Description: Antidiabetic Agent; Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitor
Brand Name US: Farxiga
Canadian Equivalent: Forxiga
CSA NA – FDA Approved – REMS (N) – Can Ship
How Does it Work
SGLT2 is in the proximal renal tubules of the nephron (a functional unit of the kidney) and is the main site of the reabsorption of filtered glucose. Dapagliflozin, Forxiga/Farxiga inhibits this transporter which lowers glucose reabsorption and lowers the renal threshold for glucose resulting in its urinary excretion thereby lowering plasma glucose concentrations. It also reduces sodium reabsorption and increases sodium delivery to the distal tubule which may decrease cardiac preload/afterload and downregulate sympathetic activity.
Indications For Use
Dapagliflozin, Forxiga/Farxiga is indicated for Diabetes mellitus type 2 and as adjunctive therapy for the treatment of heart failure with reduced ejection fraction.
Before starting Dapagliflozin, Forxiga/Farxiga make sure your physician is aware of any allergies, medications you currently take, if you have kidney disease, a history of diabetic ketoacidosis, have had bariatric surgery, are pregnant, or breastfeeding.
5-10mg once daily
Pharmacist Tips On Using
How to Take Dapagliflozin, Forxiga/Farxiga: Follow instructions provided by physician/pharmacy label, take consistently at the same time each day usually in the morning due to diuretic effect unless otherwise directed, store at room temperature. Monitor blood pressure when initiating due to diuretic effect.
You Need to Avoid: Do not skip a standard diabetic foot care regimen. Must monitor for wounds or signs of a new infection, ulcers, sores or new pain or tenderness. A trial involving a similar medication (canagliflozin) showed a higher frequency of lower limb amputations compared to placebo so caution must be taken. There is no direct evidence of dapagliflozin having this effect but due to similarities, it should be taken seriously. Avoid volume depletion or dehydration due to the diuretic effect of this medication.
Urinary tract infection (due to sugar content in urine – more common in females due to shorter urethra), increased urine output, genitourinary fungal infection (more common in females), nasopharyngitis, back pain, influenza, dyslipidemia, nausea, thirst
(Note this is not a complete list of side effects only the most common ones)
Frequently Asked Questions
What is hypoglycemia?
Hypoglycemia is a condition of low blood sugar (>3.9mmol/L-Canada; 70mg/dL-US) which is considered a medical emergency whereas hyperglycemia is a slow progressive condition. It generally occurs with irregularities in diet, exercise, and medications in diabetic patients. It is preferably treated with simple sugars such as dextrose; regular table sugar can work but is slower acting as it needs to be digested and if blood sugar is extremely low this delay can be a problem. Hypoglycemia has a large host of progressive symptoms from hunger, headache, nausea, sweating, palpitations, mood swings, irritability to seizure, coma and in severe cases, death.