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Dapagliflozin is an SGLT2 inhibitor that excretes excess sugar in the urine while at the same time protecting the heart and kidneys. It is used for type 2 diabetes, heart failure and chronic kidney disease – when taken correctly and paused correctly on sick days.
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Never stop dapagliflozin permanently on your own. Pausing during acute illness can make sense, but it should be discussed – always coordinate any changes with your practice. Dapagliflozin (brand name Forxiga®) is a modern SGLT2 inhibitor. The medication makes the body excrete excess sugar in the urine – while at the same time protecting the heart and kidneys. That is why it is used not only for type 2 diabetes, but also for heart failure and chronic kidney disease, once a day as a tablet.
| Property | Details |
|---|---|
| Active ingredient | Dapagliflozin |
| Brand name | Forxiga® |
| ATC code | A10BK01 |
| Drug class | SGLT2 inhibitor (gliflozin) |
| Form | Film-coated tablets 5 and 10 mg |
| Intake | Once daily, independent of meals |
| Standard dose | 10 mg/day |
| Prescription only | Yes |
| Special feature | Triple benefit: diabetes, heart failure, kidney protection |
The blood is filtered in the kidneys. Sugar (glucose) that initially passes into the urine is normally almost completely reabsorbed into the blood – via a transporter called SGLT2. This is exactly the transporter that dapagliflozin blocks. As a result, some of the sugar is not reabsorbed but excreted with the urine. Blood sugar falls – and this happens entirely without the body's own insulin.
Because calories, salt and water are also lost along with the sugar, dapagliflozin additionally eases the load on the heart and circulation. That is why it not only helps with type 2 diabetes, but also improves the prognosis in heart failure and slows the progression of chronic kidney disease. This protective effect on the heart and kidneys occurs even in people without diabetes.
The usual dose is 10 mg once daily, independent of food and at a fixed time. Because the medication leads to increased urination, many people choose to take it in the morning. Unlike the older metformin, no slow dose titration is needed.
| Situation | Dose |
|---|---|
| Type 2 diabetes (standard) | 10 mg once/day |
| Heart failure | 10 mg once/day |
| Chronic kidney disease | 10 mg once/day |
| Starting dose for diabetes (if needed) | 5 mg once/day |
A missed dose is made up as soon as it is noticed – but never take the double amount in one day. If it is only noticed the next day, the missed dose is skipped. What generally applies to a missed dose is explained in the guide Forgotten medication.
brite reliably reminds you to take your daily dapagliflozin and documents it seamlessly.
Together with empagliflozin, dapagliflozin belongs to the group of SGLT2 inhibitors. Both work via the same mechanism and have shown a similar benefit for the heart and kidneys in large studies. In everyday use the differences are small – the choice is made by the practice based on approval, kidney values and accompanying conditions.
| Property | Dapagliflozin | Empagliflozin |
|---|---|---|
| Brand name | Forxiga® | Jardiance® |
| Standard dose | 10 mg once/day | 10 mg once/day |
| Target | SGLT2 in the kidney | SGLT2 in the kidney |
| Approved for | Diabetes, heart failure, kidney disease | Diabetes, heart failure, kidney disease |
| Intake | Independent of meals | Independent of meals |
Neither of the two active ingredients is categorically "the better" one. Anyone already well controlled on an SGLT2 inhibitor should not switch without good reason – a change is always decided by the treating practice.
Because more water is excreted along with the sugar, the typical side effects are linked to the increased urination and the sugar-containing urine. The sugar-rich urine in particular encourages infections in the genital area.
| Side effect | Frequency | What to do? |
|---|---|---|
| Genital and urinary tract infections (thrush, cystitis) | Common | Maintain hygiene; get treatment if symptoms occur |
| Increased urination, thirst | Common | Drink enough; usually harmless |
| Dizziness due to fluid loss | Occasional | Make sure you drink enough |
| Hypoglycaemia (with insulin/sulfonylurea) | Occasional | Keep an eye on blood sugar |
| Diabetic ketoacidosis | Rare | Emergency – see warning box |
There are situations in which dapagliflozin should be paused temporarily to reduce the risk of ketoacidosis. Experts speak of the "sick day rules". This refers to days with fever, gastrointestinal infection, little food and drink, prolonged fasting or planned operations.
| Situation | Recommendation |
|---|---|
| Feverish infection, vomiting, diarrhoea | Pause until you feel well again |
| Barely eating/drinking, prolonged fasting | Pause; consult your practice |
| Planned operation | Usually pause 3 days beforehand (on medical instruction) |
| After recovery | Only restart once you are eating and drinking normally |
Such a short, targeted pause on sick days is something different from stopping the medication permanently on your own. Tell every treating practice before a procedure that you take an SGLT2 inhibitor, and agree the restart rule with your treatment team.
Because dapagliflozin causes sugar to be excreted in the urine, fungi and bacteria find a good breeding ground in the genital area. Genital infections are therefore among the most common side effects – but the risk can be significantly reduced with simple measures.
A first fungal infection is no reason to stop the medication – it can usually be treated well. Only in the case of recurring infections does the practice check whether an adjustment is needed.
Dapagliflozin has comparatively few interactions. Above all, the combination with other blood-sugar-lowering or draining agents is important. Check combinations in the interaction check.
| Substance / medication | Interaction | Recommendation |
|---|---|---|
| Insulin, sulfonylureas | Increased risk of hypoglycaemia | Adjust dose with your doctor |
| Draining agents (diuretics) | Increased fluid loss | Watch fluid intake and blood pressure |
| Blood pressure medication | Blood pressure may drop further | Watch out for dizziness |
| Metformin | Combines well, complements the effect | Common, sensible combination |
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