Dapagliflozin

About Dapagliflozin

Dapagliflozin blocks SGLT2, the kidney transporter that reabsorbs filtered glucose, so more glucose leaves in the urine; it also reduces sodium reabsorption. Farxiga is labeled to lower the risk of sustained loss of kidney function, end-stage kidney disease, cardiovascular death and hospitalization for heart failure in adults with chronic kidney disease at risk of progression; to lower the risk of cardiovascular death, hospitalization and urgent visits for heart failure in adults with heart failure; to lower the risk of hospitalization for heart failure in adults with type 2 diabetes and cardiovascular disease or several cardiovascular risk factors; and, with diet and exercise, for blood sugar control in adults and, since June 2024, children 10 and older with type 2 diabetes. For blood sugar it starts at 5 mg once a day and can rise to 10 mg; for the heart and kidney uses the dose is 10 mg once a day. It is taken with or without food, after kidney function and fluid status are checked.

There is no boxed warning; it must not be taken after a serious allergic reaction to dapagliflozin. Ketoacidosis, sometimes fatal, can occur with blood sugar below the usual level for it, such as under 250 mg/dL, so it is not used for type 1 diabetes, is stopped if ketoacidosis is suspected, and is held for at least three days before surgery or prolonged fasting when possible. It can cause dehydration and low blood pressure, especially with an eGFR below 60, older age or loop diuretics, and acute kidney injury, sometimes needing dialysis, has been reported. The label also warns of genitourinary infections, including urosepsis, kidney infections, genital yeast infections and Fournier’s gangrene, a dangerous infection of the perineum, and of low blood sugar with insulin or a sulfonylurea. Genital yeast infections in women, a stuffy or runny nose with sore throat, and urinary tract infections are the most common side effects.

For blood sugar control it is not recommended when eGFR is below 45. For the heart and kidney uses it is not started when eGFR is below 25, though people already taking it can continue, and its trials did not enroll people on dialysis. It is not recommended for chronic kidney disease in polycystic kidney disease or for people who need, or recently had, immunosuppressive therapy for kidney disease. Urine glucose tests turn positive and the 1,5-AG test is unreliable. It is not recommended in the second and third trimesters of pregnancy or during breastfeeding. In June 2026 the label’s infection warning and missed-dose advice were revised. Xigduo XR, with metformin, is a separate product also sold as generics, while the FDA lists Qtern, with saxagliptin, as discontinued.

Taking Dapagliflozin

How to take it

Once a day at about the same time, with or without food. Drink plenty of water, and tell the prescriber about vomiting, diarrhea or heavy sweating, which can cause dehydration; it is usually stopped at least 3 days before surgery.

If you miss a dose

Take it as soon as you remember. Do not double the next dose to make up for it.

Storage

At room temperature in the container it came in, tightly closed, away from excess heat and moisture (not in the bathroom), out of reach of children.

Interactions to know about

Insulin and sulfonylureas raise the risk of low blood sugar, so their doses may be lowered, and it can lower lithium levels. Alcohol can change blood sugar and worsen side effects. It makes urine glucose tests positive and the 1,5-AG test unreliable.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Dapagliflozin differs from pharmacy to pharmacy

Generic dapagliflozin, rated equivalent to Farxiga, has been sold by many makers since April 2026, and quotes for the same generic tablet can differ between pharmacies. A prescription that names Farxiga and blocks substitution is priced as a brand.

Combination tablets with metformin (Xigduo XR and its generics) are separate products, so compare quotes for the exact product and strength on the prescription.

Ways to pay less for Dapagliflozin without insurance

• Ask for generic dapagliflozin, and make sure the prescription does not block substitution.
• Ask whether dapagliflozin is on the pharmacy’s flat-price generic list, and compare more than one pharmacy.
• Once your dose is stable, ask the prescriber for a ninety-day supply.
• If you take Xigduo XR, ask whether a generic dapagliflozin and metformin extended-release tablet can be dispensed instead.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Dapagliflozin

1. 1.Is my generic rated equivalent to Farxiga?
2. 2.Should I stop it before my surgery or procedure, and when do I restart?
3. 3.Which signs of ketoacidosis or a genital infection mean I should get help right away?
4. 4.Do my insulin, sulfonylurea or lithium doses need checking?

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