dapagliflozin + metformin at a glance
Medicine class
SGLT2 inhibitor plus biguanide
Licensed role
Blood-glucose control in adults with type 2 diabetes, alongside diet and exercise
Taking the tablet
Swallow whole with water and take with food to reduce stomach effects
Urine tests
Urine will usually test positive for glucose because dapagliflozin increases glucose excretion
What is dapagliflozin + metformin used for?
Licensed for adults with type 2 diabetes alongside diet and exercise.
When the maximum tolerated metformin treatment has not provided sufficient control.
With other glucose-lowering treatments when these and metformin have not provided sufficient control.
As a fixed-combination replacement when dapagliflozin and metformin are already taken separately.
How does dapagliflozin + metformin work?
Dapagliflozin blocks SGLT2 in the kidneys, causing more glucose to leave in urine. Metformin mainly reduces liver glucose production and improves the body's response to insulin. Neither directly stimulates insulin release.
dapagliflozin + metformin preparations and strengths
Tablet
Route: Oral
Strengths: 5 mg + 1000 mg, 5 mg + 850 mg
How to take dapagliflozin + metformin
Follow the prescription label and instructions supplied with your product.
Swallow the film-coated tablet whole with water.
Take it with food to reduce metformin-related stomach effects.
Continue the diet, activity and glucose-monitoring plan agreed with your healthcare team.
During significant vomiting, diarrhoea, fever, reduced fluid intake or dehydration, temporarily stop it and contact a healthcare professional for sick-day advice.
dapagliflozin + metformin side effects
Common or expected effects
- Nausea, vomiting, diarrhoea, abdominal discomfort or reduced appetite, especially when starting treatment
- Genital thrush or related genital infection
- Urinary tract infection
- Passing urine more often
- Dizziness or back pain
- Reduced vitamin B12 levels, particularly with longer-term metformin use
- Low blood glucose when combined with insulin or a sulfonylurea
Get urgent medical advice
- Diabetic ketoacidosis, which can occur without very high blood glucose
- Lactic acidosis
- Severe dehydration or symptomatic low blood pressure
- Severe urinary infection, including kidney infection or urosepsis
- Fournier's gangrene: severe infection around the genitals or perineum
- Serious allergic reaction
dapagliflozin + metformin in pregnancy
The combination is not recommended during pregnancy because dapagliflozin information is limited and there are concerns about fetal kidney development later in pregnancy. Contact the diabetes team promptly when planning pregnancy or becoming pregnant. Metformin alone may be used during pregnancy, but this does not make the combination suitable.
dapagliflozin + metformin while breastfeeding
The combination should not be used while breastfeeding because infant exposure and safety data for dapagliflozin are inadequate. Metformin alone passes into milk in small amounts and can often be used when the infant is healthy, but changes must be agreed with the prescriber.
dapagliflozin + metformin interactions
Important interactions may involve low glucose, dehydration, kidney function or lactic acidosis.
Insulin or sulfonylureas
May increase hypoglycaemia risk, requiring review of accompanying treatment and glucose readings.
Loop or thiazide diuretics
Additive fluid loss can increase dehydration and low-blood-pressure risk.
NSAIDs, ACE inhibitors or angiotensin receptor blockers
Reduced kidney function may increase metformin accumulation and lactic-acidosis risk, requiring renal monitoring.
Common questions about dapagliflozin + metformin
Answers are fully visible for fast scanning and source review.
Is it licensed for heart failure or chronic kidney disease?
No. The selected fixed-combination products are licensed for type 2 diabetes. Dapagliflozin alone has additional licensed roles, but these do not extend to the combination tablet.
Can it cause low blood sugar?
It does not usually cause hypoglycaemia by itself, but risk rises with insulin or a sulfonylurea.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.