Forxiga: instructions for use
| What is the effect of taking the medicine? | Dapagliflozin is a substance that activates the kidneys and causes them to remove excess glucose from the body. Sugar is eliminated along with urine when its level in the blood reaches 6-8 mmol/l. In normal times, glucose is excreted in the urine only when its concentration in the blood reaches 9-11 mmol/l. Taking the drug allows you to reduce blood sugar levels both on an empty stomach and after meals. If you take Forxiga for a long time, the level of glycated hemoglobin HbA1C in the blood will decrease. |
| When to take | The drug is prescribed for the treatment of type 2 diabetes mellitus for those people who cannot control the course of the disease with diet and exercise. It is possible to use Forxiga as monotherapy and in combination with other sugar-burning drugs, as well as with insulin injections. |
| When not to take | Contraindications to the use of Forxiga:
Forxiga should also be recommended with caution to patients over 75 years of age, people with dehydration and infectious diseases of the urinary system. |
| What you need to pay special attention to | Taking the drug should be combined with physical activity and a low-carbohydrate diet. Be sure to regularly donate blood for sugar levels and come to your doctor for an examination. If you combine dapagliflozin with insulin therapy or sulfonylurea derivatives, the likelihood of developing hypoglycemia with a sharp drop in blood sugar increases. This condition requires emergency medical attention. |
| Dosage | You need to take 10 mg of the drug per day, for which you drink the tablet once a day at a certain time. At the beginning of treatment, the doctor may recommend reducing the dose to 5 mg per day. This is especially true for older people and for patients with liver problems. When the body adapts to taking the drug, the dose can be increased to 10 mg per day. There is no dependence of the drug Forxiga on food intake. |
| Possible negative reactions of the body | The drug itself, when used as monotherapy, cannot provoke the development of hypoglycemia. The danger of taking it is that it can cause urinary tract infections, as well as fungal infections of the genitals. There is also a possibility of developing acute kidney inflammation (pyelonephritis). Other side effects include:
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| Carrying a child and breastfeeding | The drug is prohibited for use during pregnancy and breastfeeding. |
| Reactions with other drugs | Forxiga in combination with other sugar-burning agents can lead to the development of hypoglycemia. It is also not recommended to take it with diuretics, as their diuretic effect will be enhanced. The attending physician who prescribes Forxiga to a patient must know what other medications he is taking. |
| Overdose | In case of an overdose of the drug, the diuretic effect is enhanced. To prevent dehydration, you need to consume more fluids. After taking a significant dose of the drug, you should consult a doctor so that he can assess the person’s condition and prescribe symptomatic treatment. |
| How to store, release form and composition | The drug is available in tablet form; they are yellow in color. The basis of the drug is dapagliflozin in dosages of 5 and 10 mg. Auxiliary components are: cellulose, anhydrous lactose, crospovidone, silicon dioxide, magnesium stearate, polyvinyl alcohol, titanium dioxide, macrogol, talc, yellow iron oxide. The drug must be stored out of the reach of children, so that the air temperature does not exceed 30 °C. The shelf life of the drug is 3 years. |
Forxiga is an expensive product that has no cheap analogues. Taking it helps not only to lower blood sugar levels, but also to lose weight, since a significant amount of sugar is excreted in the urine.
special instructions
In all patients, renal function should be monitored before starting treatment with the drug and at least once a year thereafter; before concomitant use with drugs that potentially reduce renal function, and periodically thereafter; 2–4 times a year for renal dysfunction close to moderate renal dysfunction. Forxiga should be discontinued if GFR is less than 60 ml/min/1.73 m2 or creatinine clearance decreases to less than 60 ml/min.
The increased diuresis caused by dapagliflozin may be accompanied by a slight drop in blood pressure. In patients with very high blood glucose levels, the diuretic effect of the drug may be more pronounced.
Forxiga is prescribed with caution to patients for whom even a slight decrease in blood pressure during treatment with the drug may pose a certain risk (for example, with cardiovascular diseases and a history of arterial hypotension, while using antihypertensive drugs, as well as in the elderly).
In the event of a decrease in circulating blood volume, Forxiga should be suspended until this condition is corrected.
When glucose is excreted by the kidneys, the risk of developing urinary tract infections increases; therefore, in patients with urosepsis or pyelonephritis, it is recommended to temporarily discontinue dapagliflozin therapy during the treatment of these diseases.
Elderly patients have an increased risk of decreased circulating blood volume (especially while taking diuretics). Thus, among patients over 65 years of age, adverse reactions caused by a decrease in circulating blood volume occurred more often.
In patients taking Forsiga tablets, the results of a urine test for glucose will be positive, since the mechanism of action of the drug is associated specifically with the excretion of blood sugar through the kidneys.
Impact on the ability to drive vehicles and complex mechanisms
No relevant studies have been conducted.
What to choose: Forciga or Jardines?
There is no comparative characterization of these two drugs. Forsiga began to be sold earlier than Jardines. Therefore, there are many more reviews about the drug Forxiga. However, this does not mean that it is better. There is an assumption that both of these drugs are equally effective.
The price for a package of Jardines is higher than the price for a package of Forsig. Before choosing a particular drug, you need to read the instructions for use. It is possible that a person will have contraindications to one of them. Particular caution should be exercised in patients suffering from renal pathologies. After all, both of these drugs can cause severe complications from the urinary system. So, pyelonephritis is a serious kidney damage that will require taking antibiotics. It is difficult to get rid of pyelonephritis, especially for people who suffer from diabetes.
Drug interactions
Forxiga may enhance the diuretic effect of loop and thiazide diuretics, which in turn leads to an increased risk of arterial hypotension and dehydration.
Dapagliflozin does not inhibit or induce isoenzymes of the cytochrome P450 system, so no drug interactions are expected with drugs whose metabolism occurs under the influence of these isoenzymes.
Metformin, sitagliptin, voglibose, bumetanide, simvastatin, pioglitazone, glimepiride, hydrochlorothiazide or valsartan do not alter the pharmacokinetics of dapagliflozin.
Rifampicin reduces the systemic exposure of dapagliflozin by 22%, but no clinically significant effect on renal glucose excretion was detected. Also, clinically significant interactions should not be expected when used concomitantly with phenytoin, carbamazepine or phenobarbital.
Mefenamic acid increases the AUC of dapagliflozin by 55%, but the daily excretion of glucose in urine does not change.
The effects of alcohol, smoking, herbal preparations and special diets on the pharmacokinetics of Forxiga have not been studied.
Forxiga: how to take?
Forxiga should be prescribed by a doctor. It is recommended to start treatment with a daily dose of 5 mg. After some time, it can be increased to 10 mg per day. If, in parallel, a person is prescribed insulin injections or sulfonylurea derivatives (Diabeton MV, Maninil, Amaryl), then their dosage must be reduced. Otherwise, the risk of developing hypoglycemia increases.
How long should you take Forxiga?
Forxiga is prescribed for a long term. You need to take it on an ongoing basis throughout your life.
How to combine taking Forxiga with insulin injections?
If taking Forxiga is combined with insulin injections, it is necessary to reduce the dosage of the hormone. Only a doctor should select the dose. Self-treatment can lead to hypoglycemia and even death.
Is it possible to combine taking Forxiga with alcoholic beverages?
There is no information in the official instructions about taking Forxiga with alcoholic beverages. Therefore, a person can drink alcohol only at the risk of his own health.
What can replace the drug Forxiga?
The question of replacing Forxiga may arise in the following cases:
- Blood sugar does not drop to the required levels.
- The drug is too expensive.
- The drug helps in the fight against diabetes, but people are afraid of developing severe side effects.
Blood sugar always decreases after taking Forxiga. The exception is those cases when the pancreas has exhausted all its reserves and does not produce insulin. Although even in this situation, the sugar level will drop, but this may not be enough. In this case, no pills will help; the person will need insulin injections.
You should consult your doctor about changing the drug. The doctor will help you choose an inexpensive and safe medicine.
If I don't have diabetes, can I take Forxiga for weight loss?
It is useless for healthy people suffering from obesity to take Forxiga. It removes glucose from the body only if its level exceeds 7-8 mmol/l. If a person does not suffer from diabetes, then the glucose in his blood never reaches such values. Therefore, Forxiga will not allow you to lose weight.
Author of the article:
Alekseeva Maria Yurievna |
Therapist Education: From 2010 to 2021 practicing physician at the therapeutic hospital of the central medical unit No. 21, the city of Elektrostal. Since 2021 he has been working at diagnostic center No. 3. Our authors
Relevance of the issue
As can be seen from the reviews of experts, Forxiga is a tablet product developed for people with diabetes. Not only the effectiveness of the drug in terms of controlling the concentration of glucose in the circulatory system is noted, but also the additional effect of enhancing medications that stabilize cardiac activity. While taking the drug, as noted in reviews of Forxiga 10 mg, blood pressure decreased significantly. Individuals who were prescribed this drug were able to control the concentration of cholesterol in the circulatory system. The positives, however, go hand in hand with the negatives. Thus, other people noted a complete lack of effect. Experts explain this by the individual characteristics of the body.
Reviews from endocrinologists about Forsiga are mostly positive, as are those from people who took these pills, but the weaknesses of the drug are noted. The medication provokes side effects that you need to be prepared for. Some experienced fever, itching, and changes in the frequency of the urge to empty the bladder. Persons suffering from inflammatory processes in the reproductive and urinary systems often experience exacerbations of these pathologies.
Features of influence
In case of failure of liver function in mild to moderate form, no special dosage adjustment is required. In case of severe liver dysfunction, the treatment program should begin with a dose of five milligrams. If the body responds well, the volume is doubled.
The effectiveness of dapagliflozin use is largely determined by renal functionality. If the functioning of this organ is moderately severe, the effectiveness of taking the medicine is reduced. In case of severe failures, the effect may be zero. The drug in question should not be used for severe, moderate degrees of renal failure, when creatinine clearance is less than 60 ml/min. The composition cannot be used during the terminal stage. In case of mild renal failure, no special dosage adjustment is made.
Adverse reactions
During therapy with Forxiga, patients may develop side effects:
- on the part of the skin and skin appendages – increased sweating;
- from the nervous system - drowsiness, dizziness, tremor of the limbs, lethargy;
- from the cardiovascular system - shortness of breath, rapid heartbeat, decreased blood pressure;
- infectious diseases - vaginal candidiasis, balanitis and balanoposthitis, vulvovaginitis, colpitis, itching of the external genitalia;
- metabolic disorders - rapid decrease in blood glucose levels, increased thirst, decrease in circulating blood volume;
- from the digestive system - nausea, severe hunger, constipation, bloating, rumbling in the intestines;
- laboratory indicators - increased cholesterol and lipid levels, increased hematocrit, increased creatinine concentration in the blood, increased urea levels.
Is everything known?
As you can find out from the reviews of endocrinologists, Forxiga is a fairly reliable drug, although it appeared on the market quite recently. Doctors note: the possible negative consequences that the medicine can cause are mentioned by the manufacturer in the accompanying instructions. Nothing sudden or unexpected happens. Specialists can warn patients in advance what the consequences of taking pills may be.
According to patient reviews, Forxiga is accompanied by clear instructions. Those who have studied it in detail admit that there were no undesirable consequences of taking it, other than those mentioned by the manufacturer. The instructions describe in detail how the product works, and it is written in fairly understandable language. It is not difficult to understand even for a person far from medicine. Separately, patient reviews of Forsiga note the simplicity and clarity of the instructions in aspects related to the application program: everything is described intelligibly. This significantly reduces the likelihood of inadvertently taking medication by mistake.
