Can glipizide, Farxiga (dapagliflozin), and Rybelsus (semaglutide) be taken together?

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Last updated: May 16, 2025View editorial policy

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From the Guidelines

It is not recommended to take glipizide, Farxiga (dapagliflozin), and Rybelsus (semaglutide) together without medical supervision. This combination includes three different diabetes medications that work through different mechanisms, which could potentially cause dangerously low blood sugar (hypoglycemia). Glipizide is a sulfonylurea that stimulates insulin release, Farxiga is an SGLT2 inhibitor that increases glucose excretion through urine, and Rybelsus is a GLP-1 receptor agonist that improves insulin secretion and reduces glucagon.

Key Considerations

  • The risk of hypoglycemia is particularly concerning with glipizide in this mix, as noted in the study by 1.
  • Additionally, there may be overlapping side effects such as gastrointestinal issues.
  • You should consult with your doctor before taking these medications together, as they will need to evaluate your specific health situation, diabetes control, kidney function, and other factors to determine if this combination is appropriate for you.

Combination Therapy

According to the study by 1, combination therapy is often required to maintain glycemic goals in type 2 diabetes, but initial combination therapy should be considered in people presenting with specific factors.

Medication Interactions

The study by 1 provides guidance on dose adjustments for medications in patients with chronic kidney disease, which is an important consideration when taking multiple diabetes medications.

Recommendations

  • Consult with your doctor before taking glipizide, Farxiga, and Rybelsus together.
  • Carefully monitor and adjust doses as needed to avoid hypoglycemia and other side effects.
  • Consider alternative medication combinations that may be safer and more effective for your specific health situation.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Medication Interactions

  • The combination of glipizide, Farxiga (dapagliflozin), and Rybelsus (oral semaglutide) has not been directly studied in the provided evidence.
  • However, studies have investigated the efficacy and safety of combining dapagliflozin with other medications, including sulfonylureas like glipizide 2 and glucagon-like peptide-1 receptor agonists like semaglutide 3, 4, 5.

Efficacy and Safety

  • Dapagliflozin has been shown to be effective in reducing HbA1c levels, body weight, and blood pressure, with a lower risk of hypoglycemia compared to glipizide 2, 6.
  • The combination of dapagliflozin and semaglutide has been found to be effective in improving glycemic control, reducing body weight, and lowering blood pressure, with a potential for pharmacological remission of type 2 diabetes 3, 4, 5.

Potential Interactions

  • The use of glipizide, a sulfonylurea, with dapagliflozin, an SGLT2 inhibitor, may increase the risk of hypoglycemia, although this was not directly studied in the provided evidence.
  • The combination of dapagliflozin and semaglutide has been found to be safe and effective, with no significant increase in adverse events 3, 4, 5.

Conclusion Not Provided

As per the instructions, no conclusion will be drawn from the provided evidence. The information is presented to provide an overview of the potential interactions and efficacy of the medications in question.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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