From the Guidelines
Farxiga (dapagliflozin) does not increase the risk of hypoglycemia when used alone. As an SGLT2 inhibitor, Farxiga works by preventing the kidneys from reabsorbing glucose, allowing it to be excreted in urine [ 1 ]. This mechanism doesn't directly stimulate insulin production or increase insulin sensitivity, which are common causes of hypoglycemia with other diabetes medications.
Some key points to consider when using Farxiga include:
- The risk of hypoglycemia increases significantly when Farxiga is combined with insulin or insulin secretagogues like sulfonylureas [ 1 ].
- In these combination therapies, dose adjustments of insulin or sulfonylureas may be necessary to prevent low blood sugar episodes.
- Patients should monitor their blood glucose levels regularly, especially when starting Farxiga or changing doses.
- They should also be aware of hypoglycemia symptoms such as shakiness, sweating, confusion, and weakness.
- Adequate food intake and avoiding excessive alcohol consumption are important preventive measures.
The low hypoglycemia risk when used as monotherapy is one of the advantages of SGLT2 inhibitors like Farxiga compared to some other antidiabetic medications [ 1 ]. Recent studies have also shown that SGLT2 inhibitors can reduce the risk of major cardiovascular adverse events, renal events, and hospitalization rates for heart failure [ 1 ].
From the FDA Drug Label
Insulin and insulin secretagogues (e.g., sulfonylureas) are known to cause hypoglycemia. DAPAGLIFLOZIN TABLETS may increase the risk of hypoglycemia when combined with insulin or an insulin secretagogue [see Adverse Reactions (6. 1)]. 5.4 Hypoglycemia with Concomitant Use with Insulin and Insulin Secretagogues
Hypoglycemia risk with Farxiga (dapagliflozin):
- Farxiga may increase the risk of hypoglycemia when used with insulin or insulin secretagogues.
- The risk of hypoglycemia is increased when Farxiga is used concomitantly with insulin or insulin secretagogues.
- A lower dose of insulin or insulin secretagogue may be required to minimize the risk of hypoglycemia when these agents are used in combination with Farxiga 2, 2, 2.
- Key points:
- Monitor for signs and symptoms of hypoglycemia
- Adjust the dose of insulin or insulin secretagogue as needed to minimize the risk of hypoglycemia
- Educate patients on the signs and symptoms of hypoglycemia and the importance of monitoring their blood glucose levels.
From the Research
Farxiga and Hypoglycemia Risk
- The risk of hypoglycemia with Farxiga (dapagliflozin) is considered low, as its mechanism of action is independent of insulin secretion or action 3, 4, 5, 6, 7.
- Studies have shown that dapagliflozin provides complementary therapy when used in combination with other antihyperglycaemic drugs, with a low risk of hypoglycaemia 3, 4, 5.
- The incidence of hypoglycaemic events reported with dapagliflozin in clinical trials varied depending on the background therapy, but overall, the risk is considered low 4, 6.
- Dapagliflozin's efficacy in glycemic control without the risk of hypoglycemia makes it an advantageous choice for patients insufficiently managed on other antidiabetic drugs 6.
Key Findings
- Dapagliflozin has been shown to improve glycemic parameters in patients with type 2 diabetes when used as monotherapy or in combination with other therapies 3, 4, 5, 7.
- The treatment is associated with weight reduction and has a low intrinsic propensity to cause hypoglycemia 4, 7.
- Dapagliflozin may offer the advantage of a complementary mechanism of action when added to other therapies 3, 4, 7.