Dapagliflozin+Metformin, Xigduo
Description: Antidiabetic Agent, Sodium-Glucose Cotransporter (SGLT2) Inhibitor, Sodium-Glucose Transporter 2 (SGLT2) Inhibitor
“Alert: US Warning
Metformin has been associated with lactic acidosis resulting in death, hypothermia, hypotension and arrhythmias. If metformin-associated lactic acidosis is suspected, immediately discontinue medication and institute general supportive measures. Prompt hemodialysis is recommended.”
CSA NA – FDA Approved – REMS (N) – Can Ship
How Does It Work
Xigduo is a combination of dapagliflozin, a sodium-glucose cotransporter (SGLT2) inhibitor and metformin, a biguanide that works together to lower blood glucose levels in type 2 diabetes. Metformin decreases the production of glucose from the liver, reducing intestinal absorption of glucose and improves insulin sensitivity. Dapagliflozin inhibits sodium-glucose cotransporter 2 (SGLT2) in the proximal renal tubules, reduces the reabsorption of filtered glucose from the renal tubules resulting in increased urinary excretion of glucose, thereby lowering the blood glucose concentration.
Indications For Use
Type 2 Diabetes
Precautions
Before starting Dapagliflozin+Metformin, Xigduo XR/Xigduo make sure your physician is aware of any allergies or medications you currently take, and activities you perform. Dapagliflozin+Metformin, Xigduo XR/Xigduo have been associated with an increased incidence of bone fractures, genital mycotic infections (i.e. vulvovaginal mycotic infection, vulvovaginal candidiasis, vulvovaginitis, candida balanitis, balanoposthitis), hypotension, ketoacidosis, lower limb amputation, necrotizing fasciitis, vitamin B12 deficiency, and worsening renal function. Dapagliflozin+Metformin, Xigduo XR/Xigduo should not be used in patients with heart failure, renal and/or hepatic impairment.
Usual Dosing
Usual (Oral): Initial dose should be based on your current daily dose of dapagliflozin and metformin.
ER: Take once daily. Maximum daily dose of dapagliflozin 10mg/metformin 2000mg.
IR: Take twice daily. Maximum daily dose of dapagliflozin 10mg/metformin 2000mg.
Note: If present, correct volume depletion prior to initiation. If converting from a metformin ER product that is being taken in the evening, skip the last dose before starting the dapagliflozin/metformin combination product. May require a gradual dose reduction of insulin and/or insulin secretagogues to avoid hypoglycemia.
Pharmacist Tips On Using
How to Take Dapagliflozin+Metformin, Xigduo: Take with meals, the same time each day. Swallow the tablet whole, do not break, crush, or chew.
Side Effects
Headache, dizziness, dyslipidemia, genitourinary fungal infection, influenza, nausea, constipation, urinary tract infection, increased urine output, cough, pharyngitis
Note this is not a complete list of side effects, only the most common.
Frequently Asked Questions
What do I do if the side effects are not tolerable?
If the side effects are causing a lot of distress speak to our physician as soon as possible to discuss options.