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Forxiga (dapagliflozin) is an orally administered anti-diabetic medication used in the treatment of type 2 diabetes. A gliflozin inhibitor, it works by reducing the reabsorption of blood glucose by the kidneys, allowing it to pass out of the body in urine instead.

Gliflozin inhibitors are novel in that they remove blood glucose not only from the blood but from the body entirely, improving both blood glucose levels and control. Forxiga has been demonstrated to precipitate the excretion of up to 119 grams---over four ounces---of glucose into the urine stream.

The medication is an excellent addition to diet and exercise, and is compatible with most other type 2 diabetes medications if Forxiga alone does not provide adequate control. Since blood glucose is the primary problem in type 2 diabetes, removing it from the body---using Forxiga alone or in combination with other medications---helps alleviate symptoms and slows or halts progression of the disease.

Patients taking Forxiga will also appreciate its convenience:

• Administered via tablet---no needles or injections
• Easy to carry and take discreetly
• Once-a-day administration
• Can be taken with or without food as desired
• Unlikely to produce hypoglycemia

Forxiga will not provide benefit in type 1 diabetes, and it should not be used to treat diabetic ketoacidosis.

What to Expect from Forxiga

Patients are strongly advised to have kidney function tested prior to starting treatment, and at regular intervals for the duration of treatment. Diabetes alone puts kidneys at risk of damage, and as most medications are filtered through the kidney, treatment with most medications can increase this risk. Regular doctor checkups can be an unwanted expense and hassle, but untreated kidney damage can lead to even more costly, painful, and potentially fatal complications. Unfortunately symptoms are rarely noticeable by patients until damage is already severe; regular screenings are important.

Moderate or severe kidney damage will likely influence dosage:

• Patients with evidence of kidney damage or who are otherwise at increased risk of side effects are typically started on 5 mg per day.
• Otherwise healthy patients usually start with 10 mg per day.
• Tablets are taken once per day, usually in the morning, with or without food as desired.
• Tablets should be taken at the same time each day. There should be at least 12 hours between doses.

Treatment may continue for as long as it provides benefit, which may be for the remainder of life if lifestyle changes are unable to address the underlying issue.

Potential Complications

Forxiga can increase urination, and will almost certainly increase glucose in urine. This puts patients at increased risk of dehydration, urinary tract infections, and yeast infections. Ensuring proper hydration is important for overall health even in the best of circumstances; in diabetes, it's extra critical for kidney health. A doctor can recommend simple, affordable treatments for urinary tract or yeast infections, if they develop.

There is a slight association with Forxiga and an increased risk of lower limb amputation. Patients with type 2 diabetes---whether taking Forxiga or not----should maintain a regimen of regular foot inspection and report ulcers, cracks, numbness, circulation problems, redness, or other symptoms to a to a doctor. Likewise feet should be examined directly by a physician during routine checkups.

Forxiga may lower blood pressure. Patients should be alert for symptoms and consult a doctor if experienced:

• Dizziness
• Lightheadedness
• Unsteadiness
• Dimming or blurring of vision
• Weakness
• Fatigue
• Nausea
• Fainting
• Cold, clammy skin
• Pale skin

This product should not be used if pregnant or breastfeeding. A doctor can recommend more suitable treatments.

Forxiga is commonly taken with other diabetes medications, such as metformin. Always double-check with a doctor or pharmacist before mixing medications; while they most likely can be used together, dosage adjustments of one or both will likely be needed.