FARXIGA/FORXIGA (Dapagliflozin)

What is this medication?

FARXIGA/FORXIGA (Dapagliflozin)
Antidiabetic Agent; Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitor 

Brand Name US: Farxiga
Canadian Equivalent: Forxiga

Dapagliflozin is indicated for Diabetes mellitus type 2 and as an adjunctive therapy for the treatment of heart failure with reduced ejection fraction.

How does this medication work? 

SGLT2 is in the proximal renal tubules of the nephron (a functional unit of the kidney) and is the main site of reabsorption of filtered glucose.  FARXIGA/FORXIGA (Dapagliflozin) 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.

How should I take this medication? 

Oral: Take 5-10mg once daily.

How to Take: Follow instructions provided by physician/pharmacy label, take consistently at same time each day usually in the morning due to diuretic effect unless otherwise directed.  Monitor blood pressure when initiating due to diuretic effect.

Note: Do not skip standard diabetic foot care regimen.  Must monitor for wounds or signs of 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 diuretic effect of this medication.

What should I watch for while using this medication? 

Before starting FARXIGA/FORXIGA (Dapagliflozin), 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.

What if I miss a dose?

If you miss a dose of medication, try to take it as soon as possible. However, if it is almost time for your next dose, take only that scheduled dose. Do not take double or extra doses.

How should I store this medication?

Keep out of the reach of children at all times. Store at room temperature, 59 to 86° F (15 to 30° C). Protect from light. Keep the container tightly closed. Properly dispose of any unused medication after the expiration date.

What are the possible side effects of using 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 for FARXIGA/FORXIGA (Dapagliflozin), only common ones.