Dapagliflozin at a glance
Medicine class
Sodium-glucose co-transporter 2 (SGLT2) inhibitor.
Main licensed uses
Type 2 diabetes, symptomatic chronic heart failure and chronic kidney disease.
Taking the tablet
Swallow whole, with or without food.
Urine glucose tests
Positive urine glucose tests are an expected effect.
What is Dapagliflozin used for?
The selected UK product is licensed for:
Insufficiently controlled type 2 diabetes in adults and children aged 10 years and over, alongside diet and exercise. It may be used when metformin is unsuitable because of intolerance or alongside other diabetes medicines.
Symptomatic chronic heart failure in adults, including people without diabetes.
Chronic kidney disease in adults, including people without diabetes.
How does Dapagliflozin work?
Dapagliflozin blocks SGLT2 in the kidney, reducing the return of filtered glucose and sodium to the blood. More glucose, sodium and water leave in the urine. This lowers blood glucose and changes pressure and fluid handling within the kidneys and circulation, contributing to its kidney and heart effects.
Dapagliflozin preparations and strengths
Tablet
Route: Oral
Strengths: 5 mg, 10 mg
How to take Dapagliflozin
Swallow the film-coated tablet whole, with or without food. Follow the pack label and contact a pharmacist or prescriber if swallowing is difficult or the instructions are unclear.
Keep adequately hydrated unless a clinician has advised fluid restriction.
Vomiting, diarrhoea, fever or inability to eat and drink can increase dehydration and ketoacidosis risk. Obtain professional advice because temporary interruption may be needed.
Do not stop insulin independently when dapagliflozin is interrupted.
Dapagliflozin side effects
Common or expected effects
- Genital thrush or related genital infection
- Urinary tract infection
- Passing urine more often or discomfort when urinating
- Dizziness or back pain
- Low blood glucose when combined with insulin or a sulfonylurea
Get urgent medical advice
- Diabetic ketoacidosis, which may occur with near-normal blood glucose
- Severe urinary infection, including kidney infection or urosepsis
- Dehydration, low blood pressure or marked reduction in urine output
- Fournier’s gangrene: severe genital or perineal pain, tenderness, redness or swelling with fever or malaise
- Serious allergic reaction or angioedema
Dapagliflozin in pregnancy
Dapagliflozin is not recommended during pregnancy because human evidence is limited and animal studies identified concerns about the developing kidney. Anyone planning pregnancy or who becomes pregnant should obtain prompt prescriber or specialist review.
Dapagliflozin while breastfeeding
Dapagliflozin should not be used while breastfeeding. It is unknown whether it enters human milk, and a risk to the infant—particularly the developing kidneys—cannot be excluded.
Dapagliflozin interactions
Important medicine combinations include:
Insulin and sulfonylureas, such as gliclazide
The combination increases hypoglycaemia risk, so accompanying diabetes treatment may require clinician review.
Loop or thiazide diuretics, such as furosemide
Additive fluid loss can increase dehydration and low-blood-pressure risk.
Blood-pressure-lowering medicines
Dizziness or symptomatic low blood pressure may be more likely, particularly with dehydration.
Common questions about Dapagliflozin
Answers are fully visible for fast scanning and source review.
Can dapagliflozin be used without diabetes?
Yes. It is licensed for symptomatic chronic heart failure and chronic kidney disease in adults with or without diabetes.
Can dapagliflozin cause low blood sugar?
It has a low hypoglycaemia risk by itself, but risk increases with insulin or a sulfonylurea such as gliclazide.
Can ketoacidosis occur with a normal glucose reading?
Yes. It may occur when blood glucose is only moderately raised or near normal, so symptoms require urgent assessment regardless of the reading.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.