, natural supplements or alternative medicines.
What medications may interact with Forxiga?
- medicines you take for diabetes to lower your blood sugar levels. This includes sulfonylurea medication such as glyburide, gliclazide or glimepiride, or insulin. If you take FORXIGA with any of these medicines, it can increase the risk of low blood sugar. Your healthcare professional will tell you how much of each medicine to take.
- medicines used to lower your blood pressure, including diuretics, known as water pills. If you take FORXIGA with these medicines, it can increase the risk of dehydration
How to take Forxiga?
- as directed by your healthcare professional
- once a day
- at any time of the day
- by mouth
- with or without food
Swallow tablet whole. Do not cut or divide FORXIGA tablets.
What is the usual dose of Forxiga?
The dose of FORXIGA prescribed to you will depend on your condition and your response to treatment.
Patients with type 2 diabetes:
To control your blood sugar: the usual adult starting dose is one 5 mg tablet a day. Your healthcare professional may increase your dose to one 10 mg tablet a day, if needed.
To reduce your risk of hospitalization due to heart failure: the usual adult dose is one 10 mg tablet a day.
Patients with Heart Failure or Chronic Kidney Disease:
The usual adult dose is one 10 mg tablet a day.
What should you do if you overdose on Forxiga?
If you think you, or a person you are caring for, have taken too much FORXIGA, contact a healthcare professional, hospital emergency department, or regional poison control centre immediately, even if there are no symptoms.
What to do if you miss a Forxiga dose?
If you miss a dose of FORXIGA, take it as soon as you remember. If you do not remember until it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not take a double dose.
What are possible side effects from using FORXIGA?
These are not all the possible side effects you may feel when taking FORXIGA. If you experience any side effects not listed here, contact your healthcare professional.
Side effects may include:
- sore throat
- flu (fever, tiredness, body aches)
- stuffy or runny nose
- back pain
- pain in the arms, legs, hands or feet
- joint pain
If any of these affects you severely, tell your healthcare professional.
FORXIGA can cause abnormal blood test results. Your healthcare professional will decide when to perform blood tests. They will tell you if your test results are abnormal and if you need treatment to correct these side effects.
What are the serious side effects of Forxiga?
Serious side effects and what to do about them
Symptom / effect
Talk to your healthcare professional
Stop taking drug and get immediate medical help
Only if severe
In all cases
Urinary tract infection: Pain or burning sensation while urinating, frequent urination, blood in urine, pain in the pelvis, strong smelling urine, cloudy urine
Yeast infection of vagina: severe itching, burning, soreness, irritation, and a whitish or whitish-gray cottage cheese-like discharge
Yeast infection of penis: red, swollen, itchy head of penis, thick, lumpy discharge under foreskin, unpleasant odour, difficulty retracting foreskin, pain passing urine or during sex
Volume depletion (loss of needed fluids from the body; dehydration): dry or sticky mouth, headache, dizziness or urinating less often than normal, thirst
Hypotension (low blood pressure): dizziness, fainting, lightheaded-ness; may occur when you go from lying to sitting to standing up
Hypoglycemia (low blood sugar) in patients with type 2 diabetes: shaking, sweating, rapid heartbeat, change in vision, hunger, headache and change in mood
Diabetic ketoacidosis (DKA) in patients with type 2 diabetes: difficulty breathing, nausea, vomiting, stomach pain, loss of appetite, confusion, feeling very thirsty, feeling unusual tiredness, a sweet smell to the breath, a sweet or metallic taste in the mouth, or a different odour to urine or sweat
Kidney problems in patients with type 2 diabetes: any change in the amount, frequency or colour (pale or dark) of urine
Fournier’s gangrene (a serious infection affecting soft tissue around the groin): pain or tenderness, redness of the skin, or swelling in the genital or perineal area, with or without fever or feeling very weak, tired, or uncomfortable
Acute kidney infection: painful, urgent or frequent urination, lower back (flank) pain, fever or chills, cloudy or foul smelling urine, blood in your urine
Urosepsis (severe infection that spreads from urinary tract throughout body): fever or low body temperature, chills, rapid breathing, rapid heartbeat, pain with urination, difficulty urinating, frequent urination
Pancreatitis (inflammation of the pancreas): upper abdominal pain, fever, rapid heart beat, nausea, vomiting, tenderness when touching the abdomen
If you have a troublesome symptom or side effect that is not listed here or becomes bad enough to interfere with your daily activities, tell your healthcare professional.
How to store Forxiga?
- Store at room temperature (15 to 30 °C).
- Keep FORXIGA out of the reach and sight of children.
Disclaimer: We have made every effort to ensure that all information is factually correct and up to date, however this article is not comprehensive and does not contain all relevant information about the topic. IT should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should consult your doctor or pharmacist before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.