Dapagliflozin
Is It Right for You?
A complete guide to Dapagliflozin — what it treats, how it works, dosages, side effects, and when a clinician may prescribe it following an online consultation.
What Is Dapagliflozin?
Dapagliflozin is a medicine used to treat type 2 diabetes. It lowers blood sugar by helping the kidneys remove excess glucose from the body in the urine. It is also used to help protect the heart and kidneys in certain patients.
It belongs to a group of medicines called SGLT2 inhibitors and is taken as a tablet once a day. It is available under the brand name Forxiga and is used either on its own or alongside other diabetes treatments.
Dapagliflozin is a prescription-only medication in the UK. A licensed clinician must review your diabetes control, kidney function, and medical history before it can be prescribed - which can now be done conveniently through a telehealth consultation.
What Conditions Is Dapagliflozin Used For?
Dapagliflozin is prescribed for:
lowering blood sugar, alone or in combination with other diabetes medicines.
reducing the risk of hospitalisation and improving outcomes in certain patients with heart failure.
slowing the progression of kidney disease in eligible patients.
Rarely, SGLT2 inhibitors can cause a serious condition called diabetic ketoacidosis, sometimes even when blood sugar is not high. Seek urgent medical help if you feel very unwell with nausea, vomiting, tummy pain, rapid breathing, or unusual tiredness.
How Does Dapagliflozin Work?
Dapagliflozin works in the kidneys. Normally the kidneys filter glucose out of the blood and then reabsorb it back. Dapagliflozin blocks a protein called SGLT2 that is responsible for this reabsorption.
By blocking SGLT2, more glucose is passed out of the body in the urine instead of being returned to the blood. This lowers blood sugar levels and, because glucose carries calories and water with it, can also lead to modest weight loss and lower blood pressure.
These effects on fluid balance and the heart and kidneys are thought to explain why dapagliflozin also benefits people with heart failure and kidney disease, even beyond its effect on blood sugar.
Dosages & Administration
The correct dose depends on the type and severity of infection, age, weight, and kidney function. Always follow your clinician's instructions. The table below is for general reference only.
Administration Tips
Take at the same time each day, with or without food. Swallow the tablet whole with water.
Keep well hydrated and pay attention to genital and urinary hygiene, as this medicine increases glucose in the urine.
Side Effects of Dapagliflozin
Side effects often relate to the extra glucose passing through the urinary tract. Most are manageable.
- Genital thrush or itching
- Urinary tract infections
- Passing more urine
- Increased thirst
- Dizziness, especially when standing
- Mild weight loss
- Diabetic ketoacidosis - feeling very unwell, nausea, rapid breathing
- Severe genital infection (including rare Fournier's gangrene - pain, swelling, redness of the genital area)
- Signs of serious dehydration
- Symptoms of a serious urinary infection with fever
- Persistent low blood sugar (when combined with other diabetes medicines)
If you become acutely unwell, are unable to eat or drink normally, or are having surgery, you may be advised to stop dapagliflozin temporarily to reduce the risk of ketoacidosis. Follow your clinician's sick-day guidance.
Drug Interactions
Always disclose all prescription drugs, over-the-counter medicines, vitamins, and supplements to your clinician or pharmacist before starting dapagliflozin.
Combined use can increase the risk of dehydration and low blood pressure. Your clinician may monitor you more closely.
When taken with these, the risk of low blood sugar rises, so their dose may need to be reduced.
Dapagliflozin can add to their blood-pressure-lowering effect, occasionally causing dizziness.
These may affect kidney function, especially if you are also dehydrated.
Important Warnings
Your kidney function should be checked before and during treatment, as dapagliflozin's effect on blood sugar depends on the kidneys working adequately.
Because it increases urine output, dapagliflozin can cause dehydration and low blood pressure, particularly in older adults or those on diuretics. Drink adequately and report dizziness.
Extra glucose in the urine raises the risk of thrush and urinary infections. Good hygiene helps; tell your clinician if infections are frequent or severe.
Dapagliflozin is not recommended in pregnancy or breastfeeding. Tell your clinician if you are pregnant, planning pregnancy, or breastfeeding so treatment can be changed.
Speak to a Clinician About Treatment
Getting advice no longer means sitting in a waiting room. Through The GP Service, you can consult with a licensed clinician in minutes — from home, on your lunch break, or wherever works for you. If treatment is clinically appropriate, your clinician can issue a prescription during the consultation. A consultation does not guarantee a prescription.
The treatment you need, when you need it.
Dapagliflozin FAQs
Yes. A licensed clinician can review your diabetes control, kidney function, and history through a telehealth consultation and prescribe dapagliflozin if appropriate, with ongoing monitoring.
Many people lose a modest amount of weight because glucose - and its calories - is passed out in the urine. It is not licensed as a weight-loss medicine, however.
Extra glucose in the urine creates conditions where yeast can grow. Good genital hygiene reduces the risk; tell your clinician if infections recur so they can be treated.
Moderate alcohol is usually acceptable, but heavy drinking increases the risk of low blood sugar and dehydration. Discuss your situation with your clinician.
If you are vomiting, unable to eat or drink, or seriously ill, follow your sick-day rules - you may be advised to pause the medicine to avoid ketoacidosis, and you should seek medical advice.
Take it as soon as you remember unless it is almost time for the next dose, in which case skip it. Do not take a double dose.