From the Guidelines
Dapagliflozin, an SGLT2 inhibitor, is associated with several side effects, including urinary tract infections, genital yeast infections, and increased urination, as well as more serious but less common side effects like diabetic ketoacidosis, acute kidney injury, and Fournier's gangrene, as reported in the most recent study 1.
Common Side Effects
- Urinary tract infections
- Genital yeast infections
- Increased urination
- Volume depletion symptoms like dizziness, lightheadedness, and low blood pressure
Less Common but Serious Side Effects
- Diabetic ketoacidosis (even with normal blood sugar levels)
- Acute kidney injury
- Serious urinary tract infections that can progress to blood infections
- Fournier's gangrene (a rare but serious genital infection)
- Hypoglycemia when used with insulin or insulin secretagogues
- Increased LDL cholesterol levels
- Bone fracture risk may be elevated with long-term use due to effects on bone mineral density
Recommendations for Patients
- Maintain adequate hydration
- Practice good genital hygiene
- Monitor for signs of infection
- Seek immediate medical attention for severe symptoms like extreme thirst, confusion, unusual fatigue, or genital pain/tenderness These side effects occur because dapagliflozin blocks glucose reabsorption in the kidneys, altering fluid balance and creating an environment that can favor certain infections, as explained in 1.
From the FDA Drug Label
Signs and symptoms of low blood sugar may include: ∘ headache ∘ confusion ∘ hunger ∘ shaking or feeling jittery ∘ drowsiness ∘ dizziness ∘ fast heartbeat ∘ weakness ∘ sweating ∘ irritability A rare but serious bacterial infection that causes damage to the tissue under the skin (necrotizing fasciitis) in the area between and around the anus and genitals (perineum) Serious allergic reaction Low vitamin B12 (vitamin B12 deficiency). Vaginal yeast infection. Yeast infection of the penis (balanitis). The most common side effects of Dapagliflozin and Metformin HCl extended-release tablets include: ∘ vaginal yeast infections ∘ diarrhea ∘ headache ∘ stuffy or runny nose and sore throat ∘ urinary tract infection
The side effects of dapagliflozin include:
- Low blood sugar symptoms such as headache, confusion, hunger, shaking or feeling jittery, drowsiness, dizziness, fast heartbeat, weakness, sweating, irritability
- Necrotizing fasciitis of the perineum, a rare but serious bacterial infection
- Serious allergic reaction
- Low vitamin B12 (vitamin B12 deficiency)
- Vaginal yeast infection and yeast infection of the penis (balanitis)
- Common side effects:
- Vaginal yeast infections
- Diarrhea
- Headache
- Stuffy or runny nose and sore throat
- Urinary tract infection 2
From the Research
Side Effects of Dapagliflozin
The side effects of dapagliflozin, an SGLT2 inhibitor, include:
- Genital infections, which were more frequent in patients who received dapagliflozin than in placebo recipients 3
- Urinary tract infections, which were also more frequent in patients who received dapagliflozin than in placebo recipients 3, 4
- Hypoglycemic episodes, which were scarce with dapagliflozin 3
- Diabetic ketoacidosis, a rare but serious side effect of SGLT2 inhibitors, which can be increased by the use of a ketogenic diet 5
- Volume depletion, which was increased by SGLT2 inhibitors 6
- Increased risk of urinary tract infection in patients with male urinary tract outlet obstruction 4
- Increased risk of genital fungal infections in women and patients with previous genital fungal infections 7
Patient-Specific Risk Factors
Certain patient-specific risk factors can increase the likelihood of experiencing side effects from dapagliflozin, including:
- Female sex, which increases the risk of genital fungal infections 7
- Prior history of genital fungal infection, which increases the risk of genital fungal infections 7
- Male urinary tract outlet obstruction, which increases the risk of urinary tract infection 4
- Use of a ketogenic diet, which increases the risk of diabetic ketoacidosis 5