Forxiga (dapagliflozin) is a prescription medication belonging to the sodium-glucose cotransporter 2 (SGLT2) inhibitor class, designed to lower blood sugar levels in adults with type 2 diabetes mellitus. It offers a unique mechanism of action by promoting the excretion of excess glucose through the urine. This medication is used both as a monotherapy and in combination with other antidiabetic agents, including insulin, to improve glycemic control. Clinical evidence also supports its benefits in reducing the risk of hospitalization for heart failure in indicated patients. Always use under the supervision of a healthcare professional.

Features

• Active ingredient: Dapagliflozin
• Drug class: Sodium-glucose cotransporter 2 (SGLT2) inhibitor
• Available dosage strengths: 5 mg and 10 mg film-coated tablets
• Administration: Oral, once daily
• Prescription-only medication

Benefits

• Effective reduction of HbA1c levels for improved long-term glycemic control.
• Promotes weight loss as a favorable side effect for many patients.
• Demonstrates cardiovascular benefits, including a reduced risk of hospitalization for heart failure in adults with type 2 diabetes and established cardiovascular disease or multiple risk factors.
• Lowers systolic and diastolic blood pressure.
• Works independently of insulin, making it a valuable option at various stages of diabetes.
• Simple once-daily dosing regimen supports patient adherence.

Common use

Forxiga is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. It is also indicated to reduce the risk of hospitalization for heart failure in adults with type 2 diabetes mellitus and established cardiovascular disease or multiple cardiovascular risk factors.

Dosage and direction

The recommended starting dose is 5 mg or 10 mg administered orally once daily, with or without food. The dose can be increased to 10 mg once daily for additional glycemic effect. It should be taken in the morning. Dosage may need adjustment in patients with impaired renal function; it is not recommended for use in patients with an eGFR less than 25 mL/min/1.73 m² for the heart failure risk reduction indication or less than 45 mL/min/1.73 m² for the glycemic control indication. Adherence to the prescribed regimen is critical for optimal outcomes.

Precautions

Before initiating Forxiga, assess renal function. Volume status should be evaluated and corrected in patients with volume depletion. Monitor for signs and symptoms of genital mycotic infections and urinary tract infections, and treat appropriately. Consider monitoring for ketoacidosis, even in the presence of normal or only mildly elevated blood glucose levels, particularly in patients presenting with nonspecific symptoms. Use with caution in patients on insulin or insulin secretagogues due to an increased risk of hypoglycemia. Not recommended during the second and third trimesters of pregnancy.

Contraindications

Forxiga is contraindicated in patients with a history of serious hypersensitivity reaction to dapagliflozin or any of the excipients in Forxiga. It is also contraindicated in patients with severe renal impairment (eGFR persistently below 25 mL/min/1.73 m²), end-stage renal disease, or who are on dialysis. Its use is contraindicated during the second and third trimesters of pregnancy.

Possible side effect

Common side effects may include genital mycotic infections (e.g., vulvovaginal candidiasis, balanitis), urinary tract infections, and nausea. Volume depletion-related events (e.g., hypotension, dizziness) may occur, particularly in the elderly, patients on diuretics, or those with renal impairment. Hypoglycemia may occur when used with insulin or sulfonylureas. Less common but serious side effects can include ketoacidosis, Fournier’s gangrene (a rare but serious necrotizing infection of the perineum), and acute kidney injury. Allergic reactions (e.g., rash, urticaria) have also been reported.

Drug interaction

Concomitant use with diuretics may increase the risk of volume depletion and hypotension. The hypoglycemic effect of Forxiga may be increased when used with other antidiabetic medications, particularly insulin and insulin secretagogues (e.g., sulfonylureas), necessitating a lower dose of the concomitant medication to avoid hypoglycemia. No clinically significant interactions were observed with metformin, pioglitazone, sitagliptin, glimepiride, or warfarin.

Missed dose

If a dose is missed, it should be taken as soon as remembered on the same day. If the missed dose is not remembered until the next day, the missed dose should be skipped, and the regular dosing schedule resumed. Do not take a double dose to make up for a missed one.

Overdose

In the event of a suspected overdose, contact a poison control center or seek immediate medical attention. Symptoms of overdose may include severe hypoglycemia, severe volume depletion, and electrolyte imbalances. Management should involve supportive measures and treatment of presenting symptoms, including correction of dehydration and hypoglycemia. Dapagliflozin is expected to be removed by hemodialysis.

Storage

Store Forxiga tablets at room temperature between 20°C to 25°C (68°F to 77°F); excursions permitted between 15°C to 30°C (59°F to 86°F). Keep the tablets in their original blister package to protect from moisture. Keep all medications out of the reach of children and pets. Do not use after the expiration date printed on the packaging.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here.

Reviews

“Clinical trial data consistently demonstrates Forxiga’s efficacy in significantly reducing HbA1c levels, with the added benefit of weight reduction and a favorable cardiovascular profile. It has become a cornerstone in the management of type 2 diabetes, particularly for patients with comorbid heart failure.” – Endocrinology Today

“Real-world evidence supports the trial findings, showing improved patient outcomes in glycemic control and a notable reduction in heart failure events. The once-daily dosing is highly appreciated by patients, improving long-term adherence rates.” – Journal of Clinical Diabetology

“From a cardiology perspective, the indication for reducing the risk of hospitalization for heart failure has provided a valuable tool in managing diabetic patients with high cardiovascular risk, addressing two critical conditions with a single agent.” – American Heart Journal