You may have more than one side effect if you take the diabetes drug dapagliflozin (Farxiga) or none at all. Most are mild, and they often go away in a few weeks as your body grows accustomed to the drug.
You can take steps to avoid or deal with some of these side effects. The most important thing is to carefully follow your doctor’s instructions for taking the drug. And if any side effect bothers you a lot or interferes with your daily life, tell your doctor about it.
Serious side effects are rare, but it’s important to know what to do if they happen to you.
How to Manage Common Side Effects of Dapagliflozin (Farxiga)
Some of the more common side effects of this medication are:
Changes in how much or how often you pee. You may pee more often, including at night, or pee a larger amount than usual. Dapagliflozin lowers blood sugar by stopping your kidneys from reabsorbing glucose from your blood. The extra glucose leaves your body in your urine, so you pee more.
Even if this happens to you, don’t cut down on how much liquid you drink. That could lead to dehydration, another possibly serious side effect of dapagliflozin. But it’s a good idea to avoid caffeinated drinks and alcohol, since both can make you pee more. You might try to drink more of your liquids in the daytime to avoid getting up during the night. But don’t let yourself get too thirsty.
Cold-like symptoms. Some people get a stuffy nose or sore throat when they start taking this medication. You may be able to manage these symptoms with over-the-counter medicines or home remedies. Eat honey or suck on a lozenge if you have a sore throat. Moisture can help both symptoms, so consider using a humidifier. Ask your doctor about using a saline nasal rinse if you have a runny or stuffy nose.
Yeast infections. Yeast infections of the penis or, more often, the vagina are the most common side effect of this drug. This can happen because the extra sugar in your urine creates an environment that helps yeast grow.
You might notice symptoms like:
- Itching
- Discharge
- Odor
- Pain
- Redness and swelling
- A burning feeling when you pee
You may be able to treat a yeast infection with an over-the-counter antifungal cream or suppository. If your symptoms don’t go away in a week or so, see your doctor. They can prescribe medication to clear up the infection.
To reduce your risk of yeast infections:
- Maintain good blood sugar control as your doctor recommends.
- Avoid douches, feminine deodorants, and scented feminine hygiene products.
- Don’t sit around in a wet bathing suit or damp gym clothes.
- Wear cotton underwear and loose-fitting pants.
- Avoid sex when you have a yeast infection, as you can pass an infection to your partner and they can reinfect you.
How to Manage Other Side Effects of Dapagliflozin (Farxiga)
Some other side effects you could have when taking dapagliflozin include:
Dizziness. This tends to be more common when you first start taking the medicine. It may happen when you stand from a sitting or lying position. If you feel dizzy, rest and see if the feeling passes. When you get up, especially from lying down, go slowly. Don’t drive or use machinery while you’re feeling dizzy.
Urinary tract infections. Dapagliflozin can increase your risk for urinary tract infections (UTIs), which happen when bacteria infect any part of your urinary tract. As with yeast infections, that’s thought to be because the extra glucose in your urine may make it easier for bacteria to grow. Most urinary infections are mild, but they can be serious.
Symptoms may include:
- You need to pee more often, and it feels more urgent
- A burning feeling when you pee
- Pain in your belly area
- Urine that’s cloudy, dark, or bloody
- Your urine has a strong odor
Signs of a kidney infection, a more serious type of UTI, include:
- Back pain
- Fever
- Chills
- Vomiting
- Nausea
Call your doctor right away if you have these symptoms.
You can test yourself for a UTI using a kit at home, or go to a health care professional for a test. Some UTIs go away on their own. But you’ll probably need antibiotics. Call your doctor if:
- Your symptoms don’t go away after a few days.
- The symptoms are getting worse.
- You keep getting UTIs.
To protect yourself against UTIs, make it a habit to:
- Drink plenty of liquids to help flush bacteria from your urinary tract.
- Wipe from front to back after you go to the bathroom.
- Pee after you have sex to help clear out bacteria.
- Take showers instead of baths.
- Avoid using sprays and powders in your genital area.
What to Do if You Have Serious Side Effects With Dapagliflozin (Farxiga)
This doesn’t happen often, but some side effects you may have on dapagliflozin could be serious. These include:
Dehydration. Because dapagliflozin makes you pee more, it reduces fluid levels in your body. If you have mild dehydration, you can probably manage it by drinking plenty of liquids. But in more serious cases, you may need to go to the hospital to get fluids through an IV. Serious dehydration can be fatal if it goes untreated.
Symptoms of mild dehydration include:
- Feeling very thirsty
- Headache
- Peeing very little
- Urine that’s dark yellow
- A dry mouth
Get medical help right away if you:
- Are confused or irritable
- Feel very sleepy or tired
- Have a fast heartbeat
- Are breathing quickly
- Faint or lose consciousness
You’re at a higher risk for dehydration if you:
- Take medicine to lower your blood pressure
- Are over 65
- Follow a low-salt diet
- Have kidney problems
Always let your doctor know if you’re drinking or eating less than usual, such as when you’re sick. Also tell them if you vomit or have diarrhea. All of these things can lead to dehydration.
The best way to avoid dehydration is to drink enough. Ask your doctor how much fluid you need each day. For most people, that’s 91-125 ounces a day. But this includes all the fluid in your diet, and we get about 20% of our fluids from food.
Low blood sugar. Sometimes dapagliflozin can make your blood sugar get too low. That’s called hypoglycemia, and it’s more likely to happen if you also take another diabetes drug. When you take this drug, you’ll need to monitor your blood sugar regularly and work to keep it in the range your doctor recommends.
Low blood sugar can cause these symptoms:
- Headache
- Hunger
- Irritability
- Shakiness or a jittery feeling
- Weakness
- Dizziness
- Sweating
- A fast heartbeat
- Confusion
If your blood sugar is between 55 to 69 milligrams per deciliter, you can treat it yourself using the 15-15 rule. Consume 15 grams of carbohydrates (that might be 1/2 cup of fruit juice or a tablespoon of honey), then check your blood sugar after 15 minutes. If it’s not in your target range, repeat the cycle until it gets there.
If your sugar gets below 55 milligrams per deciliter, you’ll likely need help checking and treating your blood sugar. Make sure your caregivers or loved ones know what to do. They may need to give you a shot of glucagon prescribed by your doctor. You may need emergency medical care after a glucagon shot.
Allergic reactions. It’s possible to be allergic to dapagliflozin or its ingredients. Your reaction might be mild, with symptoms like a rash and itching. But you need to tell your doctor about it right away in case this develops into a more serious problem.
In rare cases, you could have a serious allergic reaction with symptoms like:
- Hives
- Swelling of the face, lips, tongue, or throat
- Trouble swallowing or breathing
If you have any of these signs, stop taking dapagliflozin and call 911.
Fournier’s gangrene. One of the most serious possible side effects of dapagliflozin is a rare bacterial infection called necrotizing fasciitis or Fournier’s gangrene. It damages tissue under the skin around your anus and genitals. Call your doctor right away if you have:
- Fever
- Chills
- Weakness or tiredness
- Pain, redness, or swelling in the genital area
This infection can get worse quickly, leading to:
- Swollen or discolored skin
- Blisters filled with bloody or yellowish fluid
- A drop in blood pressure
- Sepsis, a response to infection that can be deadly
You may need multiple surgeries to remove dead tissue.
Ketoacidosis. Rarely, dapagliflozin can lead to this dangerous condition. It happens when your body uses fat instead of glucose for energy. This prompts your liver to release acids called ketones. If too many ketones build up too quickly, it can cause ketoacidosis. This is more likely when you’re sick and not eating and drinking as much as usual.
Early symptoms of ketoacidosis are:
- Extreme thirst
- Peeing much more than usual
- Sweet-smelling or fruity breath
Call your doctor right away if you notice these signs. If you have a monitor that can check ketone levels, check them at home, even if your blood sugar is below 250 milliliters per deciliter.
Call 911 if you also have:
- Nausea or vomiting
- Tiredness
- Belly pain
- Trouble breathing
- Confusion
If you have ketoacidosis, you’ll probably need to get extra fluids, insulin, and electrolytes in the hospital.
To protect yourself from this condition, regularly check your blood sugar and try to keep it in the range your doctor recommends. Tell your doctor any time you get sick or start eating and drinking less for any reason.
Kidney problems. Although dapagliflozin can help some people with chronic kidney disease, a few people have reported sudden kidney damage or failure. Research into whether this is a side effect of dapagliflozin has had mixed results.
Before you start taking this drug, tell your doctor about any previous or current kidney issues you have. Make sure they know when you’re drinking less because of illness or lose hydration due to sun exposure, vomiting, or diarrhea. You may need to temporarily stop taking dapagliflozin.
Side Effects From Combination Drugs
If you’re on another medication that combines dapagliflozin with another drug, you may also have some side effects from those medications.
Dapagliflozin and metformin (Xigduo XR). In addition to kidney problems, vitamin B12 deficiencies, high cholesterol, and bladder cancer, it can cause lactic acidosis. That happens when you have low blood pressure and not enough oxygen getting into your tissues. As a result, too much lactic acid builds up in your blood.
Some signs are:
- Colds hands or feet
- Dizziness
- Feeling tired
- Difficulty breathing
- Slow or irregular heartbeat
Call your doctor if you think you have this. They usually use IV fluids and medicines to reduce acidity in your blood.
Dapagliflozin and saxagliptin (Qtern). In addition to heart failure and other side effects, some people on this medicine got pancreatitis, an inflammation of the pancreas. Doctors usually treat it with IV fluids and pain medication.
Dapagliflozin, saxagliptin, and metformin (Qternmet XR). Lactic acidosis, pancreatitis, heart failure, joint pain, and dehydration are some of the serious side effects you may have on Qternmet XR.
It can also lead to bullous pemphigoid, a rare skin condition that causes blistering and itchy skin. This can go away on its own, but may take years to resolve. Doctors treat it with various medications, though basic wound care at home may help.
