From the FDA Drug Label
Dapagliflozin also reduces sodium reabsorption and increases the delivery of sodium to the distal tubule.
The FDA drug label does not answer the question.
From the Research
Farxiga (dapagliflozin) can potentially lower potassium levels, but it rarely causes clinically significant hypokalemia. As an SGLT2 inhibitor, Farxiga primarily works by preventing glucose reabsorption in the kidneys, leading to increased glucose excretion in urine. While its main effect is not on potassium, it can indirectly affect electrolyte balance through increased urination and changes in insulin levels. Patients taking Farxiga should be aware that mild decreases in potassium may occur, particularly if they are also taking other medications that lower potassium (like certain diuretics) or have risk factors such as poor dietary intake or gastrointestinal losses. Symptoms of hypokalemia include muscle weakness, cramping, irregular heartbeat, and fatigue. Regular monitoring of electrolyte levels is recommended, especially when starting treatment. Maintaining adequate hydration and consuming potassium-rich foods can help prevent significant potassium drops. If concerning symptoms develop, patients should contact their healthcare provider promptly rather than discontinuing the medication without medical advice. According to a pooled analysis of clinical trials 1, dapagliflozin was not associated with an increased risk of hyperkalemia or severe hypokalemia in patients with type 2 diabetes mellitus. Additionally, a study published in 2020 2 found that dapagliflozin had a beneficial effect on kidney function and cardiovascular outcomes in patients with chronic kidney disease, with or without type 2 diabetes, but did not specifically address the effect on potassium levels. However, the most recent and highest quality study on this topic is the 2020 study 2, which provides evidence that dapagliflozin is safe and effective in patients with chronic kidney disease, but does not provide direct evidence on the effect of dapagliflozin on potassium levels. Therefore, based on the available evidence, patients taking Farxiga should be monitored for potential changes in potassium levels, but the risk of clinically significant hypokalemia is low. Key points to consider:
- Farxiga can indirectly affect electrolyte balance
- Mild decreases in potassium may occur, particularly with certain medications or risk factors
- Regular monitoring of electrolyte levels is recommended
- Maintaining adequate hydration and consuming potassium-rich foods can help prevent significant potassium drops
- The risk of clinically significant hypokalemia is low, according to the available evidence 1, 2.