Dapagliflozin

What is dapagliflozin?

Dapagliflozin is a prescription medication used to manage several chronic conditions[1]. 

What is dapagliflozin used to treat?

Dapagliflozin is used for[1]: 

• Type 2 diabetes – to help control blood sugar levels alongside diet and exercise 

• Heart failure – to reduce the risk of hospitalization and cardiovascular death 

• Chronic kidney disease (CKD) – to slow disease progression and reduce the risk of kidney failure and heart-related complications 

It is not suitable for people with type 1 diabetes. 

How does dapagliflozin work?

Dapagliflozin works by blocking SGLT2 proteins in the kidneys. This prevents glucose from being re-absorbed into the blood. Instead, glucose is excreted in urine, lowering blood sugar levels. It also helps reduce blood pressure and strain on the heart, which is beneficial in heart failure and CKD[1]. 

Who can take dapagliflozin?

Most adults can take dapagliflozin, and most children over 10 years old can take it for type 2 diabetes. 

It may not be suitable for people who[1]: 

• have ever had an allergic reaction to dapagliflozin or any other medicine 

• get frequent urinary tract infections 

• have low blood pressure, severe kidney impairment, or liver disease 

• are pregnant, trying to become pregnant or breastfeeding 

Please tell your doctor or pharmacist about any conditions you may have before you start treatment and always follow the instructions in the Patient Information Leaflet[2]. 

How do you take dapagliflozin?

Dapagliflozin is taken once each day, ideally at the same time to maintain effective levels in the body. The tablets should be swallowed whole, with a glass of water and avoiding cutting or chewing the tablets[1]. 

What is the typical dosage of dapagliflozin?

The usual dose for any indication is 10mg once daily, though this may be adjusted in individual cases. 

Can you stop taking dapagliflozin?

Do not stop taking dapagliflozin without consulting your doctor or pharmacist. If you stop taking it suddenly, your condition may get worse[1]. 

What do you do if you take too much dapagliflozin?

If you take more than the prescribed dose of dapagliflozin, you must contact your doctor. Taking too much can cause low blood sugar, excessive urination, or dehydration[1].  

What do you do if you forget a dose of dapagliflozin?

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. Never take 2 doses at the same time[1]. 

What are the side effects of dapagliflozin?

The most common side effects include[1]: 

• Genital infections (e.g., thrush) 

• Feeling dizzy 

• Increased urination 

• Thirst 

The rarer, but more serious side effects are[1]: 

• Dehydration – you are thirsty, sleepy, tired, and/or passing less urine 

• Urinary tract infection 

• Ketoacidosis 

• Kidney problems 

• Low blood pressure 

• Low blood sugar (especially when combined with other diabetes medication) 

Ketoacidosis (DKA) occurs when your cells do not have enough sugar and so uses fat for energy, which creates ketones. When the level of ketones builds too high, the blood becomes acidic which can become a medical emergency.  

Signs and symptoms include: 

• Increased thirst 

• Increased urination 

• Feeling nauseous 

• Confusion and tiredness 

• Deep or fast breathing  

• A fruity smelling breath 

• Dry mouth and skin 

• May cause fainting or unconsciousness in severe cases 

If you experience these symptoms, you should seek medical attention. 

Low blood sugar (hypoglycaemia) occurs quickly. It can usually be managed by following the “15-minute rule”. It is advised to eat or drink 15g to 20g of fast acting carbohydrate, such as those found in fresh orange juice, glucose tablets, and sugar containing sweets. You should then wait 15 minutes to see if your symptoms have eased. It is also advisable to eat a longer acting carbohydrate to help stabilise your blood sugars, reducing the recurrence of hypoglycaemia. Long-acting carbohydrates can be found in bread, bananas, and cereals.  

Signs and symptoms of hypoglycaemia include: 

• Shaking and trembling 

• Sweating 

• Feeling hungry 

• Irritability 

• Tiredness or weakness 

• Feeling dizzy or lightheaded 

• Tingling lips 

• Blurred vision 

• Slurred speech, seizures or loss of consciousness in severe cases. 

You will need to call 999 and seek medical attention if you or someone else is unconscious, having a seizure, or unable to swallow, and if your blood sugar levels do not rise after treatment. 

If you have a severe allergic reaction (swelling, difficulty breathing, rash), call 999 or go to A&E immediately. 

If you experience any side effects, including those not listed, you are encouraged to report them via the Yellow Card Scheme or contact your doctor, pharmacist, or nurse. This information is intended as a summary for general awareness and does not replace professional medical advice. 

The information provided in the side effects section is not a comprehensive list of all possible side effects associated with this medication. For a complete list of side effects, please refer to the Patient Information Leaflet (PIL) provided with your medication or consult your healthcare professional[2]. 

Taking other medications with dapagliflozin

Dapagliflozin is generally safe to use with other medications, however extra caution should be taken with the following[1]:

• Diuretics (water pills) – may increase dehydration risk 

• Insulin or sulfonylureas – may increase risk of low blood sugar 

• Medicines for high blood pressure – eg. ramipril 

• Lithium – dapagliflozin may increase lithium levels 

Always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine so they can make sure the treatment is appropriate for you.  

Always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine, and follow the instructions in the Patient Information Leaflet[2]. 

Frequently asked questions about dapagliflozin

Can dapagliflozin cause weight loss? 
Yes, some people may lose weight due to glucose loss, however, this is not the main purpose for this medication[1]. 

Can I drink alcohol while taking dapagliflozin? 
Drinking alcohol in moderation is ok when taking dapagliflozin, however alcohol can increase the risk of dehydration and hypoglycaemia and so extra caution should be taken[1]. 

Is dapagliflozin safe during pregnancy or breastfeeding? 
The manufacturer advises that dapagliflozin should not be taken during pregnancy or breast feeding[1]. 

Please inform your doctor if you are pregnant, planning to be pregnant, or breastfeeding. 

How long does it take to work? 
Dapagliflozin starts to work to lower blood sugars in a few hours, but it may take a week to take full effect. It may take a month or two before you notice any improvement in symptoms with heart and kidney treatments[1]. 

For the official NHS guide to dapagliflozin, visit their website.